Oaklea

Oaklea is a residential care home providing accommodation and personal care to up to 5 people. The service provides support to people with a learning disability and autistic people. At the time of our inspection there were 4 people using the service.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence, and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance the Care Quality Commission (CQC) follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Based on our inspection of key areas safe and well-led, we found:

Right Support:

The service gave people care and support in a safe, clean environment which was equipped, furnished and maintained to meet their sensory and physical needs. 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.

Right Care:

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded promptly to their individual needs. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

Right Culture:

People received good quality care, support and treatment because staff were trained to meet their needs and wishes. Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing and achieving good outcomes.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection

The last rating for this service was good (published 2 October 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Oaklea provides accommodation and personal care for up to five people living with autistic spectrum disorder and/ or other mental health needs. People in care homes receive accommodation and their care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided and both were looked at during this inspection. At the time of our inspection there were five people living in the care home.

At the time of the inspection, staff were providing a personal care service to one person who was living in their own home. When people live in their own home, CQC do not regulate the premises within which they live, only the ‘personal care’ being provided.

The service has been developed and adapted in line with values that underpin the Registering the Right Support and other best guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can lead as ordinary life as any citizen.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.

At our last inspection in September 2015, we rated the service good. At this inspection we found the evidence continued to support the rating of good. There was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. However, some elements of the service were outstanding.

People experienced outstanding care that was extremely flexible and responsive to their individual needs and preferences, from a dedicated staff team who consistently went above and beyond what was expected of them. The personalised care provided achieved exceptional outcomes for people, enriching the quality of their lives and improving their physical and mental wellbeing.

People were fully involved in planning their care and led active, fulfilling lives, supported by staff who were totally committed to promoting their independence.

Feedback provided by people, their families and professionals, consistently highlighted staff had an excellent understanding of individual’s social and cultural diversity, their values and beliefs, and how they wanted to receive their care and support.

Staff had taken innovative steps to meet people’s information and communication needs, which ensured they complied with the Accessible Information Standard. Staff went the extra mile to address people’s needs in relation to their protected equality characteristics.

The registered manager and provider consistently used the learning from complaints, concerns and reviews as an opportunity for improvement.

Staff tactfully supported people and their families to explore and record their wishes about their preferred care options at the end of their life.

People were protected from avoidable harm, neglect, abuse and discrimination by staff who understood their responsibilities to safeguard people. Risks to people were assessed and plans were devised to minimise potential risks, whilst promoting people’s independence. Medicines were administered safely. Prospective staff underwent relevant pre-employment checks to ensure they were suitable to work with the people who lived with autism or a learning disability. There were always sufficient suitable staff with the right experience and skills mix, to provide care and support to meet people’s needs.

Staff were enabled by the provider to develop and maintain the necessary skills to meet people’s needs. The registered manager and staff understood their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Where people were subject to restrictions to reassure and keep them safe, these were minimised to promote their freedom and the least restrictive option(s) possible.

The registered manager had developed effective partnerships with relevant professionals and quickly referred people to external services when required to maintain their health. High standards of cleanliness and hygiene were maintained in the home, which reduced the risk of infection. People and staff followed required standards of food safety and hygiene, when preparing or handling food. People were supported to eat a healthy, balanced diet and had access to the food and drink of their choice, when they wanted it.

People’s needs were assessed regularly, reviewed and updated. People had detailed care plans which were enhanced by positive behaviour and communication support plans.

People experienced good continuity and consistency of care from regular staff who were kind and caring. There was a positive atmosphere within the home, where people were relaxed and reassured by the presence of staff.

Staff demonstrated empathy for and spoke passionately about people and their achievements, which demonstrated how they valued them as individuals. Staff consistently treated people with dignity and respect.

People were supported to take part in activities that they enjoyed. Staff supported people to maintain relationships with their families and those that mattered to them, and to develop new friendships, which protected them from the risk of social isolation.

The service was well led by the registered manager, who consistently inspired staff to deliver high quality care. The provider's values were understood by all staff, which they demonstrated when supporting people. The quality of the support people received was effectively monitored and identified shortfalls were acted on to drive continuous improvement of the service.

Further information is in the detailed findings below.

We looked at three people's care records and observed care received. People were involved in writing their care plans and were involved in making decisions concerning their care. We saw people were supported with their capacity and decisions were made in their best interest by appropriate people.

We found people's needs were assessed and their care plan contained activities to meet their identified needs. Where necessary risk assessments were in place to enable activities to occur safely for people.

We found the environment was well maintained and was suitable to provide accommodation for the five people. There were sufficient systems in place to ensure the safety of the building was maintained.

We spoke with two staff and found they received regular supervisions and training which enabled them to carry out their role effectively. One member of staff said: "I feel I am really well supported by my manager and know that I don't have to wait for my supervision if I need to talk to them about the guys."

We spoke with the provider and the manager about how they monitored the quality of the service. They shared a recent quality audit they had carried out and showed us an action plan from this. The manager said: "Quality checks were important as it made us look at ways in which we could improve the service."

People told us that they received care from staff who were 'fantastic and excellent'. They commented the staff were courteous and respectful. Another person told us that the staff were 'best you could find 'and they were supported' to do the things that we want'. People were supported to be part of the local community and undertook community based activities including attending college and work.

Staff were friendly, respectful and courteous when speaking with people. The care plans were detailed and reflected people's needs and staff said this was helpful in informing their practices. People were supported and involved in planning the home's menu. They were offered a varied diet and balanced meals that they said met their needs.

Appropriate arrangements were in place for the management of people's medicines. People had access to healthcare professionals and treatment as needed. There was a recruitment process that was followed. Information was available in an appropriate format on how to raise concerns.