Red Oak Care Home

Red Oak Care Home is a residential care home providing personal and nursing care to 13 people aged 65 and over at the time of the inspection. The service can support up to 17 people.

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

People could not be assured all equipment was suitable for their needs. Audits did not always drive improvement.

People told us they felt safe and they were supported by staff who helped them quickly if they needed this. Staff gave conflicting information regarding the staffing arrangements. We have made a recommendation about the staffing at the home.

Checks were completed to help ensure prospective staff were suitable to work with vulnerable people. Risk assessments were carried out to help minimise the risk of avoidable harm and staff knew the help and support people needed. Medicines were managed safely.

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 cared for in a clean and homely environment by staff who were caring, competent and knowledgeable about people’s needs.

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 10 February 2021).

Why we inspected

The inspection was prompted in part by notification of a specific incident. Following which a person using the service was injured. This incident is subject to a criminal investigation. As a result, this inspection did not examine the circumstances of the incident. The information CQC received about the incident indicated concerns about the management of falls from height. This inspection examined those risks. We undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

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.

You can see what action we have asked the provider to take at the end of this full report.

The provider took action to minimise the risk to people who used the service. We revisited the service and saw actions had been completed.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Red Oak Care Home on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to the safety and security of some equipment at the home. Audits did not always drive improvement.

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.

Red Oak is a residential care home providing personal care to people aged 65 and over. The service can support up to 17 people, at the time of our inspection visit there were 15 people who lived at the home.

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

The registered manager and staff had a good understanding of supporting people safely during the current pandemic. A staff member said, “I have been here over a year and it has been very hard, but love it.” A person who lived at the home said, “We are looked after great.”

Staff demonstrated a good awareness of protecting people from harm or abuse. They were patient and sensitive when in the company of people who lived there. Training for staff for infection control had been completed. This was confirmed by talking with members of the staff team and documentation seen. Staff followed correct procedures to ensure people received their medicines safely as prescribed.

Recruitment processes were thorough to ensure suitable staff were employed. Risk assessments were completed and reviewed to promote people's safety. The management team had a good system to ensure sufficient staff would be available to meet people’s needs and stay safe. Extra domestic staff had been in place to help during the pandemic.

Quality checks and audits were carried out to enable areas of improvement to be identified and the service was continually monitored by the management team. Staff said they worked well as a team and people commented the home was managed extremely well. The service worked with other health professionals to provide identified health services where this was needed.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published 28 January 2020).

Why we inspected

We wanted to assure ourselves the service remained safe since our last inspection and continued to be led well.

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 coronavirus and other infection outbreaks effectively.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We found no evidence during this inspection that people were at risk of harm. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Red Oak on our website at www.cqc.org.uk.

Follow up

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

Red Oak Care Home is a residential care home providing personal care to 15 people aged 65 and over at the time of the inspection. The service can support up to 17 people.

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

People were safely supported to receive their medicines as prescribed. We have made a recommendation about competency assessments for staff administering medicines. People were protected from the risk of abuse and avoidable harm by staff who understood how to recognise and respond to concerns. People told us they felt safe when supported by staff. Risk assessments had been developed to minimise the potential risk of avoidable harm to people during the delivery of their care. The registered manager had robust safe recruitment procedures.

People were positive about the service and said staff were kind and caring. People were treated with dignity and respect and their right to privacy was upheld. The registered manager worked in partnership with people's advocates.

People's care and support had been planned in partnership with them and their relatives. Staff had received regular training and supervision to support them in their roles. 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.

People received person-centred care which was responsive to their needs. People's communication needs had been assessed and where support was required these had been met. The registered manager managed people's concerns and complaints appropriately.

The service worked in partnership with a variety of agencies to ensure people received all the support they needed. People were happy with how the service was managed. Staff felt well supported by the registered manager and management team.

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 requires improvement (published 01 February 2019).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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

The service had deteriorated in some areas since our last inspection.

People’s medicines were managed safely and properly. However, where people chose to look after and administer their own medicines, the provider had not carried out any risk assessment. The service had a system to record and analyse any accidents or incidents. However, we saw some recorded accidents and incidents lacked detail around the incident and what action had been taken. The provider had robust recruitment procedures, however, we saw full employment histories had not always been obtained and gaps in employment had not always been explored with candidates. The home was generally clean and tidy; however, the service did not always follow good infection prevention and control practices. The registered manager had not reviewed accidents and incidents to look for any emerging themes or trends, which could help to identify measures to be put into place to help lessen the risk of recurrence. People received personalised care that was responsive to their needs and preferences. However, we found care plans were not always accurate and up to date. The provider had auditing systems to ensure they met legal requirements. However, these had not identified the shortfalls we identified during our inspection

We received consistently positive feedback from people about Red Oak Care Home. People told us it was homely, safe and that staff were kind and treated people well. Staff understood the importance of providing person-centred care and treated everyone as individuals, respecting their abilities and promoting independence. There were enough staff on duty at the right time to enable people to receive care in a timely way. People had opportunity to access a range of activities including access to the local community. Staff had built positive caring relationships with people they supported and their families. Staff liaised with other health care professionals to ensure people's safety and meet their health needs. We received consistently positive feedback about how the service was managed.

