Archived: Oakland Care Centre

As part of this follow-up inspection, we talked to people who lived in the home and relatives. Most people who used the service spoke positively about the home, saying: 'on the whole, it's a happy place' and 'staff look after me.' One relative said staff were 'very good' with their relative but there were 'odd moments' when things were 'not so good'.

On 4 November, we saw that the provider still did not have appropriate arrangements in relation to obtaining medicine, as medications for six people had run out in October. We raised concerns with the provider, who acknowledged the concerns and sent us a letter on 5 November 2013 detailing the actions they had taken or planned to take to keep people safe.

On 12 and 13 November, we saw that the provider had made improvements in some areas, such as increased supervision of staff, improved understanding of people's preferences, and a better understanding of the Mental Capacity Act 2005. We also saw that staff adequately met people's nutritional needs, cooperated with other providers, and safeguarded people who used the service from abuse. Staff and people who used the service felt that staffing had improved but still expressed concerns to us about the deployment of staff. The provider took steps to ensure the premises and equipment were safe and suitable.

But, they still did not meet the requirements of the regulations in other areas. For example:

Although records relating to complaints had improved, the provider still did not have an adequate system for managing complaints. Records relating to staff did not contain all the information required.

We saw that, although staff had recently updated people's care plans which provided more detail about people's care needs, some care plans were still inaccurate. Staff still did not respond to deterioration in people's health in a timely way nor maintain accurate monitoring records according to people's needs.

We saw that the provider's system for monitoring the quality of the service did not identify concerns regarding inaccurate care records, out of stock medication, or the cleanliness of equipment.

We spoke with nine people who used the service. This is what they told us: "[The staff are] not too bad" and "we don't do much here". One person told us: "I get very lonely in here. I feel like crying now when I think about it. Sometimes the carers have a quick chat but they haven't got the time." We spoke with two relatives. One relative told us: 'The home is safer this year than last because there is not so many agency staff now.'

We saw that staff did not always treat people with respect nor meet people's needs in a timely way. People who used the service were told to "wait a minute" and staff did not always return promptly to provide care or treatment. Staff and relatives told us that there were not enough staff to meet people's needs.

We found that the care home did not effectively manage medications and this resulted in missing or running out of medication or giving people the wrong dosages. We found that records relating to people's care were incomplete and some records were not fit for purpose.

We found that the provider did not adequately audit the quality of care and treatment nor adequately supervise nursing and night staff. Staff told us they felt victimised for raising concerns. The provider had a high number of incidents and complaints, but did not consistently record and investigate them. However, they did respond to written complaints.

The manager at the service was not registered with the Care Quality Commission and we have written to the provider to establish their plans to have a registered manager in place.

We were unable to speak with people on the nursing unit, as they had difficulties communicating or were asleep throughout the inspection visit. We saw that people in bed looked comfortable and clean.

We found that the provider made significant improvements to how safeguarding concerns were identified and managed. We found that people were cared for in a clean environment and that the provider was taking steps to improve infection control within the care home.

We saw that the provider made significant improvements in supporting staff through training and supervision. We found that the care home did not always have adequate numbers of staff to meet the needs of people using the service. We saw that staff did not always engage well with people using the service and that some staff did not protect people's privacy or treat people with dignity and respect.

We saw that the provider had made significant improvements to their systems of assessing and monitoring the quality of the service, such as increased audits. We found that although the provider implemented a new care records system, staff still did not complete the assessments and care plans correctly.