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Inspection carried out on 14 May 2019

During a routine inspection

About the service: Oak Vale Gardens is a care home that was registered to provide personal and nursing care and accommodation, treatment of disease, disorder and injury and diagnostic and screening procedures for up to 18 people. It provides support to people who have a brain injury. At the time of the inspection there were 16 people living at the home.

People’s experience of using this service:

Oak Vale Gardens in a care home that supports people who have had a brain injury. It aims to support people for a period of two years or less and as such does not consider itself a long term home for people but a treatment centre. People are able to stay there until such a time as they have regained as many skills and independence as possible. If possible, people are supported to visit their family home whilst staying at Oak Vale Gardens or to actively look for a new long term home when ready to move on.

Some people told us that they liked living there and had seen an improvement in their independence and skills due to the treatment and support they had received. Other people could not communicate verbally with us, however their non-verbal communication showed that they felt relaxed and confident around all members of the staff team.

People were protected from abuse and the risk of harm. Staff understood their responsibilities for keeping people safe and reporting any concerns that arose. Risks for individuals were identified and action taken to minimise them. People got their medication on time and as prescribed.

Robust recruitment practices were followed to check staff were suitable to work with vulnerable people. Staff enjoyed working at the home and took pride in supporting people with their everyday lives and to regain skills. They understood their roles and responsibilities and had received training to help them support people safely in line with best practice guidance. There was enough staff available to provide the support people needed.

A multi-disciplinary team worked at Oak Vale Gardens. Staff also worked well with outside professionals in supporting people. Staff said they felt part of the wider team and it was clear from records that the team worked well with other professionals to gain the best outcomes for people living there.

Staff understood and respected people’s right to make decisions. Where people had their liberty legally restricted, every effort was made to support the person to take part in decision making. Staff were respectful when supporting people and skilled at changing their approach in accordance with people’s individual choices and communication styles.

A clear management structure and experienced registered manager provided good role models within the home and kept a focus on supporting people as individuals to continually improve the quality of their lives.

Rating at last inspection: Good (report published 4 November 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: ongoing monitoring;

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

Inspection carried out on 6 October 2016

During a routine inspection

This inspection was unannounced and took place on 6 October 2016. The last inspection took place on 6 May 2014 and the registered provider was compliant with the regulations in force at that time. In September 2015 the service was registered by Partnerships in Care (Oak Vale) Limited with the Care Quality Commission (CQC) and this will be the first inspection since this registration.

Oak Vale Gardens is an extended rehabilitation facility which provides accommodation and support for 18 adults with an acquired brain injury and complex health and social care needs. The purpose built facility offers accommodation in easily accessed grounds with car parking facilities.

The service is a two storey building, with the upper floor being divided into two units; Unwin unit provided support for more able bodied people, whilst Stephenson unit supported people with more complex needs. Unwin and Stephenson had nine bedrooms each (all en-suite), and each unit had a quiet lounge used mainly by visiting families, a main lounge and a separate dining room. Each unit had a communal bathroom where people could access assisted bathing and shower facilities. All but four of the bedrooms had direct access onto the garden areas. We found there were a total of 17 people using the service when we inspected.

The registered provider is required to have a registered manager in post and there was a manager who had registered with the Commission and had been in post since October 2015. 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 that they felt safe living at the home. We found that staff had a good knowledge of how to keep people safe from harm and staff had been employed following robust recruitment and selection processes.

Recruitment was on-going to ensure enough staff were employed to meet the needs of people who used the service. Until the service was fully staffed there was the occasional use of agency staff, but the same staff were booked to aid the continuity of care for people using the service. Staff did not appear rushed on our inspection and there was a good atmosphere in the service.

Medicines were administered safely by staff and the arrangements for ordering, storage, administration and recording were robust.

Robust infection control practices were being used in the service and risks to people were being monitored and reviewed on a regular basis.

The registered provider had an induction and training programme in place and staff were receiving regular supervision. People were confident in the staff skills and knowledge and said they received care and support.

We saw that appropriate support with eating and drinking was provided to people who used the service and we saw that people received good quality meals and plentiful drinks throughout the day.

The main focus of the service was rehabilitation so people received regular therapy sessions from the multi-disciplinary team including physiotherapy, occupational therapy, speech and language therapy and had input from the psychologist based at the service. People had access to a range of low key social activities and events within the service, which the majority of people were satisfied with.

People were included in decisions about their care and we saw that appropriate care and support was being offered to people who used the service. We observed a number of positive interactions between the staff and people they were caring for. People received a detailed assessment to determine if the service was right for them. Assessments were person centred and included input from a range of professionals.

People were treated with respect and dignity by the staff. There was a formal complain

Inspection carried out on 6 May 2014

During a routine inspection

We considered all of the evidence we have gathered under the outcomes we had inspected

We used the information to answer the five questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

Is the service safe?

There were effective recruitment and selection processes in place and appropriate checks were undertaken before staff began work.

People were cared for in an environment that was safe as the building was newly built and well maintained.

Each person staying at the service had a Personal Evacuation Plan detailing how they could be moved out of the building quickly in an emergency. This was kept in their care file and a copy also kept in a locked emergency box next to the emergency fire equipment.

A team of senior staff including the manager were available on call in case of emergencies and to provide advice and support out of hours.

CQC monitors the operation of the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS) which applies to care homes and hospitals. At the time of the inspection the manager told us that no applications had been made by the service. We saw that the provider had up to date policies and guidance in place should it be needed.

Is the service effective?

We spoke with five relatives and two people staying at the service who told us that any issues had been resolved, they were happy with the care provided and did not have any concerns. People receiving care at Oak Vale Gardens told us that they were making good progress and there were enough staff available to support them.

We found that staff had a good understanding of people's care and support needs and knew them well. Due to the difficulties faced by some individuals in the service to communicate verbally there were various communication aids available for people to use that allowed them to be involved in their care and to give consent.

People's specific care needs were met such as ensuring that they received the correct diet and were cared for in an appropriate environment.

Is the service caring?

Before anyone moved in to the service a comprehensive pre admission assessment was conducted by a senior member of the team. This looked at the person's current specialist needs, their aims and goals for the future and what staffing levels were needed to support them.

We saw that when applicable there were very specific guidance assessments and plans to support people to go out and arrangements could be made for pets to visit.

Relatives told us '' the staff are all approachable and we feel reassured.'' and ''We are kept involved and the staff are open to listening to us.''

Is the service responsive?

We saw that the care plans and records were updated regularly and as a person's needs changed and that referrals to other specialist practitioners had been made appropriately and promptly. Any multi disciplinary meetings held had been documented and the names of people who had attended recorded. This included people such as physiotherapists and social workers as well as input from family members.

We saw that the provider had referred any concerns correctly to the appropriate professionals.

Is the service well led?

The home had a registered manager in post which indicates that the person is of good character, is physically and mentally fit and has the necessary qualifications, skills and experience.

The staff had a good understanding of what was required of them in their role and the good standards of care that they were expected to deliver.

Staff told us that they could talk to the manager and they all worked well together. All of the staff members we spoke with told us that they thought people were well cared for and that they were well supported.

We saw that documents had been reviewed and updated and there were audit systems in place that were to begin in June 2014.