Oldfield House

Oldfield House is a residential care home providing accommodation and personal care for up to 34 people. At the time of the inspection there were 24 people living at the home. Some people were living with dementia.

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

The provider had a system in place to protect people from the risk of abuse. Staff knew how to recognise and report abuse and were confident appropriate action was taken to keep people safe. Risks associated with people’s care had been identified and managed safely. People received their medicines as prescribed. Maintenance and building checks were carried out in line with current guidance and requirements.

The home was clean, and staff were following infection control guidance. Accidents and incidents were analysed, and action was taken to mitigate future risk.

The providers recruitment system ensured staff were safely employed. However, we noted documentation could be improved. We observed staff interacting with people and found there were sufficient staff available to support people. However, sometimes staff required direction to ensure they were deployed effectively.

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.

People were supported by staff who knew them well. Staff were kind, caring and considerate. Signage was in place to help people navigate around the home. There was a lack of social activities for people to engage in. The provider was in the process of recruiting to the post of well-being lead, whose role will be to ensure people have access to social stimulation.

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 4 March 2020).

Why we inspected

We received concerns in relation to leadership, person centred care and risks associated with people’s care. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good based on the findings of this inspection.

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.

We have found evidence that the provider needs to make some improvements. Please see the well led section of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for ‘Oldfield House’ 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.

Oldfield House is a residential care home providing accommodation and personal care for up to 34 people. At the time of the inspection there were 30 people living at the home. The home supports people who require care and support due to their health needs, including people living with dementia.

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

People were safe and protected from abuse and avoidable harm. Risk assessments helped protect the health and welfare of people. People received their medicines when they needed them from staff who had been trained and had their competency regularly checked. The service was providing safe and consistent staffing levels. Infection control was well managed and the home was clean and free from odours.

Staff were well trained and supported for their role so that they could meet people's assessed needs. People's rights were protected by a staff team which understood their responsibilities under the Mental Capacity Act. People were supported to have maximum choice and control of their lives and staff supported support them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.People told us they enjoyed meal times and were offered a variety of good quality meals. People's health and nutritional needs were met. The home worked effectively with external healthcare professionals.

People told us they were supported by staff who were kind and caring. People's dignity was maintained, and their privacy was respected. The provider ensured people's equality characteristics were met. People were supported to make their own decisions and independence.

The provider ensured people received a service that was responsive to their needs. People were supported to maintain and develop relationships and participate in activities that were relevant to them. People were encouraged to explore their end of life preferences. Care planning was personalised, and complaints were dealt with appropriately.

People, and their relatives where applicable, were encouraged to participate in meetings and/or complete surveys to express their opinions about the quality of the service. The provider had clear systems in place to monitor and audit the quality of people's care and support, and take corrective actions to respond to any deficits they found.

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 13 February 2016). There was also an inspection on 30 January 2018 however, the report following that inspection was withdrawn as there was an issue with some of the information that we gathered.

Why we inspected

This is a planned re-inspection because of the issue highlighted above.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.

The service has a registered manager who has been registered with the Care Quality Commission since September 2013. A registered manager is a person who has registered with the Care Quality Commission 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 2008 and associated Regulations about how the service is run.

Oldfield House is a care home situated in Stainforth, Doncaster which is registered to accommodate up to 33 people. The service is provided by Runwood Homes Limited. At the time of the inspection the home was providing residential care for 19 people, some of whom had been diagnosed with dementia. The service has several communal and dining areas and easily accessible secure gardens. The home is close to local amenities of shops and healthcare facilities.

CQC is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS), and to report on what we find. The members of the management team and nurses we spoke with had a full and up to date understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). These safeguards protect the rights of adults by ensuring that if there are restrictions on their freedom and liberty these are assessed by appropriately trained professionals. We found that appropriate DoLS applications had been made, and staff were acting in accordance with DoLS authorisations.

People’s physical health was monitored as required. This included the monitoring of people’s health conditions and symptoms so appropriate referrals to health professionals could be made. For example we saw evidence that they home regularly makes contact with district nurses, community nurses for mental health issues, and peoples own doctors. Other health professionals such as dieticians, dentists, occupational therapists and opticians were also requested as needed.

There were sufficient staff with the right skills and competencies to meet the assessed needs of people living in the home. Staff told us they felt supported by the registered manager and provider however, formal supervisions and appraisals were still being transferred onto Runwood Homes Limited’s documentation.

Staff were aware of people’s nutritional needs and made sure they supported people to have a healthy diet, with choices of a good variety of food and drink. People we spoke with told us they enjoyed the meals and there was always something on the menu they liked. We observed people being offered a second helping during breakfast and lunch. Snacks of fruit and biscuits and drinks were also available for people to help themselves

People were able to access some activities. There was an activity co-ordinator who worked two days a week at the home and we saw people enjoying being pampered in the morning and two people help to arrange fresh flowers for the dining area in the afternoon of the visit. A café area had been introduced and we saw this area was well used by people who used the service. There was a strong and visible person centred culture in the service (person centred means that care is tailored to meet the needs and aspirations of each individual).

We found the service had a friendly relaxed atmosphere which felt homely. Staff approached people in a kind and caring way which encouraged people to express how and when they needed support. Everyone we spoke with told us that they felt that the staff knew them and their likes and dislikes.

Staff told us they felt supported and they could raise any concerns with the registered manager and felt that they were listened to. People told us they were aware of the complaints procedure and said staff would assist them if they needed to use it. We noted from the records that no formal complaints had been received since the transfer of services in September 2014.

Staff knew how to recognise and respond to abuse correctly. They had a clear understanding of the homes procedures in place to safeguard vulnerable people from abuse. Medicines were stored and administered safely. We saw staff administering medication to people safely

There were systems in place to monitor and improve the quality of the service provided. However, we were unable to see how effective they were embedded as audits were relatively new following their registration in September 2015. We saw copies of reports produced by the registered manager and the provider. The reports included any actions required and these were checked each month to determine progress. The regional care director shared an action plan with us that the registered manager was working towards. The action plan related to objectives set by Runwood Homes Limited