Oak House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

People were safely supported. People did not directly comment on whether they felt safe, yet it was clear through observation people were relaxed with the staff team and had formed close bonds with staff as a trusted resource they could refer to. They used their preferred communication methods to refer to staff about how they wished to be supported. Relatives told us they felt their loved ones were safe using the service and had no concerns. Where any concerns were raised, these were effectively addressed in partnership between the family and management team. Safeguarding procedures were in place and staff were knowledgeable about the processes they could use. Staff were very clear about speaking out about poor practice and this enabled them to further uphold the rights of the individuals they supported. The provider reported any concerns they had transparently to the local authority as required. Staff were safely recruited and staffing levels enabled peoples’ needs to be met with an emphasis on ensuring continuity in support for people. Where reviews suggested further one to one staffing support, this was achieved. Medication management had improved since our last visit and was safe. While the service did not provide accommodation to people, they acted as advocates, upholding and promoting peoples’ right to safe and well-maintained accommodation. People were supported by staff who knew their needs and preferences well. Systems were in place to record and report events which occurred with evidence of reflective practice by the staff and management team. Hazards faced by people in their everyday lives were identified and reviewed in consultation with people and their relations.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider analysed any accidents or incidents that had occurred. When people had become distressed or anxious, for example, there were discussions about the cause or any environmental factors that had triggered these and how these could be avoided in the future. Communications received by CQC from the provider evidenced they undertook investigations following any concerns raised about the service. This demonstrated an open culture with opportunities to prevent re-occurrence. There was evidence of reflective practice and debriefing for all involved. Systems were in place to record and report events which occurred. Significant incidents were reported internally with evidence of reflective practice and analysis by the staff and management team.

The provider worked with people, families and healthcare partners. Support plans evidenced involvement with people and their families when required. The involvement of relatives was significant, especially where people had recently come to be supported by the provider. There were protocols in place which guided staff when and how to make referrals or escalate concerns.

There was a clear and accessible process in place for the reporting of safeguarding concerns. Managers reported these appropriately to other agencies such as the local authority safeguarding team and the Care Quality Commission. There was a whistle blowing policy in place and this was accessible to all staff. Staff were aware of this and considered the provider would take any concerns seriously. Up to date training was confirmed through training records and provided evidence staff had received training in safeguarding, the mental capacity act and best interest decision making.

Risk assessments had been devised to keep people safe when pursuing activities or during their general support. These risk assessments had been devised in conjunction using the preferences of people, input from their families and the knowledge staff had about people and their needs. All aspects of life that could cause harm to people had been considered through these assessments. These extended to assessments covering specific environmental hazard within people's individual accommodation. Staff were able to demonstrate actions to take in people’s homes in the case of an emergency. Assessments were in place to reflect the considerations needed if people needed to be evacuated from their homes in an emergency. Risk assessments involved positive risk-taking. This enabled people to experience new activities or community facilities. The safety of people at these times was taken into account.

While responsibility for peoples’ accommodation did not form part of the registration of the service, managers confirmed they liaised with housing associations in response to the day-to-day maintenance of properties. Risk assessments for staff were available relating to each address. This outlined specific environmental hazards within the homes they entered and how these would be mitigated. Information was available to staff in the event of emergencies occurring in peoples' homes such as gas leaks or flooding. Staff confirmed their awareness of steps to take in an emergency.

Staff rotas were available evidencing people had their needs met by appropriate staffing levels. Where people faced risks, staffing levels were reviewed and extra one to one staff deployed to ensure the person was safe. Risks while accessing the local community had been identified, some people received support from more than one person to maintain their safety. Staff rotas were developed reflecting peoples' assessed needs. Staff were recruited safely. This was a robust system and included all necessary checks before staff could support vulnerable people. Staff received induction and supervision on a regular basis to observe practice and check their competency to perform their role. Staff received training they needed to meet peoples care needs. This included regular training to support people with all aspects of their daily lives and assessed needs.

Managers provided evidence they had an infection control procedure in place and staff received training. Risk of infection was assessed, identified and managed to ensure it did not spread. They were aware of other agencies they could contact for advice. Health audits identified those infection control issues needed to be addressed to prevent the spread of infection.

Medication storage was safe. Competency checks and medication training was received by all support staff. All medication was stored securely. Medication records were completed and staff provided with a good deal of information about the medication and its purpose. Where people had been prescribed medication to be given when required (known as PRN), detailed protocols were in place to ensure continuity of when best to administer the medicine. Some people had specific health conditions which could seriously impact on their wellbeing. Prescribed PRN medications were available to deal with these events.