Archived: Oban House

The manager told us of leave arrangements and staffing records showed there were a number of permanent staff on annual leave during the holiday period, but we saw appropriate arrangements were in place to address this, bank staff and regular agency staff were employed to cover the temporary vacancies. An additional member of in-house staff was assigned to work at night as a "floater" when there was a high volume of agency staff on duty. This role was carried out by an experienced care worker. The manager told us this arrangement helped improve communication and promoted continuity of care.

We looked at records of staffing provision, these included a report on hours worked, staffing rosters and payroll report. We spoke with five of the regular care staff on duty, they felt staffing levels were suitable in the home and felt able to raise their concerns with the manager if they had concerns about these. The manager informed us of two occasions recently when a care worker had given short notice about being unable to attend work in the morning, and no bank or agency staff were available. The manager reviewed staffing levels and areas of need, and staff were reassigned at the start of shift to manage the vacancy on the relevant floor, the activities' coordinators were also involved in working with the team and providing any additional support.

A relative we spoke with told us they felt additional staffing levels could benefit people using the service and help to improve the standard of the service.

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service and staff told us.

Is the service safe?

We observed the way staff interacted with the people using the service and saw they treated people with respect and dignity. The staff we spoke with understood the procedures they needed to follow to ensure that people were safe. They were able to describe the different ways that people might experience abuse and the correct steps to take if they were concerned that abuse had taken place.

Most people we spoke with told us they felt safe living at Oban House. This was confirmed by discussions we had with visiting relatives. One person said 'staff are ok they speak nicely to me.' A relative told us, 'I have never seen unkindness or staff raise their voice.'

Systems were in place to make sure managers and staff learned from events such as accidents, incidents and complaints. This reduced the risks to people and helped the service continually improve.

Recruitment practice was safe and thorough. The provider could demonstrate that that the staff employed to work at the service were suitable and had the skills and experience needed to support the people living there.

We inspected staff rotas which showed that there were sufficient staff on duty to meet people's needs. People received a consistent and safe level of support.

Some care plans and daily records had missing or incomplete documentation and did not always reflect people's current care needs. This meant that some people may be at risk of receiving inappropriate care. We have asked the provider to tell us how they will make improvements in relation to people's care records.

Is the service effective?

People all had an individual care plan which set out their care needs.

It was clear from our observations and from speaking with staff that they had a good understanding of people's care and support needs and that they knew them well.

The registered manager understood their responsibilities under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). However we saw instances where mental capacity assessments had not been carried out and one example where there was no evidence of a best interest meeting being held. This meant a person's capacity may not always be considered or recorded under the Mental Capacity Act and where a person did not have capacity, decisions may not always have been made in their best interests. We have asked the provider to tell us how they will make improvements in this area.

Most people we spoke with told us they liked the food at Oban House, one person said, 'The food looks nice and is dished up nice.' Another said, 'The food is alright and I sometimes get to choose what I have.' We saw people's food preferences were recorded in their care plans and displayed in the kitchenette areas. However, we heard that people's preferences were sometimes overlooked and saw that some people needed more support to understand the menu choices. We have asked to provider to tell us how they will make improvements in offering people food choice.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people.

When speaking with staff they made it clear that they genuinely cared for the people they supported and we did not find any evidence to the contrary on the day of our visit.

Most people we spoke with described staff as caring. Comments included 'very kind', 'nice people, they have a heart of gold' and 'always pleasant.' We spoke with relatives who also felt staff did a good job with the time that they had. Comments included, 'they do a marvellous job here' and 'all lovely people'.

Is the service responsive?

People's needs were assessed before they moved into the home and were reviewed on a regular basis.

Relatives' meetings were held where relatives could discuss any issues, concerns or improvements to the service. People we spoke with told us they found these meetings helpful. Relatives told us if they ever had any issues they would speak directly to the registered manager. One relative said, 'If we have any problems we go to [the registered manager], she always sorts things out.'

People told us they were able to participate in a range of activities organised by the home's activities co-coordinator. However, on the floor on which most people living with dementia stayed, we found a lack of stimulating activities for people. We have asked the provider to tell us how they will make improvements in this area.

Is the service well-led?

The home had a registered manager who was experienced and knew the service well. People using the service, staff and relatives we spoke with said the leadership of the service was excellent and staff told us that the home was a good place to work.

The provider carried out regular checks to assess and monitor the quality of service provided. The views of people using the service and the staff that cared for them were taken on board by managers. The provider had listened to feedback and made changes that improved the overall quality of the care and support people received. This meant people could be confident the quality of the service was being assessed and monitored.

We undertook this visit in order to check if things had improved. The majority of the people we spoke with and the staff thought that they had. We found that people were able to spend their days as they wanted to. People told us that they never had to wait long for help and staff said they had more time to support people without rushing them.

However, we received constant feedback from all of the people we spoke with and their relatives that they felt there were not enough staff to meet people's needs in a timely manner. We saw that this impacted on people's ability to make choices about how they wished to be supported. People were not able to get up in the morning when they wanted to as they had to wait for help. Several people complained that they had to wait a long time for help when they rang their call bells. People would not have been able to participate in arranged activities and they told us that meals were often served late. Relatives expressed concerns that people were often still in bed when they came to visit.

A new manager was appointed to the home last year, Ms Fiona Mafeje