The Oaks Care Home

Updated 13 January 2023

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 Health and Social Care Act 2008.

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 team was made up of two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

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

Registered Manager.

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had started in September 2022 and had applied to register. We are currently assessing this application.

Notice of inspection

This inspection was unannounced. Inspection activity started on 21 November 2022 and ended on 14 December 2022. We visited the service unannounced on the 21, 23 and 28 November 2022.

What we did before the inspection

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 the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 7 people living in the service and 13 people’s relatives. We also spoke with 12 staff which included the manager, nurses, care assistants, well-being coordinator, and ancillary staff. We reviewed a range of records. This included medicines records, incident and investigation reports, risk assessments and records relating to 10 people’s care. We also reviewed 3 staff recruitment records, staff rosters, staff training records and records relating to the quality assurance of the service, including audits, and minutes of meetings.

Updated 13 January 2023

About the service

The Oaks Care Home is registered to provide accommodation, personal and nursing care for up to 61 people who may have a physical disability, living with dementia, or requiring end of life care. At the time of our inspection 48 people lived at the service.

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

Improvements were needed in the management of medicines to reduce the risk of errors being made, and to ensure all people receive their medicines as prescribed.

Staff were not always following safe infection control processes. Improvements were needed to ensure all areas of the service and equipment used were kept clean and hygienic.

Governance systems were not robust enough to ensure shortfalls were independently identified and addressed.

People told us they felt safe living in the service and if they had any concerns knew to who to talk to. One person said, “I like it here…I feel very safe,” and told us if they had a concern they would, “Speak to the nurse or [manager].”

Feedback from people living in the service, their relatives and staff identified at times the provider’s staffing levels were not being maintained. This impacted on staff being able to spend time talking with people. The manager was aware how a high level of sickness would affect maintaining the planned staffing levels and was taking action to address it.

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. However, if staffing levels are not maintained, this could have an impact on people’s choice, and being able to take part in activities.

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 24 January 2018).

Why we inspected

We received concerns in relation to the management of medicines and governance of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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

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 responded immediately during and after the inspection, carrying out a full medicines audit and producing an action plan to address concerns.

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

Enforcement

We have identified breaches in relation to medicines management and quality assurances systems at this inspection.

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 from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.