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Reports


Inspection carried out on 22 August 2019

During a routine inspection

About the service

Oak Mount Care Home is a care home, providing personal care to older people 65 and over, some of whom are living with dementia and mental health needs. The service can support up to 21 people.

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

People and relatives consistently told us they were very happy with the care and support they and their loved ones received. Staff were extremely caring, thoughtful and kind and respected their privacy and dignity. They felt listened to and valued as individuals and their wishes were respected. We observed staff practiced these values in the support they provided. People were involved in decisions about their care and were encouraged to be as independent as possible. Staff were skilled at identifying when people were upset or worried and offered compassionate and gentle reassurance. The home was friendly, homely and welcoming. Family and friends could visit at any time and felt welcomed by staff who knew them well and involved them in daily life at the home.

People and relatives told us they thought people were safe at Oak Mount Care Home and were very happy with the care people received. Robust recruitment processes were in place to ensure suitable staff were employed. There were enough staff on duty to meet people’s needs and keep them safe. Risks to people’s health and wellbeing had been identified and mitigated. Accidents and incidents were investigated by the registered manager to reduce the risk of reoccurrence and identify any learning. Medicines were well managed and staff received training in administering medicines. Staff understood their responsibilities in safeguarding people and referrals were made to the local authority when concerns were identified.

People were supported to access routine and preventative healthcare services to maintain their health and wellbeing. People had a choice of nutritious, homecooked foods which met their needs and preferences, and were offered assistance to eat their meals if required. Staff obtained consent from people for day to day decisions. People without capacity to make decisions were supported in line with the Mental Capacity Act 2005 to ensure their rights were protected.

Staff knew people very well including their likes, dislikes, preferences and wishes and were responsive to their care and support needs, including communication needs. People enjoyed a variety of activities at home and in the community, which enabled them to stay active and interact with others. People and relatives knew how to make a complaint if they needed to and felt confident it would be addressed.

The management team had developed a range of quality monitoring systems, such as surveys and audits, and feedback was used to help drive improvement. Where we identified issues during the inspection, these were raised with the registered manager and provider and were addressed straight away. People, relatives and staff spoke highly of the registered manager and provider. Staff felt very well supported by the registered manager and provider who were approachable and available for support and guidance.

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 23 February 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Inspection carried out on 24 January 2017

During a routine inspection

We previously inspected Oak Mount Care Home on the 18 and 19 May 2015 and identified three breaches of the Health and Social Care At 2008. People were not protected against risks of infection and hot water was not provided throughout the building in a safe way. People were not protected against the risks of dehydration and malnutrition and people’s needs were not always appropriately assessed. We also found quality assurance systems were not robust.

At this inspection we found the provider had made significant improvements and met all requirements issued from our last inspection.

This was an unannounced inspection which took place on the 24 and 25 January 2017 and carried out by two inspectors.

There is a registered manager at Oak Mount Care Home. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

The service provides care and support for up to 21 older people who may be living with Dementia.

The provider had systems in place to respond and manage safeguarding matters and make sure that safeguarding alerts were raised with other agencies.

People who were able to talk with us said that they felt safe in the home; and if they had any concerns they were confident these would be quickly addressed by the staff or manager.

Assessments were in place to identify risks that may be involved when meeting people’s needs. Staff were aware of people’s individual risks and were able to tell of the strategies in place to keep people safe.

Staff knew each person well and had a good knowledge of the needs of people.

There were sufficient numbers of qualified, skilled and experienced staff deployed to meet people’s needs. Staff were not hurried or rushed and when people requested care or support, this was delivered quickly.

The provider operated safe and effective recruitment procedures.

Medicines were stored and administered safely. Clear and accurate medicines records were maintained. Training records showed that staff had completed training in a range of areas that reflected their job role.

Staff received supervision and appraisals were on-going, providing them with appropriate support to carry out their roles.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. At the time of our inspection applications had been submitted by the managing authority (care home) to the supervisory body (local authority) and had yet to be authorised. The manager understood when an application should be made and how to submit one.

Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 to ensure any decisions were made in the person’s best interests.

The food menus offered variety and choice. They provided people with nutritious and a well-balanced diet. The chef prepared meals to meet people’s specialist dietary needs.

People were involved in their care planning, and staff supported people with health care appointments and visits from health care professionals. Care plans were amended to show any changes, and care plans were routinely reviewed every month to check they were up to date.

People were treated with kindness. Staff were patient and encouraged people to do what they could for themselves, whilst allowing people time for the support they needed. Staff encouraged people to make their own choices and promoted their independence.

People knew who to talk to if they had a complaint. Complaints were passed on to the manager and recorded to make sure prompt action was taken and lessons were learned which led to improvement in the service.

People’s needs were fully assessed with them before they moved to the home to make sure that the home could meet their needs. Assessments were reviewed with the person their relatives and where a

Inspection carried out on 18 & 19 May 2015

During a routine inspection

This was an unannounced, comprehensive inspection on 18 and 19 May 2015. Two inspectors visited the home on both days.

Oak Mount Care Home is registered to provide accommodation, personal care and support for up to 21 people. The home does not provide nursing care. At the time of the inspection there were 20 people living there.

The registered manager had been employed since August 2014. 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.’

