The Care Quality Commission (CQC) has dropped the rating for The Oaks Care Home from requires improvement to inadequate and placed the home into special measures to protect people, following an inspection in September and October. CQC has also issued the home with two warning notices to focus their attention on making specific changes to improve people’s safety and the management of the home.
The Oaks Care Home, run by Aurem Care (The Oaks) Limited, provides personal and nursing care for up to 61 people who may have a physical disability, be living with dementia, or who require end-of-life care. At the time of inspection, 53 people were living in the home.
This inspection was prompted in part by concerns people shared with CQC about safeguarding and leadership in the home.
CQC has dropped the home’s overall rating from requires improvement to inadequate, as well as for safe and well-led. The ratings for caring and responsive have also been dropped from good to requires improvement. This inspection didn’t assess how effective the service was, so this remains rated as good from a previous inspection.
CQC has also placed the home into special measures, meaning it will be kept under review and closely monitored to ensure people are kept safe whilst improvements are made.
Hazel Roberts, CQC deputy director of operations in the east of England, said:
“When we inspected The Oaks Care Home, we were concerned to find inconsistent leadership had left the home unable to meet people’s needs in a safe and dignified way, particularly on the home’s dementia unit. Leaders also failed to identify and respond to risks to people’s safety.
“There weren’t enough staff, and some people and their relatives said they often waited up to 30 minutes for support, and didn’t believe staff would always respond quickly if they were in pain or distress. One person said they only got a shower every couple of months because there weren’t enough staff to support them, and another person’s relative said they had to push staff to help their loved one shower.
“The home also only had three mobility chairs for eight people. This meant people couldn’t always leave their rooms when they wanted, restricting their independence. Staff tried to solve this by taking people to activities in their beds, but this approach compromised their privacy and dignity.
“People also didn’t always feel safe in the home. One person told us they were frightened of some staff who were rough with them, while others reported safeguarding concerns, including unexplained bruises and injuries. Leaders hadn’t investigated or reported these issues to CQC or to the local authority.
“We also saw leaders didn’t always listen to the concerns of people living in the service, their relatives, or their staff to keep people safe.
“This standard of care is not acceptable. This is people’s home, and they deserve the same dignity and safety many of us take for granted.
“We’ve shared our findings with the management, who have begun assembling a new leadership team. We’ll be monitoring the home closely, including through further inspections, to ensure people are safe. We’ve also issued two warning notices to focus leaders’ attention on making immediate improvements to the home’s safety and management.”
Inspectors also found:
- People didn’t always feel their complaints were listened to. One person said staff had ignored them or treated them like a child, but leaders hadn’t responded to complaints raised for them by their children
- 17 people’s bedrooms on the home’s dementia unit had door gates fitted, but many people were missing information in their care records about their mental capacity. This meant they could be unlawfully deprived of their liberty
- Staff knew the people they cared for well, but didn’t always have time to support people in a person-centred way. Inspectors saw some staff spent little time engaging positively with people
- Some people’s risk assessments weren’t always up to date or followed by staff. People or their representatives weren’t always involved in managing these risks
- Chemicals had been stored in an unlocked kitchen cupboard, which could have serious consequences if swallowed. Staff immediately fitted a lock to this cupboard when inspectors raised this
- Leaders were not always alert to inequalities that could disadvantage different groups using their service. People outside the dementia unit were able to use communal spaces to socialise and attend activities, but communal spaces on the dementia unit were not always accessible and most people stayed in their rooms
- The service had lacked continuous leadership for a long time, impacting people’s care and staff morale. Inspectors were told during this inspection of recent changes to the senior team, including plans to recruit a new manager.
The report will be published on CQC’s website in the coming days.