The Oaks Residential Care Home

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

The key question of Caring has improved too Good. Staff treated people with kindness and respected their privacy and dignity. Improved access to activities, within the home and local community promoted people’s independence, health, and wellbeing. Where people chose to stay in their rooms, or were cared for in bed, time was allocated to ensure they received individualised activities in their rooms to reduce isolation and loneliness. People were supported to maintain relationships and networks important to them, including religious communities. Staff wellbeing had improved. Staff felt supported and valued by their leaders and colleagues. Staff were able to raise concerns, and felt their concerns would be listened too, and acted on. Further work was needed to ensure managers and staff acted quickly to identify where people maybe in discomfort or distress. Additional training was needed to ensure staff were able to effectively communicate with people where their ability to verbally communicate had diminished due to advancing dementia.

This service scored 70 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Relatives provided positive feedback about the improvements made in the service and the impact this had on the care their family members received. Comments included, “The staff are always busy making sure everyone is okay. Everything is done with a smile. They certainly seem to be more caring in that way. They are really, really kind it is lovely to be there,” and “When we walked out yesterday, we all said, that was a lovely visit. My (family member) is really happy there. They always have a big smile and speaks very highly of all the staff”. Relatives descried how their family members were treated with kindness, compassion and dignity in their day-to-day care and support. Comments included, “Staff always care about (family member), they are so well looked after, nothing is put on it is all genuine,” and “As a family we know that (family member) receives the same care whether we are there or not.” Relatives told us, people’s privacy and dignity was respected and upheld at all times. One relative commented, “My (family member) is in bed all the time now. Sometimes staff don’t know I am there, they always knock the door before coming in. That shows respect”.

Staff were able to tell us about people’s needs, including their preferences about how their care was provided. Comments included, “We take people’s opinions into account, listen to them, and give them time to talk. It’s important to inform people and explain to them what we are doing, we don’t treat them like they are nobody, you have to respect them. When completing personal care, we shut windows, doors, and we don’t barge in.”

Although staff were observed promoting people’s privacy and dignity, the service had no designated room for hairdressing to be done in privacy. We observed a person who was not happy about having their hair done in the lounge in front of others. Consideration had not been given to the impact on people using the lounge watching TV or listening to the radio, due to the noise of the hairdryer. This also posed an infection control issue where people were having their hair done in the same space where they ate meals and snacks. Staff knew the importance of respecting confidentiality of information and were reminded during, daily ‘Snapshot’ meetings to keep matters regarding the home confidential to respect the privacy and dignity of people using the service.

Relatives told us, people’s needs and preferences were understood, and this was reflected in the care and support their family members received. One relative commented, “(Family member) only ate certain foods for 2 years, before they moved to The Oaks, now they eat everything. I am always kept informed of what they are doing. I am quite happy with their care.” People were supported to maintain relationships and networks important to them, including religious communities. Relatives told us, their family members were given choices and encouraged to be included in the many social activities that take place. One relative commented, “Everyone is given the same care and attention and provided with the same opportunities whatever stage of their dementia they are at. No one is left out.”

Staff told us they were aware of people’s communication needs, Comments included, “Person has limited speech, but you can read their face as whether they are happy or not. I learn from them,” and “Some people are nonverbal, I observe the cues. People have communications plans, some have their own way of communicating, it’s all documented. It’s learning to know everybody and trying to meet everyone’s needs.”

Staff were observed to be kind and caring. They made time to listen to and support people to express their views about things that mattered to them, including conversations about their families, the environment, food, and activities. However, although we saw staff were respectful towards people, care and support was not always provided in dignified way. Staff told us they used nonverbal cues or facial expression to help understand people’s needs, however we observed they were not always able to effectively communicate with people to understand signs of distress and anxiety. For example, during our visit to the service on 11 March 2024 we observed a person seated alone in the corner of the café area who appeared to be uncomfortable in the chair they were sitting in. No action was taken to find alternative seating, or to establish the cause of their distress.

