We inspected Oakwood Care Centre on 9, 10, 11 January 2017 and our visit was unannounced on day one.
This was the service’s first inspection since their registration as a new provider with the commission on 30 September 2015.
Oakwood Care Centre is situated in the Stalybridge area of Tameside. The home provides care, support and accommodation for up to 18 people who require personal care without nursing.
The home is a two storey detached building providing bedrooms, a lounge and small attached dining area on each floor. Communal bathrooms and toilet facilities are available throughout the home. The kitchen is at the rear of the building. The home has a separate laundry area and boiler room located in the cellar.
At the time of our inspection there were 15 people living at Oakwood Care Centre.
The service did not have a manager in place who was registered with CQC. A home 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. The service had a newly appointed home manager who had been in post for four days at the time of our inspection.
We identified multiple breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full report. Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.
We made one recommendation around making the home’s interior decoration more conducive to people living with dementia.
People were supported by staff who were kind and caring. People and their relatives told us they felt people living at the home were well cared for.
Care plans were in place and included information around people’s history, likes and dislikes. However, we found that people, or their representatives, were not regularly involved in deciding or reviewing how their care needs would be met.
We found some people’s documentation to consent to care and treatment had been signed by staff or relatives, who did not have the legal right to provide this consent.
We looked at the safe management and administration of medicines and found medication was not stored correctly and we found minor discrepancies and omissions in medication administration. However, no-one was placed at risk of harm.
Documentation at the home showed us that people received appropriate input from health care professionals, such as district nursing and their general practitioner (GP), to ensure they received the care and support they needed.
One staff member we spoke with understood how to safeguard people and was able to demonstrate their knowledge around safeguarding procedures and how to inform the relevant authorities if they suspected anyone was at risk from harm. However, another staff member we spoke with had not received training and could not demonstrate an understanding of safeguarding adults and the legal safeguards around people’s mental capacity and Deprivation of Liberty Safeguards (DoLS).
During our initial tour of Oakwood Care Centre on the first morning of our inspection, we noted that some areas of the home required cosmetic refurbishment and we identified issues with cleanliness and infection control in a number of areas of the building.
We found that people could not easily call for assistance; a number of call bells in people’s bedrooms were not working and call bells in communal areas were not easily accessible. Therefore, people were not always able to call for assistance when required.
Safety and maintenance checks for building and equipment safety were not in place and we found some necessary safety checks, such as electrical testing and checks for Legionella, were not up to date and placed people at risk. In addition, we found concerns around the fire safety of the building and requested immediate action be taken to ensure the safety of people living at the home. The provider informed us that these had been rectified subsequent to the inspection.
We found that safe recruitment practices were not in place. The provider had not been assured that staff employed at the home had the necessary checks, including police checks, in place to ensure only suitable staff had been employed to work with people who may be vulnerable.
Many staff did not have up-to-date training in place. Several staff were caring for people at the home and had not had any training since commencement of their employment.
We requested that staff, who did not have the required safety checks and training in place, did not care for people unsupervised until the provider could be assured that staff were safe to provide care and support to people living at the home.
Due to our findings on the first day of our inspection, we reported our initial findings to the local authority commissioning team and the provider invoked a temporary, voluntary suspension on new admissions to the home until the issues we had identified had been resolved.
The overall rating for this service is Inadequate and the service is therefore in ‘special measures’.
Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.
The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.
If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.
This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.
For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.