More information is in the full report.

Rating at last inspection: Good (Report published 27 May 2017).

About the service: Red Oak Care Home is registered to provide care for up to 17 older people. It is situated in the south of Blackpool. The home is a large detached building with a large garden and decking areas at the rear, with ramps for people to use if required. The home has two lounges and a separate dining area. All bedrooms are en-suite with communal bathroom and toilet facilities also available each floor.

Why we inspected: This inspection was brought forward due to concerns raised by the police and local authority safeguarding team during investigation of an incident. This incident is subject to a criminal investigation and, as a result, this inspection did not examine the circumstances of the incident.

However, the information shared with the Care Quality Commission about the incident indicated potential concerns about the management of risk of falls and seeking medical treatment. This inspection examined those risks.

Follow up: The next scheduled inspection will be in keeping with the overall rating. We will continue to monitor information we receive from and about the service. We may inspect sooner if we receive concerning information about the service.

Red Oak care home provides care and residential accommodation for up to17 older people who do not require nursing care. The home is situated in a residential area of Blackpool and is in close proximity to the shops, local amenities and public transport. There is a communal lounge and a dining room on the ground floor. Bedrooms are on the ground and first floor. A passenger lift provides access between floors. The rear garden provides a safe, secure outdoor area for people’s use. Parking is available on the forecourt of the home.

At the last comprehensive inspection on 07 January 2015 the service was rated overall as good.

At this inspection we found the service remained good.

There were procedures in place to protect people from abuse and unsafe care. We saw risk assessments were in place which provided guidance for staff. This minimised risks to people.

Staff supported people with medicines safely. Medicines were stored securely, administered as prescribed and disposed of appropriately.

Infection control practice was good and staff had received training in this area.

There were sufficient staff available to provide people with personal care and social and leisure activities. Staff received training to carry out their role and knew how to support and care for people. They had the skills, knowledge and experience to provide safe and effective support.

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 supported this practice.

People told us they were happy with the variety and choice of meals available to them. Staff knew people’s food likes, dislikes and any allergies people had.

Care plans were personalised detailing how people wished to be supported. People who received support or where appropriate their relatives were involved in making decisions about their care. Their consent and agreement were sought before providing care.

People knew how to raise a concern or to make a complaint. The complaints procedure was available and people said they were encouraged to raise any concerns.

Senior staff monitored the support staff provided to people. Audits of care and support records and risk assessments were carried out regularly. People and their relatives were encouraged to complete surveys about the quality of their care.

We spoke with a range of people about the home. They included the manager, staff members, residents and visitors to the home. We also asked for the views of external agencies in order to gain a balanced overview of what people experienced living at Red Oak.

We spent much of the time in the communal areas making observations of how people were being cared for. This helped us to observe the daily routines and gain an insight into how people's care and support was being managed. We observed staff assisting people who required care and support. Staff treated people with respect and ensured their dignity when supporting them. They provided support or attention as people requested it.

The people we spoke with told us they had no concerns about the care being provided. They told us they felt safe and well cared for. One person told us, "I feel at home. The staff are excellent and I am very happy."

We found new procedures and paperwork had been introduced. This was to ensure there was an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service.

The inspection took place over three separate days. The manager was not available during the first two days, as she was out of the country on leave. On these days we spoke to the person in charge, who was a senior carer. The manager was present at the home on the third day.

We spent time in areas of the home, including the lounge and the dining areas. This helped us to observe the daily routines and gain an insight into how staff spent time supporting people. We saw staff members were responsive to people's needs.

Although the care we observed on the inspection was good, there were significant concerns staff had not responded appropriately to allegations of abuse. We found that whilst staff had received training and support, suitable arrangements were not in place to safeguard people against the risk of abuse.

There was no evidence that any comments or complaints had been taken into account and dealt with through the home's complaints procedure. This meant that there wasn't an effective system in place to record people's views and to understand where improvements were needed.

We found that the manager did not notify the Care Quality Commission of a serious injury to a service user. In addition they had not notified the Commission of an allegation of abuse in relation to a service user. It is a requirement of the Care Quality Commission (Registration) Regulations 2009, that we are notified of such incidents. This is so that we can monitor services effectively and carry out our regulatory responsibilities.

The nominated individual for the company, who works at the home as manager is not registered with the Care Quality Commission. It is a condition of the home's registration that a manager is registered with the Commission.

We spoke with people who lived at the home. They told us they could express their views and were involved in making decisions about their care. They told us they felt listened to when discussing their care needs. Staff confirmed to us they also involved people to ensure they received the right care and support.

We spent time in areas of the home, including the lounge and the dining areas. This helped us to observe the daily routines and gain an insight into how people's care and support was being managed. Staff treated people with respect and provided support or attention as people requested it.

We looked at how the service was being staffed and reviewed staff training and supervision. We saw there was sufficient staff on each shift with a range of skills and experience. Staff told us they felt supported, had regular meetings with the provider and their training was kept up to date.

There were a range of audits and systems in place to monitor the quality of the service being provided.