Oak Cottage

Updated 17 February 2024

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Oak Cottage is a 'care home'. People in care homes receive accommodation and personal care as a single package under one contractual agreement dependent on their registration with us. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Inspection team

The inspection team consisted of 1 inspector.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 5 people who used the service. We spoke with 8 staff members including, the registered manager, care manager, deputy manager, representative of the provider the chef and care staff.

We looked at 3 people's care records, including risk assessments and medicines records. We also looked at quality audits, policies, training records and staff recruitment files.

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.

Updated 17 February 2024

Oak Cottage is a residential care home providing accommodation for up to 25 people who require personal care. The service provides support to older people living with dementia and mental health support needs. At the time of our inspection there were 17 people using the service of which 10 people received personal care.

People's experience of the service and what we found:

People were not always protected from the risk of abuse. Incidents were identified and reported, but not investigated or reported to the local authority. There was not always evidence of learning following incidents. However, people told us they felt safe.

People said staff were not always deployed appropriately to support them when needed. Medicines management required improving to ensure people received their medicines. Risks were not always fully assessed and documented. Improvements were needed to some infection controls practices and maintenance of the property in the service.

People's health needs were not always fully planned for, so staff did not always have detailed guidance. Staff told us they received training, however we found key gaps in their training records. Some areas of the service needed refurbishing to meet the needs of people living there.

Feedback about the food provided to people was mixed. The chef did not have the required training to support people’s specific dietary needs. Weights had not been monitored as required, and fresh fruit and snacks were not always available.

People were not supported to have maximum choice and control of their lives. Staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Although we did see staff asking people consent before supporting them.

Quality assurance systems in place were not effective at monitoring the quality and safety of people's care. Notifications were not always submitted as required. People did not feel the management team were visible or responsive to them.

People were able to access healthcare professionals as needed and staff knew people’s support needs well. Staff were seen to be caring and attentive in their approach and had formed positive, friendly relationships with people. Staff felt they worked well as a team and felt supported by the management team. The registered manager was open to feedback and eager to make improvements through the inspection.

Rating at last inspection and update

The last rating for this service was requires improvement [published 11 April 2019] and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

The last rating for this service was requires improvement (published 11 April 2019). This service has been rated requires improvement on 4 out of 5 previous inspections since 04 February 2015.

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe, effective and well-led which contained those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Oak Cottage on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to staffing, consent, safe care and treatment, staff support and governance arrangements at this inspection.

Follow Up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.