Archived: The Oaks Care Home

Updated 17 October 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

On 16 July 2019 an inspector and an Expert by Experience visited the service. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. On 17, 22 and 23 July 2019 two inspectors completed the inspection.

Service and service type

The Oaks Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This was an unannounced inspection.

What we did before the inspection

Our inspection was informed by evidence we already held about the service. We had received information of concern about staffing levels and the environment. We also checked for feedback we received from members of the public and the local authority. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During inspection

We spoke with four people who used the service and five relatives. We spoke with the six care staff, the chef, the deputy manager, the registered manager, the provider. We spoke with a representative from the care consultancy the provider had hired since 19 July 2019. We looked at aspects of five peoples care records, along with 11 people’s medicine records, handover information, audits of records and complaints. We also spoke with a fire officer, safeguarding officers from the local authority, commissioner and quality leads from the local authority and a social worker.

After the inspection.

We shared out concerns with the safeguarding officer at the local authority and commissioner and quality leads from the local authority.

Updated 17 October 2019

About the service

The Oaks Care Home is service that provides accommodation, nursing and personal care for up to 16 people. At the time of our inspection, 13 older people were living in the home, some of whom may have a physical disability and/or dementia.

The Oaks Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home is in one adapted building over two floors.

Why we inspected

This was a scheduled inspection. We had also received concerns from members of the public regarding staffing levels and the environment which we took into account.

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

People did not feel safe from abuse. Staff did not recognise different types of abuse or how to report it. The registered manager and provider did not recognise abuse and how to report this. We raised safeguarding concerns to the local authority from what people had told us and records of incidents we had read. Risks to people’s safety were not always monitored or reviewed. People told us that their care needs were not met in a timely way. People’s medicines were not always managed and stored in a safe way. People were not protected from the risk of cross infection.

People’s care was not always robustly assessed and reviewed to ensure it was up to date and in line with best practice. People were not supported by staff who had the skills and knowledge to do so. People who needed support to eat were malnutrition as records did not clearly demonstrate that people had sufficient to eat and drink. People were not supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

Staff did not treat people in a kind and caring way and their dignity was not maintained. The staff group did not always treat people as individuals and respected the choices they made. People did not always receive care and support in a person- centred way.

People’s care was not always delivered in a timely way, people experienced consistent delays in receiving personal care. The provider could not be assured the staff group had sufficient knowledge and skills to support people with their care needs including end of life care. People were not supported to maintain their hobbies and interests. Complaints were not fully addressed to ensure satisfactory outcomes were made.

There were significant and widespread shortfalls in the way the service was led. The provider and registered manager did not lead by example. People, relatives and staff were not involved in the running of the service, the provider did not have a good line of communication and was not transparent to those involved in the service. The audits the provider had in place were futile and did not escalate shortfalls to improve practice.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches in relation to safe care and treatment and governance of the service at this inspection. Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the 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.