Oulton Manor

Oulton Manor is a residential care home providing accommodation and personal care for up to 77 older people. At the time of our inspection there were 63 people using the service. Oulton Manor is a purpose built home and accommodates people over three floors. People living on the ground floor require support with residential care needs. The first and second floors support people with more complex needs including people who are living with dementia.

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

People were safe because systems were in place to make sure risks to people were assessed and actions taken to mitigate the risk. Some documentation in relation to risk required further update and development but the management team were aware of this and were in the process of addressing it. Medicines were usually managed safely with the only issue we found being addressed during our visit.

There were enough staff to keep people safe. People said they did not have to wait when they called for support at any time of day or night. The registered manager was addressing existing staff shift patterns to further improve outcomes for people.

People benefitted from living in a very pleasant, spacious and safe environment. People were protected from the spread of infection because good systems and processes were in place. All people and relatives we engaged with spoke very positively about the staff who cared for them. People felt involved in their care and we saw staff to be extremely caring and attentive. People gave us examples of staff going the extra mile for them.

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.

All people, relatives and staff we engaged with spoke very positively about the new registered manager. One relative said they had “installed a change in the fundamental ethos” of the service and a member of staff said, “Working here has improved a heck of a lot. I hope (registered manager) is here to stay.”

Auditing had been used effectively to identify and address issues, whilst some areas needed further improvement, we were confident that these were being addressed. People, their relatives and staff felt involved in the service and there were systems in place to promote this involvement. This included a resident’s committee, regular meetings and various opportunities to provide feedback.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 30 December 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe and well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Oulton Manor is a residential care home providing accommodation and personal care for up to 77 older people. At the time of our inspection there were 68 people using the service. Oulton Manor is a purpose built home and accommodates people over three floors. People living on the ground floor require support with residential care needs. The first and second floors support people with more complex needs including people who are living with dementia.

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

People were not always safe. They were at risk of harm as the provider had not assessed and mitigated the risks to people. Medicines were not managed safely.

There were not enough staff to keep people safe. We saw staff were generally kind and caring, but they were rushed, and routines were often task orientated. They were not able to respond quickly to people when they needed care, support or comfort. People were not always protected from abuse. Where there were events such as accidents, measures were not put in place to prevent events happening again. Recruitment was managed safely.

Oulton Manor was very well maintained and provided high quality, luxurious and spacious accommodation for people. People were protected from the spread of infection because good systems and processes were in place. Most people and relatives said they felt safe living at the home and spoke positively about the staff who cared for them.

The provider was unable to demonstrate robust governance arrangements. Systems and processes were in place, but they had failed to identify shortfalls and drive improvement. We received mixed feedback from staff and relatives about the management of the home.

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.

The provider was responsive to our inspection findings and responded during and after the inspection. They shared updates about what action they were taking, including a detailed action plan.

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 requires improvement (published 7 April 2020) At our last inspection we recommended that improvements were made to ensure risk assessments were updated appropriately and governance processes were more robust. At this inspection we found the provider had not acted on the recommendations and we identified ongoing shortfalls in both these areas.

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Why we inspected

We received concerns in relation to the management of medicines and safe staffing levels. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service is requires improvement. This is based on the findings at this inspection. The service has been rated requires improvement for the last two inspections.

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.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Oulton Manor on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safeguarding, safe care and treatment, medicines management, staffing and good governance.

Please see the action we have asked the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

We were somewhat assured that this service met good infection prevention and control guidelines.

The home was clean and tidy however cleaning records had not always been completed.

At the time of our inspection the home was allowing visitors and there was protocols in place to reduce the risk of infection.

Staff also recorded when they had washed their hands to ensure this was carried out on a regular basis.

The provider had appropriate arrangements to test people and staff for COVID- 19 and was following government guidance on testing.

Staff were trained on how to keep people safe from the risk of infection. All staff wore their PPE in line with government guidance.

People admitted to the service were supported following government guidelines on managing new admissions during the COVID-19 pandemic.

The home's infection prevention and control policy was up to date and in line with current guidance. The home had a contingency plan in place for when emergencies occurred.

We were somewhat assured that this service met good infection prevention and control guidelines. The home was clean and tidy however cleaning records had not always been completed.

Oulton Manor is a care home providing personal care for 74 older people some of whom may be living with dementia. The service can support up to 77 people.

People’s experience of using the service

Risk assessments did not always contain the relevant information about people’s known risks to mitigate or prevent incidents. Incidents and accidents were reported and most of the time actions were taken to prevent future occurrences. However, we found two incidents where actions had not been taken. Staff knew how to keep people safe and reported any safeguarding concerns. We found one safeguarding incident which had not been reported to the CQC. We recommended the provider ensures all risk assessments are current and all incidents are investigated, and actions are taken to mitigate risks.

Initial assessments were carried out to ensure people’s needs could be met prior to coming into the home. People told us they enjoyed the food and were provided with regular drinks to stay hydrated. When required monitoring of people’s diet intake had been completed so people remained healthy. Health professionals were involved in people’s care when required. Consent was obtained from people when staff supported them. 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. The home was beautifully decorated and also met the needs of those people living with dementia.

People and relatives said staff were kind and provided a high standard of care. Staff were active in helping people to remain as independent as possible. People were offered choices and staff respected people’s privacy and dignity. People were supported by staff who knew them well and we observed positive interactions. Staffing levels and recruitment procedures were robust.

Most care plans were carried out and included people’s individual preferences for care. However, we found some care plans lacked these details. Records were not always up to date or accurate to reflect people’s needs. We recommended the provider reviews all their records to ensure these were accurate. There was no impact on people as staff knew their needs well. Complaints were managed effectively, and people were satisfied with the actions the home took when concerns were raised. Activities were provided for people to prevent social isolation.

People and their relatives felt confident in the management team and the staff said they enjoyed working in the home. The provider had a variety of community links which benefited those people living in the home. The management team were honest and open throughout our inspection and keen to make improvements to develop the care people received.

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 28 April 2018). Since this rating was awarded the registered provider of the service has changed. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

Why we inspected

This was a planned inspection.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.