Oakwood Bungalows

About the service

Oakwood Bungalows is a residential care home providing personal and nursing care to up to 11 people. The service provides support to people with a learning disability, or autistic people and younger adults. At the time of our inspection there were 10 people using the service. People lived in 2 bungalows, 1 with 10 beds and another single occupancy bungalow.

People’s experience of using this service and what we found

Right Support:

This was a targeted inspection that considered managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirements. Based on our inspection of this area we found the manager had the skills, knowledge and experience to perform their role and a clear understanding of people’s needs and oversight of the service.

Right Care:

Based on our inspection of managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirement, we found governance processes were overall effective. Processes helped to hold staff to account, keep people safe, protect people’s rights and provide good quality care and support, however these were yet to be embedded.

Right Culture:

The scope of this inspection did not enable findings on this area to be reached

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 8 March 2023).

Why we inspected

We undertook this targeted inspection to check whether the Warning Notice we previously served in relation to Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met on a specific concern we had about manager oversight of risk. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.

We use targeted inspections to follow up on Warning Notices or to check concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

About the service

Oakwood Bungalows is a residential care home providing personal and nursing care to 11 people at the time of the inspection. The service can support up to a maximum of 11 people. The service supports people with a learning disability and autistic people, and younger adults. People lived in 2 bungalows, one with 10 beds and another single occupancy bungalow.

People’s experience of using this service and what we found

Right Support:

Fire safety risks were not always assessed or mitigated, placing people at risk of harm.

A system to analyse accidents and incidents had not been implemented. This meant action to prevent further risk of incidents or accidents was not always identified. Governance arrangements were not effective to fully ensure the quality and safety of people's care.

Staff used techniques to support people to manage their emotions, this approach reduced the need for people to be supported through the use of restraint. Staff recorded where restraint was required to keep people and others safe. However, some improvements were required to ensure lessons were learned from those incidents to reduce them happening again.

People were not supported in an environment offering interaction and stimulation at a level of intensity to meet their needs. The service was clean and well maintained.

Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome. Referrals to appropriate professionals were made in a timely manner.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care:

Safeguarding referrals or investigations had not always been made where records showed people were at risk of poor care and abuse. Where safeguarding referrals had been made, the service worked in partnership with social care organisations to protect people.

Staff had not always received up to date training but following inspection were encouraged to complete this within a set timeframe. The service had enough staff to meet people’s needs and keep them safe.

Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.

Right Culture:

Staff had enough guidance to support people to manage their distress, anxiety, feelings and emotional reactions in a personalised way.

The provider made reasonable adjustments for people so they could be involved in discussions about their support and the service. There were opportunities for staff to feedback on the running of the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 4 March 2020).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Oakwood Bungalows on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to safeguarding, safety and governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Oakwood Bungalows is a small care home providing personal and nursing care with 11 people using the service at the time of the inspection. The service supports up to 11 people with autistic spectrum conditions and/or learning disabilities, who may have behaviours that challenge and associated complex needs. There is 24-hour nursing care provided, with a sleep-in provision each night by a registered nurse, in addition to the care staff on duty.

Services for people with learning disabilities and or autism are supported

The service recognises the principles and values that underpin Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that was appropriate and inclusive for them. The service was bigger than most domestic style properties and registered for the support of up to 11 people. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area. There were deliberately no identifying signs to indicate it was a care home.

People’s experience of using this service and what we found

People were safe, staff understood how to protect them from avoidable harm. The provider assessed and managed risks to people well including supporting where behaviours were challenging. Personalised risk management plans allowed people to take positive risks while protecting them from harm. When things did go wrong, they learned from this to improve risk management plans. There were sufficient staff who had been recruited safely, with checks in relation to references and criminal records. Medicines were managed safely.

People received consistently good care that was effective to their needs. People were supported by staff who were knowledgeable and suitably trained. People's healthcare needs were monitored to ensure their day to day needs were met. Assessments and care plans for people were clear, included best practice guidance and were reviewed to ensure any changes were documented and shared with the staff team. The service involved people in decisions about their care. People used equipment and technology to ensure they could do things independently. People were supported to make choices for their meals and their nutritional needs were considered. Health care needs were reviewed, and action taken to promote people’s wellbeing.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People’s views had been obtained to drive improvements. There was a homely atmosphere and people had been encouraged to decorate and enjoy their environment as they wished. People had established positive relationships with staff. There was a strong person-centred culture throughout the service. Staff were compassionate, respect was shown to people and their dignity choices and preferences were adhered to.

People were involved in developing their planned care and support. People were supported to lead independent lives where possible. Information was provided in formats that were accessible to people. Complaints and concerns were comprehensively recorded and fully Investigated with lessons learned and action taken appropriately. Information was stored securely and confidentially.

The registered manager led by example and made sure staff were well supported and aware of their responsibilities. They used audits effectively, to reflect on any actions or trends and completed a detailed analysis from accidents or incidents which had occurred. Complaints were handled in line with the providers complaints policy.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 2nd August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

There was a registered manager in the service. 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.

People were protected from unnecessary harm by staff who knew how to recognise signs of abuse and how to report concerns. Individual risks were assessed and reviewed to keep people safe and protect them from avoidable harm. People had opportunities to be involved with a variety of activities and could choose what to be involved with. Staffing was organised flexibly to enable people to do the things they enjoyed.

Medicines were managed safely to ensure that people received their medicines as prescribed and to keep well. Staff knew why people needed medicines and when these should be taken. Staff knew how to support people to eat well and there were sufficient numbers of staff to meet peoples need.

People made decisions about their care and staff helped them to understand the information they needed to make informed decisions. Staff sought people’s consent before they provided care and they were helped to make decisions which were in their best interests. Where people’s liberty was restricted, this had been done lawfully to safeguard them.

People were treated with kindness and compassion by staff who knew them well. People liked the staff who supported them and had developed good relationships. People received personalised care and were confident that staff supported them in the way they wanted. People’s health and wellbeing needs were monitored and they were helped to organise and attend health appointments as required.

Staff listened to people’s views about their care and they were able to influence the development of the service. People knew how to complain and concerns were responded to. Staff felt well supported by the registered manager and provider. The provider and manager assessed and monitored the quality of care to ensure standards were met and maintained. They understood the requirements of their registration and informed us of information that we needed to know.