People’s care plans contained ‘basic information’ about their care needs. However, there were no specific plans in place to guide staff on how to support people living with dementia and or Alzheimer’s. Plans lacked information about the impact dementia had on people’s quality of life, or how their day was structured to provide purpose, meaning, and made well-being a priority which can often reduce agitation and improve mood. Further training was needed to ensure staff could effectively communicate with people where their ability to speak had diminished due to advancing dementia.

People were supported to maintain relationships and networks important to them, including family and friends. Relatives had access to the services social media page and were able to see daily updates with pictures of their family members taking part in various activities. Relatives commented, “No one is left out, there is always something for everyone,” and “Staff take (family member) to the café just down the road and they have been to the garden center. Staff do their best to integrate my (family member) with the community.”

A new activities member of staff had been employed whose passion for encouraging people to take part in activities shone through. They told us they were trying new activities with people, including singalong’s, baking cakes, exercises, gardening, and colouring. They told us their focus was to, “Provide activities for people based on their likes and strengths, which helped them to meet their potential.” Where people chose to stay in their rooms, or were cared for in bed, the activities member of staff had been allocated time daily to provide individualised activities in their rooms, including hand massages, playing their favourite music, and chatting.” One relative told us, “This made (family member) feel special and that they were not forgotten.”

We observed nice interactions between staff and people using the service. Staff treated people with respect and provided care and support in dignified way. Staff supported people to take part in activities and were attentive to their needs. Staff were observed making sure people's privacy and dignity was promoted and maintained. The service had a range of equipment, including hoists, assisted baths, and wet rooms to support and maximise people’s independence.

Records showed, interaction with the local community had improved, including visits, from the local pre-school, primary school, and church. The service had become a participant in activities run by the FaNs Network, including a Christmas party where people were able to engage with residents from other local care homes. Forthcoming activities were posted on the notice board in the entrance hall to the service. This included talks about dementia and inviting people to take part in a mad hatter’s tea party as part of raising awareness about nutrition and hydration. Resident meeting minutes reflected the improvements made to the provision of activities, including engagement with external charities promoting activities for older people’s wellbeing and to reduce loneliness. This had included, the Together Project with Crafty Connections, where people had been matched with a child and become pen pals, instead of sending letters, they send craft projects, and the children do the same.

Whilst well meaning, managers and staff on occasion had not responded to people’s immediate needs. They had not always responded quickly enough to establish the cause of people’s distress and anxiety or taken action to minimise signs of discomfort.

Whist immediate action was taken following the inspection to seek urgent attention to address a person’s discomfort and pain, due to potential pressure wound, senior managers acknowledged there were several delay’s to obtaining professional support. Senior managers advised they had learned from the experience and had instigated changes to pre-empt and avoid similar situations occurring in the future. They had completed a ‘lessons learned’ session with staff on how to escalate concerns if they do not get a satisfactory response from health professionals.

Staff lacked knowledge and experience on how to support people at times of distress and anxiety. For example, during our visit on 11 March 2024, we observed a person who refused food and fluids, and appeared to be uncomfortable in the chair they were sitting in. The senior carer showed us a body map indicating the beginnings of a pressure area on the person’s hip. Staff were observed trying to provide reassurance but were slow to assess if the person was in discomfort or pain due to a potential pressure wound, inappropriate seating, poor diet, and reluctance to take their medicines.

The registered manager told us improvements had been made to promote staff inclusion and wellbeing, which in turn had resulted in better outcomes for people. Staff told us they had better support, were able to raise concerns with senior managers and felt their concerns would be listened too and acted on. Staff felt valued by managers and their colleagues. Staff comments included, “The manager is always fair to me. They listen, and is easy to talk to, they understand where you are coming from,” and “The deputy knows we know what to do but is there to help if we need it. They are easy to talk to and work with, I feel they trust me, and they make me feel like I am somebody.”

Recruitment processes had improved. The providers equal opportunities policy had been followed ensuring all applicants had been considered based on their merit irrespective of their protected equality characteristics, resulting in a multi-cultural and diverse workforce. Support had been provided to overseas staff making the immigration process a smooth transition, including provision of temporary accommodation and financial assistance. The provider had recognised the importance of supporting staff wellbeing, including arrangements for working hours to be adjusted to meet family commitments.