Tall Oaks

Updated 14 July 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was completed by one inspector.

Service and service type

Tall Oaks is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered with the Care Quality Commission. A registered manager means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The service did have a manager who had submitted their application to become the registered manager to CQC, this was being processed.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all of this information to plan our inspection.

During the inspection

We spoke with two people who used the service about their experience of the care provided, the manager, the deputy manager and the operations manager. The other four people living at the service were not able to give us verbal feedback about their care. To help understand their experiences, we spent time in the communal areas observing staff's interactions with people and the care provided.

After the inspection

Following the inspection we spoke with five relatives. We either spoke with or received written feedback on the service from a further five day and night care staff and maintenance staff. We also received written feedback on the service from one professional.

We reviewed a range of records. These included two people’s care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 14 July 2021

About the service

Tall Oaks is a residential care home providing personal and nursing care to six people at the time of the inspection who were all living with a learning disability and/or autism.

The service is a chalet bungalow with four bedrooms downstairs and two bedrooms upstairs, there is a lift. The bedrooms each have an ensuite bathroom and there is a communal lounge/dining room and kitchen. There is an enclosed garden with a patio which is wheelchair accessible.

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

People told us they liked where they lived and they were well cared for. Relatives told us they had a good relationship with staff who they trusted to care for their loved ones. They felt staff had ‘pulled out all the stops during Covid.’

People were protected from avoidable harm and abuse. Processes were in place to keep them and their belongings safe. Staff reported any incidents which were reviewed to identify any actions required. Potential risks to people had been assessed and measures were in place to manage them . There were sufficient numbers of suitable staff rostered. People’s medicines were managed safely. Processes were in place to protect people from the risks of acquiring an infection, including the COVID-19 pandemic.

People’s needs were assessed, and the delivery of their care reflected national guidance. People were supported by appropriately trained staff. Staff supported people to eat and drink according to their needs. Staff worked both with and across organisations to ensure people received effective care and their health needs were met. People's needs were met by the design of the service, which was accessible for people who used wheelchairs.

People received personalised care which was responsive to their needs. People were provided with information in a format suitable for their needs. Staff ensured people had sufficient opportunities for stimulation, including regular contact with their families. Processes were in place to enable people or their representatives to raise any issues. Staff had access to relevant policies and guidance for when people required end of life care.

The manager understood the challenges facing the service and was taking relevant actions to ensure these were addressed. The manager monitored the culture and quality of the service. Processes were in place to assess the quality of the service provided and to identify potential areas for improvement.

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.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

• The service was located within a residential community and people told us they had ready access to local shops and amenities. The service blended in with the neighbouring properties and there were no obvious signs or indications it was a care home. People’s bedrooms were decorated and personalised to their tastes.

Right care:

• People received personalised care which reflected their care needs, routines and preferences.

Right culture:

• The provider and manager promoted a culture focused on meeting people’s needs and promoted open and honest communications with people and their families.

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 31 July 2019). There was one breach of regulation, good governance.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 5 June 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report covers our findings in relation to the Key Questions of Safe, Effective, Responsive and Well-led.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

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

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.

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.