Archived: Oaklands

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.

At the last inspection, the service was rated Good.

The inspection was undertaken as part of our routine re-inspection programme, to review the rating from the first comprehensive inspection completed on 19 November 2014.

At this inspection we found the service remained Good.

People felt safe in the service and were relaxed in the presence of staff which enabled them to enjoy a good quality of life. Safeguarding procedures had been followed and appropriate action was taken to keep people safe, minimising any risks to their health and safety. Medicines were managed safely and the processes in place ensured that the administration and handling of medicines was suitable

People were cared for by staff that were supported to undertake training to improve their knowledge and advance their skills to enable them to perform their roles and responsibilities. People were 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. Where appropriate people living at the service had their freedom lawfully restricted under a Deprivation of Liberty Safeguard (DoLS) authorisation. People had their healthcare needs identified and were able to access healthcare professionals, such as their GP and dentist.

People were at the centre of their care and staff acknowledged them as individuals. People told us that staff were kind and caring and were always treated with dignity and respect. People were supported to make decisions about their care and treatment and maintain their independence.

People were encouraged to take part in activities and interests of their choice. They had access to information in an easy read format about how to make a complaint. Relatives could approach staff with concerns and knew how to make a formal complaint to the provider.

The registered provider had robust systems in place to monitor the quality of the service and make improvements. People, their relatives and staff found the registered manager approachable. We found that the service had good leadership and that staff were positive in their desire to provide good quality care for people.

Further information is in the detailed findings below.

We visited Oaklands on 31 December 2013, and spoke with staff about how they monitored people's dietary intake and ensured that they received adequate nutrition. Although we were not able to speak with people, as they were out of the home participating in activities, we saw from service user meeting records, that people were happy with the food choices they were given.

We found there was a sufficient variety of food within the home for people, and noted they were given a choice of food and drink. We were told by the manager that staff were conscious of the importance of monitoring people's nutritional status and had received guidance from the dieticians as to nutritional enhancement. We were also informed that a recent budgetary increase had helped to purchase additional food items that would benefit people with specific dietary requirements. We therefore found no evidence to substantiate the concerns.

We observed that people were offered support at a level which encouraged independence and ensured their individual needs were met. There was a very calm and homely atmosphere and people appeared relaxed in the company of the staff supporting them. We found staff were friendly, polite and respectful in their approach to people and interacted appropriately with them. One person said, 'I'm happy here.' Another told us, 'Staff are really kind and help me to be independent.'

We reviewed four care records and found that people were referred to other professionals for treatment when required. This meant their health and well-being needs were appropriately met.

We found medicines were stored and disposed of safely. People told us they were given medicines on time and we observed that specific medication guidelines for individuals were followed.

Staff received regular training that enabled them to provide appropriate care and support to people. We were told that, 'The training offered by the company is great, there is so much on offer.'

We found that records were updated on a regular basis and stored safely, in a locked room so as to protect people's confidentiality.