We carried out an unannounced inspection of this home on 20 April 2015. Oak View Residential Care Home provides accommodation and care for up to 34 people who are over the age of 65, and may have mental health conditions or live with dementia. The home provides accomodation over two floors and stair lifts are in place to assist people to move between the floors. At the time of our inspection 32 people lived at the home.
The service had a registered manager. 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.
People felt safe at the home. Staff knew them well and they felt confident any concerns they might have would be addressed. The registered provider and staff had a good awareness of how to safeguard people from abuse. Policies and procedures were in place to support staff in the management of safeguarding issues. Staff were confident to raise any issues with the management team and confident these would be addressed promptly and efficiently. Safe recruitment practices in place meant staff were suitable to work with people in a care setting.
Risk assessments in place did not inform care plans and records, to ensure people received individualised, safe and specific care based on their needs . Incidents and accidents were not recorded, monitored and reported in a way which ensured the safety and welfare of people.
Medicines were stored securely and people received their medicines in a safe and effective way. We have made a recommendation for the provider on the management of “as required” medicines.
Staff at the home were guided by the principles of the Mental Capacity Act 2005 (MCA) when working with people who lacked capacity to make decisions. The Care Quality Commission monitors the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. These had been implemented appropriately to ensure the safety and welfare of people. Care records reflected support people received in decision making and who should be involved with this.
Staff knew people very well and interacted with them in a calm, encouraging and positive manner at all times. They ensured people were offered choice at every opportunity and demonstrated good communication skills. Staff received training to support them in their role. However, not all staff had received training in MCA and Dols.
Nutritious and well-presented food was provided for people. Dietary requirements were recognised and recorded. People had access to external health and social care professionals for support and treatment as was required.
People felt valued, happy and content in their home. They enjoyed living at the home and found staff very caring and compassionate. Their privacy and dignity was respected at all times and they felt able to express their views and have them respected and acted upon.
Whilst assessments of people’s needs had been completed on and since admission to the home, care plans did not always reflect person centred and individualised plans of care for people.
Relatives and health and social care professionals found staff and the registered manager responsive to and effective in meeting the needs of people.
An activities coordinator was available to support people on five afternoons per week. Whilst some activities had been planned the home lacked the provision of stimulating activities which encouraged people’s independence and reflected their choices. We have made a recommendation abut the activities avaialable for people who live with dementia.
People and their relatives spoke highly of the registered manager and their staff. They said the manager and senior staff 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 did not have an effective system of audit in place to ensure incidents and accidents were reported, recorded and followed up in a way which ensured the safety and welfare of people. Audits of care plans were not sufficiently robust to ensure they were individualised and consistently updated.
We found a number of breaches of the Health and Social care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.