Oaklands Care Home

Oaklands Care Home is residential care home providing accommodation and personal care for up to 15 people in one adapted building. The service supports older people, some living with early stages of dementia. There were nine people living in the service at the time of our last inspection. There were 15 people living at the service at the time of this review.

Background to this report

At our previous focused inspection at Oaklands Care Home on 17 February 2021 and 18 March 2021 we identified concerns relating to Safe. We found that systems were either not in place or robust enough to demonstrate infection control was effectively managed. This was a breach of regulation 12 (Safe care and treatment) for which we issued a requirement notice. The key question Safe was rated requires improvement and the overall location rating was Good.

The full report of that inspection can be found by selecting the ‘all reports’ link for Oaklands Care Home on our website at www.cqc.org.uk.

Why we carried out this review

We carried out this review on 6 April 2022 to follow-up on the requirement notice and assess whether the provider has addressed the improvements required at our previous inspection. We did this using a ‘desk-based’ review process because evidence to demonstrate that the requirement notice had been met could be obtained and assessed remotely without needing an inspection visit to the location. This was not an inspection: the scope of this review did not include a visit to the service or an assessment of the outcomes for people using the service.

What we found

Details of the findings from this remote assessment can be found under the Safe section of this report.

Through this review we assessed that the provider, Primos Care Limited, has taken action to meet the requirement notice issued after the last inspection. They are therefore no longer in breach of regulation 12.

Rating at last inspection and update

Following the last inspection, this location was rated Good although the Safe key question was rated Requires Improvement.

Through this review, evidence reviewed remotely provided assurance that improvements had been made to address all issues that resulted in the Safe key question being rated Requires Improvement. The rating for Safe has therefore been updated to good.

Oaklands Care Home is residential care home providing accommodation and personal care for up to 15 people in one adapted building. The service supports older people, some living with early stages of dementia. There were nine people living in the service at the time of out inspection.

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

We found shortfalls in keeping people safe. Infection prevention and control was not being effectively managed in line with the most up to date government guidance. Areas of the service were not being adequately cleaned. During the COVID-19 outbreak, the service had not fully followed their safe recruitment and induction systems. This meant the previously demonstrated good standard in safe had not been maintained.

The directors acknowledged improvements were needed, including infection prevention and control. They were clear about how they were going to fix these issues and learn from them to make the required improvements

Relatives and staff spoke highly of the friendly culture of the service. A relative told us, “What I like is that the service is small and very personal. They know my [Person], the staff know and care for them really well.” Staff felt supported by the directors and management team, who they described as approachable.

Staff understood their role in safeguarding people from harm, including advocating for people to ensure any concerns were heard and dealt with. People received their medication as prescribed. Risks associated with people’s care needs were assessed and guidance was in place for staff to keep people safe.

Relatives told us people were provided with safe care, and staff kept them updated on any changes to their family member’s health and welfare. One relative told us their family member, “Seems happy enough, they would tell me if they were not. It’s never easy to put a relative in a home, but we [Family] are very happy with Oaklands. The staff are good at sorting [family member] healthcare needs…”

None of relatives felt they had needed to make any complaints, but if they did they would feel comfortable to raise it with the management. All felt they were involved in making decisions about their family members care including initial assessment of needs. One relative told us, “Can’t fault the home, the staff have been very accommodating, they have gone out of their way to make them feel at home.”

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

Rating at last inspection

The last rating for this service was good (published 28 November 2018)

Why we inspected

We received concerns in relation to management, staffing, infection control, record keeping and medicines. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service remains as good.

We have identified a breach of regulation in relation to infection control at this inspection. You can see what action we have asked the provider to take at the end of this full report.

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

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 for the provider to understand what they will do to improve the standard of safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Oaklands Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service accommodates 14 people in one adapted building. At the time of our inspection there were six people using the service.

Oaklands Care Home was previously owned and ran by Oaklands Care Home Limited. The last inspection of the service under this provider was carried out on 16 October 2017. The final rating following the inspection was 'Requires Improvement'. Breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 were identified in relation to failings in identifying and managing risks to people’s welfare and safety. People’s care was not person centred and staff failed to treat people with dignity and respect. Staff had not received the right level of training to recognise where people’s health had deteriorated and did not always demonstrate they knew how to provide the right care. The requirements of the Mental Capacity Act 2005 (MCA) where not being followed where people lacked capacity to make decisions. We also found that improvements were needed in relation to the recruitment of staff to ensure they were safe to work with people in a social care setting. The governance and quality assurance systems were not effective and had not identified failings in the service.

This was the first inspection of Oaklands Care Home under the new provider Primos Care Limited and we found significant improvements had been made. A new manager was in post and had registered with the Care Quality Commission (CQC) to manage the service. A registered manager like registered providers, 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 risk of harm and staff had a good understanding of processes to keep people safe and how to report concerns. Safeguarding incidents were managed well. Peoples’ medicines were being managed safely. There were sufficient numbers of staff available to meet people’s needs. A thorough recruitment and selection process was in place, which ensured staff recruited had the right skills and experience, and were suitable to work with people who used the service.

Staff had access to the training they needed that gave them skills and knowledge to carry out their roles. Staff knew the needs of the people they supported well. They showed concern for people in a caring way and respond to their needs quickly, however, there were missed opportunities where staff could have spent meaningful time with people to provide stimulation and promote their wellbeing.

People were supported to eat and drink enough to maintain a balanced diet. People were supported to live healthier lives and had good access to healthcare services, where required. People and their relatives were complimentary about the attitude and capability of the staff. Staff had developed good relationships with people using the service. Staff treated people with kindness, promoted their independence and respected their privacy and dignity.

People were supported to express their views and be actively involved in making decisions about their care. Consent to care and treatment was being managed and sought in line with legislation and guidance. Staff understood the need to obtain consent from people before providing care and support. Further work was needed to ensure the provider was meeting the requirements of the Accessible Information Standards. This set of standards sets out the specific, approach for providers of health and social care to identify, record, share and meet the communication needs of people with a disability, impairment or sensory loss.

Systems were in place to ensure people’s concerns and complaints were listened and responded to. No one currently using the service was receiving end of their life care, however feedback from people’s relatives in thank you cards and discussions with staff confirmed people were supported to have a comfortable, dignified and pain-free death.

Systems were in place to ensure performance, risks and regulatory requirements were understood and managed. The registered manager and staff had a clear understanding of what was needed to ensure the service continued to develop, and ensure people received high-quality care. There had been significant improvements made to the premises, to ensure it was safe. These changes are ongoing, with planned maintenance, redecoration and landscaping the gardens. The improvements made showed that there had been a willingness by the provider, the registered manager and staff to work in partnership with other agencies to improve the service.

Feedback in surveys and resident and relatives meetings showed people, their relatives and staff were positive about the change of provider and the appointment of the new registered manager. They felt the service was moving in the right direction, and staff morale had improved. Staff felt supported by the manager and felt there was good leadership in the service. Staff were clear about the provider's philosophy of care and how this linked to the vision and values of the service in relation to providing compassionate care, with dignity and respect.