The inspection was carried out in response to information of concern.

The feedback we received from people and their relatives and visitors was that Oak Mount Care Home was a caring and well run home. People told us that staff were kind and helpful. One person told us, “The staff are super, they’ll do anything for you and they come quickly if you need them”. Others told us that they felt respected and supported to live their life in the home as they wished.

We found a number of breaches of the Health and Social Care Regulations 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of this report.

Risks to people’s health were not safely managed because systems to prevent and manage infections were not robust. Neither the provider, registered manager nor staff had recognised that a lack of hand washing facilities was an infection control risk and there were issues regarding the supply of hot water in various parts of the home.

Systems to manage the administration of people’s medicines were  robust and meant that people received their medicines as they were prescribed. We could not be sure that people always received all of the food and fluids they needed to maintain good health.

We observed that there were times when staff were rushed and had a number of other tasks to complete in addition to their caring duties. This meant that some people’s care was task focussed rather than person centred.

The layout of the building meant that it cannot always meet the needs of people if they increase during their stay, especially with regard to mobility. The registered manager was aware of this and told us they discussed this issue with people prior to moving into the home or as and when their care needs increased.

Staff received regular supervision and training and were knowledgeable about their roles and responsibilities. They had the skills to help people with their care and support needs.

Some assessments of people’s needs had not recognised specific care needs such as the management of diabetes or behaviour that challenges others. This meant that there was no guidance for staff to refer to if they needed it in these areas.

Observations and feedback from the staff, relatives and professionals showed us that the home had an open and caring culture.

The management structure of the home was clear. People told us that they knew how to make complaints and found the registered manager and provider approachable. Systems to monitor the safety and quality of the service required improvement.

Inspection carried out on 2 September 2014

During a routine inspection

We found that the registered manager had left the home in June 2014 and a new manager was in place. We saw the new manager had applied to the Care Quality Commission in June 2014 for registration. A registered manager is a person who has registered with the Care Quality Commission to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider.

We spoke with six of the 19 people who lived at the home, the manager, two of the directors, five members of staff, two relatives of people living at the home and a visiting professional.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

Is the service caring?

Is the service responsive?

Is the service safe?

Is the service effective?

Is the service well led?

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people who used the service, their relatives and friends and the staff told us.

Is the service safe?

People were treated with respect and dignity by the staff. People told us they felt safe. Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

We saw systems were in place to help ensure managers and staff learn from events such as accidents and incidents, complaints and concerns. This reduced the risk to people and helped the service to continually improve.

The home had policies and procedures in place in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application should be made and how to submit one. This meant people were safeguarded.

The manager was responsible for arranging staff rotas and took people's care needs into account when making decisions about numbers, qualifications, skills and experience of staff required. This helped to ensure people's needs were met

Is the service effective?

There was an advocacy service available to people if needed. This meant people could access additional support when they required it.

Specialist dietary requirements, mobility, equipment and communication needs had been identified in care plans where necessary. People said they had been involved in the planning of their care and care plans reflected their current needs and wishes. One person told us; "They ask my opinion about everything, it makes me feel like I matter".

Is the service caring?

People were supported by kind and attentive staff and were spoken to with dignity and respect. One person told us; "I am so happy here, everyone is so kind to me" and another person said, "I cannot fault this place, it's wonderful". We spoke to a visiting professional who told us, "From what I have seen, everyone appears to be very happy here".

People's preferences, interests and needs had been recorded and care and support was provided in accordance with people's wishes.

Is the service responsive?

People had access to daily activities both inside and outside of the home.

People knew how to make a complaint if they were unhappy. The complaints procedure was clearly displayed and easily accessible on the notice board in the hallway People we spoke with told us they had no complaints to make. We saw there was a complaints log, but there had been no entries since the last inspection. People told us if they had any issues they spoke with members of the staff team or the manager and things were dealt with immediately. This demonstrated to us that people were happy with the service they received. A comments log and suggestion box was clearly displayed in the hallway for people to use. We found only positive comments about the service had been made.

Is the service well led?

People who used the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Comments and ideas were listened to and acted upon in a timely manner.

The service worked well with other agencies and services to help ensure people received their care in a cohesive manner.

The service had a quality assurance system and records showed notes for action were addressed promptly.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes which were in place. This helped to ensure people received a good quality service.

Inspection carried out on 23 August 2013

During a routine inspection

People told us they were very happy with the care and support provided at the service. One person told us "it is a lovely home and I am really happy here � the staff are lovely and the food is good". Another told us "staff are nice and if anything is wrong they listen to me and help me. I feel safe here."

People's choices and consent to care and support were observed to be respected at all times during our visit. We observed staff supporting people with day to day activities, and the interaction was observed to be sincere, respectful and responsive to individual support needs.

People chose how to occupy themselves in the service. We observed that people were spending time in the communal areas listening to music and singing together. During our inspection we observed people spending time in their bedrooms watching television and reading. We observed staff spending the majority of their time with people who used the service. They frequently checked on them to ensure they were alright when spending time on their own.

We saw staff supporting people to make their own choices about what they had for lunch and what activities they took part in. Staff knew exactly how each person communicated which meant people's wishes were understood and respected.

Staff were well supported and received on-going training and development to be able to effectively meet people's support needs.