This unannounced inspection took place on 22 December 2014.
Oakdene Residential Home provides accommodation and care for up to 19 people who are over the age of 65 and may live with dementia. The home is a large converted property and accommodation is provided over three floors. A stair lift is in place to assist people to move between the first two floors. The third floor provides more independent accommodation for one person who is able to access this area without further aid. There were 19 people living at the home at the time of our inspection.
The home is run by the registered provider as an individual. They are the person registered with the Care Quality Commission to manage the service. A ‘registered person’ has the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People said they felt safe at the home. They were able to talk openly and honestly with staff and were sure any concerns or issues they had would be dealt with effectively. Staff knew people well and felt confident people would speak with them to raise any concerns. The registered provider and staff had a good awareness of how to safeguard people from abuse. Policies and procedures were in place to enable staff to manage safeguarding issues and the registered provider demonstrated a good working relationship with the local authority.
Risk assessments were in place for people. Some care plans lacked detailed instruction for staff on how to reduce risk for some people. However, daily records showed staff knew people well and supported people to reduce risks. Individual personal evacuation plans were available for people in the event of an emergency evacuation.
There were sufficient staff to meet the needs of people. Through robust recruitment, training and supervision processes, people were cared for by people who had the right skills to meet their needs. People received their medicines in a safe and effective way by staff who had received appropriate training and updates. Medicines were stored safely and an audit of administration was carried out daily.
Staff at the home had been guided by the principles of the Mental Capacity Act 2005 (MCA) when working with people who lacked capacity to make some decisions. Some care plans lacked sufficiently detailed information on guiding staff to what decisions a person may not be able to make and when to involve others in this process. However, daily notes evidenced staff practically applying the principles of the MCA.. The Care Quality Commission monitors the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered provider and staff had an understanding of the MCA and DoLS. They had sought advice from the local authority on DoLS and were in the process of assuring all necessary applications were made for these.
Staff knew people very well and interacted with people in a calm, encouraging and positive manner. They ensured people were offered choice at every opportunity and demonstrated good communication skills.
Nutritious and well-presented homemade food was provided for people, with visitors and relatives actively encouraged to join people for lunch. Dietary requirements were recognised, recorded and met in a clean and efficient kitchen.
People had access to external health and social care professionals for support and treatment as was required. The home fostered good working relationships with other professionals including community nurses and GP’s.
People said they felt valued, happy and content in their home. They said they enjoyed living there and found staff very caring and compassionate. Their privacy and dignity was respected and they felt able to express their views and have them respected and acted upon.
People had their needs assessed on admission to the home. The information gathered informed care plans and risk assessments which were discussed and agreed with people and their families. Care plans did not always reflect all the actions staff needed to take to assist people with their needs, however daily records identified the actions staff took to support people. People said they were supported to meet all their needs and often did not wish to participate in a review of their care plans as staff knew them very well and would always respond to their needs. Relatives and health and social care professionals spoke highly of the very responsive nature of the home in ensuring people’s needs were met.
People had access to activities they requested and enjoyed. An activities coordinator knew people’s preferences for social interactions and worked with staff to ensure these needs were met.
The home had an open and honest culture where people were encouraged to voice their opinions and have these addressed. People and their relatives spoke highly of the registered provider and their staff. They said they were easy to talk to, open to suggestions for improvements or new ways of supporting people, and always responded to them positively and with encouragement.
The registered provider had a system of quality assurance in place to ensure the safety and welfare of people. This included audits in; infection control, care plans, health and safety, medicines management and equipment. They were quick to respond to any concerns or issues raised with them. Incidents and accidents were monitored and actions taken to reduce the risk of these recurring. The home had received no complaints in the time since our last inspection and had received many compliments and letters of appreciation from people and their relatives.