Background to this inspection
Updated
23 March 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
Our inspection was completed by two inspectors including a member of the medicines team and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Oakley House Ltd is a 'care home'. People in care homes receive accommodation and nursing or personal care as a 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 had a manager registered with the Care Quality Commission. This means they and the Provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider completed a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with five people who used the service about their experience of the care provided. We observed care and interaction between people and staff. We spoke with six members of staff including the registered manager, provider and care staff.
We reviewed a range of records including three care plans, daily care notes, nine people’s medication records, safeguarding records and incident and accidents. We also reviewed three staff recruitment files.
After the inspection
We reviewed a variety of records relating to the management of the service including audits and policies.
Updated
23 March 2022
About the service
Oakley House Ltd is a residential care home providing personal care for up to 11 people with a mental health diagnosis and a learning disability. At the time of the inspection there were nine people living at the service.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Right Care:
The model of support did not always promote maximum choice and independence. The ethos, attitudes and behaviours of managers and staff did not always ensure that people lead confident inclusive and empowered lives.
Right Support:
The provider could not show how they met some of the principles of Right support, right care, right culture. This meant we could not be assured that people who used the service were able to live as full a life as possible and achieve the best possible outcomes.
Right culture:
Although people told us they felt safe and were happy living at Oakley House, the provider did not focus on people's quality of life, and care delivery was not person centred. Staff did not always recognise how to promote people's rights, choice or independence.
People received their medicines as prescribed and staff supported them to manage their treatment by arranging blood tests and healthcare appointments. However, improvements were required around the guidance for staff for when some medicines were required. The provider was also not following the guidance required when visitors were attending the service.
Risk associated with people’s care was managed well by staff. People told us they felt safe at the service and staff ensured they were protected from the risk of abuse and neglect. 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. Staff received appropriate training in relation to their role and were encouraged to progress.
People enjoyed the meals at the service and where they were at risk nutritionally staff supported them with this. Staff ensured that people were supported with their ongoing health.
Rating at last inspection
The last rating for this service was Good (published 11 March 2020).
Why we inspected
We undertook this inspection to assess that the service is applying the principles of Right support, right care, right culture. We had also received concerns that related to whether people were protected from the risk of abuse.
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.
This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.
The ratings from the previous inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Oakley House Ltd on our website at www.cqc.org.uk.
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.