Archived: Oakdale Also known as Encore Oakdale Poole LTD

Oakdale is a purpose-built home in a residential area of Bournemouth. It is registered to provide nursing care and support for up to 84 older people some whom were living with dementia. The home is split over three floors which are accessible by stairs or a lift. There were 67 people receiving care and support at the time of inspection.

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

Developments to governance systems had been made and the overall management oversight of the home had improved. Some processes were still being embedded and further were planned. The management staff structure introduced was stable and this had increased confidence in leadership within 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 home had identified some paperwork was not always in place to record people’s decision-making capabilities. We have made a recommendation about assessment of mental capacity.

People, their relatives, staff and external professionals told us Oakdale was a safe place to be. Improvements had been made across the whole service. However, the manager and provider were still working on increasing confidence especially with relatives and visitors to the home.

People were protected from avoidable harm as infection control procedures were in place and robust, the home was clean, tidy and free from clutter. Staff had access to enough personal protective equipment (PPE) to support safety from infections. Risks people faced in their daily lives had been assessed and steps to reduce them were known to staff. Staff worked in a safe way, environmental and utility checks throughout the home were robust.

Staff knew how to recognise signs of abuse and how to raise their concerns, they were confident they would be followed up. People received their medicines as prescribed, staff who gave medicines were trained and had their competency assessed. People had access to health care services as needed and these were sought in a timely manner. People were supported to have enough to eat and drink. Where there were concerns or risks for people’s nutrition robust measures were in place to support the need.

Staff felt supported and proud to work at Oakdale. Training and supervision meant staff had the necessary skills to support the needs of people. Significant developments had been made in diabetes and dementia care within the home. This included working with external agencies to pilot good practice initiatives. Health and social care professionals worked well with the home and gave positive feedback about their relationship with Oakdale.

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 19 June 2019) and there was a breach 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 carried out an unannounced comprehensive inspection of this service on 11 May 2021. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve good governance.

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, effective 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.

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

Follow up

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

Oakdale is a nursing home providing personal and nursing care to 41 people aged 65 and over at the time of the inspection. It can support up to 84 people. The home has three floors. There were 24 people on the ground floor and 17 people on the first floor. The home had partnered with the local authority to support people to move from hospital into short stay rooms on the first floor. The second floor was closed.

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

At the previous inspection in January 2021 we made a recommendation about auditing. Despite this there were still gaps in auditing. This meant quality assurance systems were not operating effectively.

Although there was a visiting protocol to help prevent the spread of infection, the home did not follow this completely when the inspectors arrived. Records showed the protocol had been followed at all other times.

The home had experienced a turnover of managers since it opened. Since April 2021 the home had had a new manager who was applying to register with CQC. People, staff and relatives spoke positively about this manager, who they felt was approachable and supportive.

Staff understood the importance of supporting people emotionally as well as physically. This had been particularly important during the COVID-19 pandemic. One relative told us, “The staff were good with COVID-19 and helped [family member] with [family member’s] anxiety and facilitated me being able to speak to [family member].”

People told us they felt safe living at Oakdale. Relatives expressed confidence their family members were kept safe. One person said, “Oh yes, it’s totally safe here, the staff are fantastic.” Risks to people were assessed, recorded and regularly reviewed. Equipment required to help reduce risks in people’s lives was in place and checked to ensure it was in good working order.

There were enough staff to meet people’s needs. The home completed dependency scoring when people moved in and regularly reviewed this to ensure enough staff with the required skills were on shift to support them. One person told us, “There are always plenty of staff around.”

People’s dietary needs were known and met, including if they had allergies to certain foods or were on safe swallow plans created by speech and language therapists.

At the previous inspection we found communication with relatives was not always consistent. This was improving with the new manager in post, the relaxation of COVID-19 visiting restrictions and the scheduling of relatives’ meetings.

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 told us they got on well as a team, helped each other and enjoyed working at Oakdale. This was evident during the inspection. One staff member told us, “I have worked for a lot of care companies and I feel happy to work at Oakdale.”

The home had continued a partnership with the local authority to support people to move from hospital to short stay 'step down' placements. This was helping to support the wider health and social care system during the COVID-19 pandemic.

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

Rating at last inspection

This service was registered with us on 24 October 2019 and this is the first full inspection.

Why we inspected

This inspection was carried out to follow up on our focused inspection in 18 January 2021 and to provide a first rating for the service.

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 improvement.

Please see the well led section of this full report

Enforcement

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified a breach in relation to the management of the home at this inspection.

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

Follow up

We will monitor the provider’s progress with their action plan to understand how and by when they will improve the standards of quality and safety. We will work alongside the provider and local authority when doing that. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Oakdale is a nursing home providing personal and nursing care to 33 people aged 65 and over at the time of the inspection. The service can support up to 84 people. The home has three floors. There were 24 people on the ground floor and 9 people on the first floor. The home had recently partnered with the local authority to support people to move from hospital into short stay rooms on the first floor. The second floor was currently closed.

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

There were enough staff on shift to help ensure people’s needs were met safely. Although staffing numbers had fluctuated in recent months this was linked to a position of overstaffing in late 2020, a subsequent reduction in staffing to better match the numbers of people living there and then an increase in January 2021 required to support admissions under a new partnership with the local authority.

Management within the home had not always been consistent. There was currently no registered manager. Staff felt management could be more visible around the home and engage with them more.

Although a number of audits were undertaken these were not always up to date or accurate. We have made a recommendation about auditing.

People said they felt listened to. Communication with relatives was not always consistent. Some told us they received regular updates whereas others felt they had to initiate calls to the service to get these.

Staff told us they got on well with their colleagues and supported each other. They described the team as “one big family.”

Staff had a good understanding of the signs and symptoms that could indicate people were being harmed or abused and knew how to report this both internally and to external agencies.

People’s medicines were managed safely. When errors had occurred required follow up actions were taken to help prevent a re-occurrence.

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 had partnered with the local authority to support people to move from hospital to short stay 'step down' placements. This was helping to support the wider health and social care system during the Covid-19 pandemic.

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

Rating at last inspection

This service was registered with us on 24/10/2019 and this is the first inspection.

Why we inspected

We received concerns in relation to the management of people’s risks and the governance of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them.

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 coronavirus and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the Well Led section of this report.

Follow up

We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.