Archived: Oaklands

Oaklands provides accommodation for a maximum of 46 older adults who have nursing care needs and who may be living with dementia. There were 22 people living at the home at the time of the inspection and one of these people was in hospital. The home was divided into two units, but people were free to use all parts of the home.

The service has a registered manager who was present throughout the inspection. A registered manager is a person who has registered with the Care Quality Commission 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 not enough staff available to meet people's requests for support in a timely manner. We had identified this at our last inspection, and the registered provider's action plan had not been effective at improving this situation.

People told us they felt safe living at the service. Staff were aware of how to recognise possible signs of abuse and the need to report any concerns.

Whilst most medicines were given safely we found that there were some improvements needed to the application and recording of topical medicines, such as creams. There were systems in place to monitor medication administration.

The staff had been provided with training about the Mental Capacity Act (2005) but could not explain how they put this into practice when supporting the people living at the service. Staff received basic training to ensure they were aware about safe care and some of the people’s individual needs.

Most people had their healthcare needs met and received support to maintain their nutritional and hydration needs. During our inspection we observed individual staff treating people with dignity and respect, however failing to provide people with meaningful occupation, company and autonomy showed that people were not consistently treated with respect.

People and their relatives gave us mixed feedback about the care provided. Everyone told us that staff were kind and caring and knew people well, however people told us the number of staff was not always adequate to meet people's needs well. Staff that we spoke with were enthusiastic about their role and could describe how people preferred to be supported.

There were very limited opportunities for people to join in with activities they liked, and which reduced the risk of them becoming socially isolated. People and their relatives all told us this was an area that needed improvement.

The service had ensured people maintained relationships with those who were important to them.

People living at the home and their relatives were aware of how to raise concerns and were confident that any concerns raised would be dealt with in a timely manner.

People, relatives, staff and health professionals were happy with how the service was managed. The registered manager had improved the quality monitoring of the service although this had not been entirely effective, and further work was needed.

You can see what action we told the provider to take at the back of the report.

We gathered evidence against the outcome we inspected to help answer our five key questions; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

At the time of the inspection there were 33 people living at the home. During this inspection we spoke to seven people who used the service and spoke to the relatives of three people. We carried out observations of specific people who were unable to talk to us because of their health conditions. We looked at care records for six people, spoke with seven staff and the management team of the home.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People who used the service and relatives we spoke with told us they either felt safe when being supported with their personal care or their relative received safe care.

The provider worked with other agencies to investigate issues of concern to ensure people were kept safe.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) under the Mental Capacity Act 2005. There had been no applications to deprive any people of their liberty at the time of our inspection however we found that the provider had a suitable process to follow if required.

Is the service effective?

People's health and care needs had been reviewed with them and their families. A relative of a person who used the service told us, 'I know what [person's name] needs, 'cause they tell me'.

Where necessary, risk assessments had been undertaken and were used to help staff provide appropriate, safe and consistent support to people who used the service.

Is the service caring?

All the people we spoke to confirmed that staff were kind to them. Comments included, 'I like it here, this is the best place for me, they are very good', and 'The staff are lovely there. I am sure [my relative] is well looked after.' We observed staff respond promptly to people's individual care needs and wishes and saw that they promoted social interaction.

When speaking with staff it was clear that they genuinely cared and knew about the people they were supporting.

Is the service responsive?

We saw that people were regularly asked if there was anything they needed. Relatives told us that the provider made them feel comfortable to raise concerns.

At our last inspection we were concerned that the provider did not always respond to people's individual interests and experiences because activities did not reflect individual preferences. At this inspection we saw the provider had taken action to improve the activities people could take part in. A person who used the service told us, 'There is more to do now, we can go shopping if we want.'

The service worked well with other agencies and services to make sure people received care in a coherent and timely way. People were supported to attend doctors, dentists and other health appointments when needed.

Is the service well-led?

After our last inspection, the provider had sent us a plan identifying what actions they intended to take in order to ensure the service was compliant with current health and social care legislation. At this inspection we saw that the provider had responded to our last report and some improvements had been made.

One of the named managers of the home as detailed at the beginning of the report no longer works at the location. The provider is aware that this person needs to apply to deregister.

People told us and we saw that staff were polite, respected people's dignity and spoke to them as adults.

People experienced care, treatment and support that met their needs and protected their rights. However activities were limited and some activities were not suitable for all the people who used the service. A relative of a person who used the service told us, 'It is not always a happy place to visit. Residents just sit there'.

People received sufficient quantities of food and drink to meet their needs and were supported to make choices about what they ate and drank.

There was enough staff with to meet people's needs.

The provider had suitable arrangements in place for making sure that standards were monitored and improved. These included audits of services and regular staff meetings. A relative of a person who used the service told us, 'The manager is always around. They always ask us if everything is alright when we visit.'

We noted that one of the registered managers, Elaine Lancelot no longer worked at the location. The provider is aware of the need to formally apply for the registration of this person to be cancelled.

We saw that staff treated people with respect and dignity. However there were some occasions where the opportunity for some people to exercise choice was compromised, although that we saw that the manager was taking action to make improvements.

People's needs had been assessed by a range of professionals which meant their health care needs had been monitored and met.

Staff knew how to safeguard people from harm and told us that they felt confident that if they had to report any abuse, suitable action would be taken.

There was enough staff to meet people's needs.

The provider was able to protect people against the risk of unsafe care and treatment by regularly assessing and monitoring the quality of the service and introducing changes as required.

We noted that the named registered manager no longer worked at the location. The provider is aware that this person needs to apply to deregister. The new manager had started at the location but had not yet applied to become the registered manager.

We saw that all of the staff at the home spoke to people who used the service with warmth and kindness but they did not always support their privacy and dignity.

People did not always receive the appropriate care to meet their individual needs. A member of staff told us, 'I can not always get help to lift or turn people when I need it'.

We saw that the provider had not made suitable arrangements to ensure that people were safeguarded against the risk of abuse.

The provider had not ensured there were enough competent staff to meet the health and welfare needs of the people or enough staff with managerial skills to support staff.

The provider did not protect people from unsafe care and treatment because they did not review complaints, incidents or hold regular staff meetings.

We noted that the registered manager as mentioned in this report no longer worked at the location. The provider is aware of the need to formally apply for the registration of this person to be cancelled. There was a new manager in post however they were not registered.