15 and 17 April 2015
During a routine inspection
The inspection took place on 15 April 2015 and was unannounced. We carried out a second visit to the home announced on 17 April 2015 to complete the inspection.
We last inspected the service in July 2014, where we found a in breach of one regulation which related to the management of medicines. We carried out a review in September 2014 and found that the improvements had been made and the provider was now meeting this regulation.
The Oaks Care Home accommodates up to 45 older people, most of whom have dementia related conditions. There were 20 people living at the home at the time of the inspection.
There was a manager in post. She was in the process of applying to be a registered manager. She had completed her “fit person’s interview” with a Care Quality Commission (CQC) registration inspector. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
There were safeguarding procedures in place. Staff knew what action to take if abuse was suspected. We spoke with the local authority safeguarding officer who told us that there were no organisational safeguarding concerns regarding the service.
We spent time looking around the premises and saw that the building was generally clean and well maintained. There were no offensive odours in any of the areas we checked. We found the design and decoration of the premises met the needs of people who had a dementia related condition.
We checked medicines management. We noted that medicines administration records were completed accurately. The manager was in the process of identifying a more suitable room for the storage of medicines.
Staff told us that training courses were available in safe working practices and to meet the specific needs of people who lived at the home. For example, dementia care training to further support people with this condition.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS). DoLS are part of the Mental Capacity Act 2005 (MCA). These safeguards aim to make sure that people are looked after in a way that does not inappropriately restrict their freedom. We found that the service had made a number of applications to the local authority to deprive people of their liberty in line with legislation and case law. There was evidence that “decision specific” mental capacity assessments had been completed and best interests decisions made.
People and relatives were complimentary about the meals at the home. We observed that staff supported people with their dietary requirements. Staff who worked at the home were knowledgeable about people’s needs. We observed positive interactions between people and staff. Staff communicated well with people.
Relatives with whom we spoke on the days of the inspection, were happy with the service. One relative said, “It’s in between good and outstanding - a B plus I would say.” Other comments included, “I’m happy with my choice” and “Nobody wants their parents in a home, but you want them cared for and I find in here I can trust them to look after her. They follow my instructions. I have no complaints.”
There was an activities coordinator employed to help meet the social needs of people who lived there. An activities programme was in place.
The manager explained that the service had been through a period of significant challenge since she had taken up the post of manager in September 2014. Occupancy levels had fallen following a number of expected deaths. Most staff informed us that more support from the manager would be appreciated and commented that morale was sometimes low.
A number of checks were carried out by the manager. These included checks on health and safety; care plans; the dining experience; infection control and medicines. Action was taken when concerns were highlighted during these checks. It was sometimes difficult however, to ascertain what actions had been taken in response to checks and tests of the premises. This was due to the provider using an external maintenance company who did not update the computerised system when remedial work had been carried out.