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Inspection carried out on 15 November 2017

During a routine inspection

Oakcroft Nursing Home provides accommodation and personal care for older people, some of whom were living with dementia. 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.

Oakcroft Nursing Home accommodates up to 28 people in one adapted building with a well-maintained garden. At the time of our inspection, 23 people were living at the service.

At the last inspection on 29 July 2015, the service was rated Good.

We carried out this unannounced comprehensive inspection of the service on 15 and 16 November 2017. At this inspection, we found the service remained Good.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. Staff sought the consent of people before delivering care.

People were happy at the service. People were protected from abuse because staff understood safeguarding procedures about how to identify and report concerns. Appropriate arrangements were in place to identify and manage risks to people’s health and well-being.

There were sufficient numbers of suitably skilled staff deployed at the service, which ensured people received appropriate care. People received support from staff who underwent pre-employment checks to determine their suitability to provide care.

People took their medicines when needed with the support of competent staff. Staff administered and managed people’s medicines in line with the provider’s procedures and best practice guidance.

People’s care needs were met because staff were trained and skilled to undertake their role. Staff received the support they required to do their work and had regular training and supervision to develop their practice.

People had access to healthcare services they needed to maintain their health. People received meals that met their nutritional and hydration needs and food preferences.

People received care which staff provided in a kind and compassionate way. People had their privacy and dignity maintained at the service. People took part in planning and making decisions about their care.

People enjoyed taking part in a wide range of activities provided at the service. Staff supported people to maintain relationships that mattered to them and ensured they were not at risk of social isolation.

People received care in line with their assessed needs. Staff were kept informed of changes to people’s needs and the support they required. Care and support plans were adopted to meet people’s individual needs.

People knew how to make a complaint and were confident the registered manager would resolve any concerns they raised. People using the service and their relatives had received the provider’s complaints procedure and understood how to escalate concerns to external agencies. The provider actively sought the views of people about the service and acted on their feedback to improve care delivery.

People using the service, their relatives and staff commended the registered manager for their leadership and management of the service. People received care and support that was monitored and audited. Improvement plans were put in place to ensure staff delivered high standards of care.

The provider and registered manager maintained close working relationships with external agencies to ensure people’s care met best practice guidance.

Inspection carried out on 29 July 2015

During a routine inspection

Oakcroft Nursing Home provides personal care, including nursing care and accommodation for up to 28 people. On the day of the inspection 22 people were using the service. It is located in a large house with a garden.

The previous inspection of the service took place on 26 February 2014. It was found to meet all the regulations inspected at that time. This unannounced inspection took place on 29 July 2015.

The service has a registered manager. 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.

People told us the provider and registered manager were committed to improving the quality of the service. They held regular meetings with people, relatives and staff to obtain their views. They listened to people and acted on their suggestions. The management team checked the quality of care and support people received and ensured staff kept accurate and up to date records.

People had the opportunity to follow their individual hobbies and interests. They said they enjoyed using the service. People told us staff were kind and friendly and treated them with respect. The building was clean and well-maintained and people had a choice of meals.

People received safe and effective care. The registered manager had ensured staff understood their work role. Staff received training and support which equipped them to meet people’s needs.

Risks to people were assessed and managed effectively. There were enough suitable staff on duty to meet people’s needs.

Staff knew people well and understood how to communicate with them so they could be involved in identifying their needs and planning their support. Relatives told us staff also involved them in this process.

People were supported in accordance with the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). People received their medicines safely as prescribed.

Inspection carried out on 26 February 2014

During an inspection looking at part of the service

At this visit we found that action had been taken to improve the service in response to our findings in October 2013. People who used the service were protected from the risks of unsafe or inappropriate care and treatment. Care and treatment was planned and delivered in a way that was intended to ensure people�s safety and welfare. Care arrangements had improved, people's care needs were kept under review, any change to individual's conditions were identified and responded to accordingly. Staff we spoke with were aware of people�s risk assessments and how to intervene and manage these risks when they arose.

Management arrangements were strengthened, these had ensured staff were provided with direction and leadership. Staff we spoke with told us they felt supported in their role, they were motivated and had regular and frequent supervision and had their practice appraised.

People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

Inspection carried out on 8 October 2013

During a routine inspection

During the inspection we met with all twenty one people who lived at the service and three visitors. Following the inspection we spoke on the telephone with the relatives of seven people using the service. We spoke with nursing and care staff who worked at the service and with the manager. We had contact with four professionals involved with the service by telephone.

People who lived at the service told us that they felt well cared for and they liked the staff who provided care. One person described staff as "so gentle and kind".

We heard that professionals had found minor inconsistencies in care delivery, they told of errors in care records and this was also reflected in our findings. We found omissions and inaccuracies in record keeping.

We found that people enjoyed the small scale environment; they told us this gave a more homely feel and it suited their needs. People who lived at the service and their relatives were asked their views and found that changes were made to reflect their wishes.

The service had no registered manager in place to give direction and leadership to the staff team. The impact of this was reflected in our findings. The home has not made the progress required and a number of shortfalls were found as a result. Record keeping was unsatisfactory, practices were appraised and staff did not receive the support and training required.