Background to this inspection
Updated
10 September 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. 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 Care Act 2014.
Inspection team:
One inspector carried out this inspection.
Service and service type:
Oaklands 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 inspection was unannounced.
What we did before the inspection:
We reviewed information we had received about the service since the last inspection. We received feedback from the local authorities who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.
During the inspection:
We spoke with two people who use the service about their experience of the care provided. We observed interactions between staff and people who used the service. We spoke with three staff members, the registered manager and a visiting health care professional.
We reviewed a range of records. This included two people’s care records which included all aspects of care and risk. We looked at two staff files in relation to recruitment, training and staff supervision. A variety of records relating to the management of the service, including audits, policies and procedures were reviewed.
After the inspection:
The registered manager sent us further evidence in relation to training, staff supervision and quality assurance records.
Updated
10 September 2019
About the service:
Oaklands is a service which provided personal care to five people living with a learning disability or autism at the time of the inspection. People have their own bedrooms and share communal areas such as the lounge, the kitchen and adapted bathrooms. The service can support up to seven people.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found:
The registered manager and provider audits were not always effective at identifying improvements to the service. On some occasion’s potential risks to people’s health and safety were not identified. The provider had not learned lessons from previous experiences or used these lessons to continually improve the service.
Staff recruitment checks were not always completed thoroughly to ensure that staff members were safe to work at the service.
People were not always supported to have maximum choice and control of their lives and systems in place at the service did not always support this practice. This was evident in areas such as finances and agreements to use shared vehicles. Staff supported people in the least restrictive way possible and in their best interests in other areas.
The service needed some re-decoration to make it more accessible for people to use. The service would also benefit from a deep clean in some areas. The registered manager showed us that there were plans to complete this.
People were positive about their care. One person said, ‘‘Oaklands is a lovely place and is definitely my home for life. I love it here.’’
The service didn't apply the full range of the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people did not fully reflect the principles and values of Registering the Right Support as people's consent was not always sought in their best interests.
People were supported with kindness respect and compassion. Staff were passionate about treating people as individuals and knowing what was important to them. People were able to make choices about their care and were supported to do this in their preferred communication method.
People were supported to access the community and take part in activities of their choosing. People told us that these activities were important to them and that they promoted their independence.
People were supported safely with their medicines. People had assessments in place to protect them from known risks. There were enough staff at the service to support people safely. Staff members were knowledgeable and received effective training and supervision to perform their job roles.
People were positive about the food and drink at the service and were actively encouraged to take part in food preparation. People had choices of food and drink and when they wanted to eat. People were supported to visit health care professionals when this support was needed.
People had access to a complaints policy and procedure. People had been supported to put plans in place for the end of their life if they had chosen to do so.
The registered manager and staff team promoted person centred care and empowered people living at the service. People and the staff team were encouraged to make decisions and feedback about the service. The registered manager and staff team worked with other organisations to ensure good outcomes for people.
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 the service was Good (published 15 February 2017).
Why we inspected:
This was a planned inspection based on the previous rating. We have found evidence that the provider needs to make improvements. Please see the Safe, Effective 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 a breach in relation to good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
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.