The Oaks Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last inspection we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of the legal regulation in relation to governance.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Records did not always evidence that an effective system was in place to assess people’s needs.

An electronic care management system was in place. There were shortfalls relating to the assessment of medicines management, nutrition and hydration, catheter care, falls management and distressed behaviours.

The provider had formulated an action plan prior to our assessment and updated it during and following our site visits and those visits carried out by the local authority and ICB, to ensure improvements were made.

An effective system was not fully in place to demonstrate that care and support was delivered in line with best practice guidance and legal requirements.

There was a lack of meaningful activities to support people’s social needs and emotional wellbeing. Staff described the actions they carried out to support a person when they displayed distressed behaviours. These actions were not included in the person’s care plan and there was no evidence they had been agreed with a health and social care professional.

We observed the mealtime experience. Staff provided support in a calm unhurried and caring manner. However, records did not always evidence that staff supported people with their diet and fluids in line with their assessed needs.

The provider had formulated an action plan prior to our assessment and updated it during and following our site visits and those visits carried out by the local authority and ICB, to ensure improvements were made.

An effective system was not fully in place at the time of our assessment to ensure staff teams worked together well.

Several staff told us that teamwork and communication, including the electronic handover system was not always effective. The provider was aware of the issues and were working with staff to support them. Further training, meetings and supervision sessions and appraisals were being organised and undertaken. The interim manager explained that staff compliance with reading the electronic handover system was variable and this was being closely monitored.

Records did not always evidence how staff supported people to live healthier lives. There were shortfalls relating to medicines management, nutrition and hydration, supporting people who displayed distressed behaviours and meeting people’s social needs. External partners told us that referrals to health care professionals had not always been made in a timely manner to ensure people’s safety and wellbeing.

The provider had formulated an action plan prior to our assessment and updated it during and following our site visits and those visits carried out by the local authority and ICB, to ensure improvements were made.

An effective system was not fully in place to evidence that staff monitored and improved people’s outcomes.

We identified concerns relating to medicines management, nutrition and hydration and supporting people’s social needs. These shortfalls did not fully evidence that people were supported to achieve good outcomes.

Records did not always show that staff monitored people’s bowels in line with their assessed needs. In addition, records did not demonstrate that checks were carried out in line with one person’s diabetic care plan to monitor their condition.

The provider had formulated an action plan prior to our assessment and updated it during and following our site visits and those visits carried out by the local authority and ICB, to ensure improvements were made.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty had the appropriate legal authority and were being met.

Records did not always demonstrate how staff followed the principles of the MCA. This meant there was a risk that people received care which did not uphold their rights.

The local authority told us that DoLS applications had not always been submitted for authorisation and review in a timely manner. The interim manager told us it took time to assess people’s capacity and applications were submitted, once people’s capacity had been assessed.