Oulton Park Care Centre is a residential care home providing personal and nursing care to 48 people aged 65 and over at the time of the inspection. The service can support up to 60 people.The service provides purpose-built accommodation on one level. The service has a dedicated unit that specialises in providing care to people living with dementia.
People’s experience of using this service and what we found
We were prompted to bring this inspection forward because of concerns shared with us regarding the management of the service and poor care. The service has had three registered mangers since August 2018 and the last registered manager had left shortly before our inspection, a new manager had been quickly recruited and had assured us they would apply for registration in the near future. However, this quick succession of managers had been disruptive to the management of the service and its efforts to improve the quality of service people received.
Medicines had not always been managed in a way that ensured that people received them safely and at the right time. During our observations we found there was poor practice in its management and administration. Most of our concerns in regard of the medicines had already been noted and action was being taken to better manage the medicines and retrain staff.
People's nutritional and hydration needs were assessed to ensure they received appropriate support that met their needs. Although, we saw examples where specialist diets needed to be recorded with more clarity. The service worked to ensure that people received person centred care when they used and were supported by different services.
People received care that was personalised and responsive to their needs, the care plans held enough information to guide staff on meeting people’s needs but would benefit if more detail was included. However, staff knew people well, understood them and their personal preferences. People’s experiences, concerns and complaints were listened to; steps had been taken to investigate complaints and to make any changes needed.
The service has gone through many changes with three different registered managers since August 2018. This had had a negative effect on people’s wellbeing and the management of the service. However, the newly appointed manager was liked by people living in the service, their relatives and staff. They told us they were open and made themselves available. It had been recognised that the staff had also had a difficult time and were receiving support, many of them had worked under all of the previous managers and had to get used to the many different management styles. There was still work that needed to be done, but work was underway to make improvements to the quality of the service people received.
There were various quality assurance systems in place, but we noted that a number of issues identified in the latest audit had also been identified in previous audits without action being taken. This was possibly due to the lack of management leadership; the last two registered managers had left after only three months and seven months respectively. The provider acknowledged our concerns and ensured us that they would be monitoring the service and would support the new manager as they settled into their post.
People where well protected from bullying, harassment and abuse by staff that were trained to recognise abusive situations and knew how to report any incidents they witnessed or suspected. Staff we spoke with during the inspection understood their responsibilities to raise concerns and there were arrangements in place in place for reviewing and investigating incidents when things went wrong.
Personal risks to people were fully assessed and steps had been put in place to keep people safe. Staffing levels were sufficient to keep people safe. People were protected by staff that had been safely recruited. The home was clean, and staff had access to equipment that protected them and the people they supported from cross infection.
People’s needs were assessed, and they received care in line with current legislation from staff that had the knowledge and skills they needed to carry out their roles.
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. Meaning people were asked for their consent by staff before supporting them in line with legislation and guidance.
Staff we spoke with talked about the people who used the service in a caring and positive way. People told us that staff were kind, caring and protected their privacy and dignity. We saw evidence in records that people were able to express their views and staff listened to what they said and took action to ensure their decisions were acted on.
The building was purpose built to accommodate older people with wide corridors, safe access and easily read signage to help people find their way about. The gardens were well maintained, and people told us they enjoyed walking in the gardens and helping to look after them.
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 comprehensive inspection for this service was on 6 November 2018 and the resulting rating was Requires Improvement. (Published December 2018) At this inspection there was a breach of regulation with regard to the management of medicines.
The provider completed an action plan after that inspection to show what they would do and by when to improve.
On 2 May 2019, after concerns were raised with us in regard to continued medicines errors, we undertook a focused inspection to review the Key Questions of safe and Well-led only. We also checked what action had been taken with regard to the breach of regulation in the management of medicines from the previous inspection.
No areas of concern were identified in the other Key Questions, we therefore did not inspect them. Ratings from the previous comprehensive inspection for those Key Questions were used in calculating the overall rating at that inspection.
During that inspection we found there was no longer a breach of regulation but that further improvements were still required. The rating remained as Requires Improvement. (Published May 2019)
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Oulton Park Care Centre on our website at www.cqc.org.uk.