Archived: Oaklands

Updated 5 July 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This unannounced inspection took place on the 25 and 26 May 2016. On day one the inspection team comprised of two inspector's. On the second day the inspection team comprised of an inspector, an expert by experience and a specialist advisor. An expert by experience is someone who has experience of caring for someone who uses this type of care service. A specialist advisor is a health care professional with qualifications and experience related to the needs of the people the service supports.

We looked at the information we already had about the provider. Providers are required to notify the Care Quality Commission about specific events and incidents that occur including serious injuries to people receiving care. We refer to these as notifications. The provider had completed a Provider Information Return (PIR) and returned this to us within the timescale requested. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information from notifications and the PIR to plan the areas we wanted to focus our inspection on. We contacted the local authority who commission services from the provider for their views of the service.

We spoke with eight people who lived at the home. We met all the other people who lived at the home. Some people living at the home were unable to communicate verbally due to their health conditions. We spent time in communal areas to determine how care was delivered and we used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with the registered manager, and individually with four members of staff. We spoke with five relatives. We looked at records including parts of six care plans and medication administration records. We looked at three staff files including a review of the provider’s recruitment process. We sampled records from training plans, incident and accident reports and quality assurance records to see how the provider monitored the quality of the service.

Updated 5 July 2016

This unannounced inspection took place on the 25 and 26 May 2016. The service was last inspected in April 2015, when we identified it was not meeting three regulations. At that time people could not be confident that their complaints would be identified and responded to, that there would be adequate numbers of staff available to meet their needs, or that the systems in place to monitor the safety and quality of the service were effective. At this inspection we found that work had been undertaken to address these issues. People could now be certain their complaints would be listened to and acted upon. Further work was required to improve staffing and monitoring of the service.

Oaklands provides accommodation for a maximum of 46 older adults who have nursing care needs and who may be living with dementia. There were 22 people living at the home at the time of the inspection and one of these people was in hospital. The home was divided into two units, but people were free to use all parts of the home.

The service has a registered manager who was present throughout the inspection. 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.

There were not enough staff available to meet people's requests for support in a timely manner. We had identified this at our last inspection, and the registered provider's action plan had not been effective at improving this situation.

People told us they felt safe living at the service. Staff were aware of how to recognise possible signs of abuse and the need to report any concerns.

Whilst most medicines were given safely we found that there were some improvements needed to the application and recording of topical medicines, such as creams. There were systems in place to monitor medication administration.

The staff had been provided with training about the Mental Capacity Act (2005) but could not explain how they put this into practice when supporting the people living at the service. Staff received basic training to ensure they were aware about safe care and some of the people’s individual needs.

Most people had their healthcare needs met and received support to maintain their nutritional and hydration needs. During our inspection we observed individual staff treating people with dignity and respect, however failing to provide people with meaningful occupation, company and autonomy showed that people were not consistently treated with respect.

People and their relatives gave us mixed feedback about the care provided. Everyone told us that staff were kind and caring and knew people well, however people told us the number of staff was not always adequate to meet people's needs well. Staff that we spoke with were enthusiastic about their role and could describe how people preferred to be supported.

There were very limited opportunities for people to join in with activities they liked, and which reduced the risk of them becoming socially isolated. People and their relatives all told us this was an area that needed improvement.

The service had ensured people maintained relationships with those who were important to them.

People living at the home and their relatives were aware of how to raise concerns and were confident that any concerns raised would be dealt with in a timely manner.

People, relatives, staff and health professionals were happy with how the service was managed. The registered manager had improved the quality monitoring of the service although this had not been entirely effective, and further work was needed.

You can see what action we told the provider to take at the back of the report.