Great Oaks

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. This is the first assessment for this service under the new provider. This key question has been rated good. This meant people were safe and protected from avoidable harm. Lessons were learnt from events within the service. Safeguarding procedures were in place. There were sufficient numbers of staff on duty and recruitment checks were completed. People had risk assessments in place for all of their care and support. Environmental and equipment safety checks were carried out. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act 2005 (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA, whether appropriate legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. People and their relatives told us staff helped them to overcome certain difficulties, such as frequent falls. Staff told us they identified themes and trends through events that occurred in the service. The provider had oversight of accidents, incidents and events, these were reviewed within the service daily, weekly and monthly. In addition, the provider shared learning throughout all their locations. Accidents and incidents had been followed up, the necessary referrals made and where necessary medical advice was sought.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. People and their relatives told us communications had improved in recent months and were assured they would have access to the necessary external professionals. Staff told us working relationships with professionals were effective. A health and social care professional told us, “I have on numerous occasions, required various follow up and [names of staff] have been exceptional in finding a solution for a positive outcome.” Records held on the provider’s electronic system were accessible if a person needed to transition to another service such as, hospital or another care service. Summary care plans, risks and medical conditions were available from the electronic system and records confirmed this.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. Feedback received during the assessment told us people were safe living at Great Oaks. Staff knew how to recognise and raise concerns; they told us concerns were followed up. Confidence in the systems was improving. All legal applications had been made in accordance with DoLS, this meant people’s rights were fully respected. The manager had oversight of DoLS applications, authorisations, and conditions and used a tracker process to ensure all documentation was in date.

The service worked with people to understand and manage risks by thinking holistically. They provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Risks for people had been identified, assessed and ways of working meant risks were reduced. Risk assessments were detailed on the providers electronic care planning system. The system was newly implemented and therefore information was in the process of being transferred, we were assured the information was accessible to staff and people during the process.

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. People and their relatives told us they felt the environment was safe and well maintained. People were happy to have their person belongings with them in their bedrooms. Risk assessments for the environment were in place and equipment was well maintained. The service was fully accessible, and people could move around safely. There was a dedicated staff member who ensured all assessments were completed and checks maintained, this included those by qualified, external professionals. All required safety checks had been carried out and actions addressed. This included fire safety, water safety and other utility checks.

The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. People told us staff were there when they needed them. People and their relatives told us there were sufficient numbers of suitably trained staff to meet people’s needs . Staff received training and support to ensure they could carry out their role, records confirmed staff training had taken place. Staff told us they felt fully supported by the management team. Formal supervisions were carried out and the manager told us they could access support at any time. Observations throughout the assessment showed staff to be busy but attending to people in a timely manner. Staffing numbers had been calculated to meet people’s needs; this helped the manager understand how many staff were needed to provide safe care. Each person had their dependency assessed to calculate the safe number of staff required to meet their needs. Procedures were in place to ensure the required checks were carried out on staff before they commenced their employment. This included enhanced Disclosure and Barring Service (DBS) checks for adults. DBS checks provide information including details about convictions and cautions held on the police national computer. The information helps employers make safer recruitment decisions. Overall staff were recruited safely, and recruitment checks were in place. However, the provider was working on recruitment processes within the ongoing improvements.

The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. People and their relatives told us the home was clean and tidy, this included people’s own bedrooms. Communal areas had been refurbished and were easier to keep clean. Dedicated housekeeping staff ensured the home was clean. We observed the home to be clean and hygienic. Personal protective equipment (PPE) was worn appropriately by staff. Safe infection prevention and control procedures were in place and were supported by a clear policy. Infection control procedures and audits were in line with good practice guidance and had the oversight of the provider. Staff had plentiful supplies of cleaning materials, products, and PPE.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened. People received their medicines safely as prescribed for them. Staff were knowledgeable about people and their medicines, and people’s preferences were taken into account. Guidance for the safe use of flammable creams were being introduced in the provider’s electronic care planning system. When medicines were prescribed to be taken ‘as required’ there was personalised information in place to guide staff when these might be needed. When people were prescribed medicines in the form of patches, then removal of previous patches, and sites of application and rotation were recorded. Some actions had been identified from medicines audits and plans were in place to develop recordings. Medicines were stored safely and there were appropriate arrangements for disposal, and for controlled drugs. There was suitable temperature monitoring being carried out. Staff had training and competency checks to make sure they gave medicines safely.