This was an unannounced inspection carried out on 8 and 9 April 2015. The service has a new provider registered in September 2014. This is the first inspection since the new provider registered.
Oaklands is a care home situated in the Bessacarr district of Doncaster. It is registered to provide accommodation for older people who require personal care and nursing care. It can accommodate up to 34 people. The service is near public transport and is in easy distance of the town centre and other amenities.
The home had a registered manager who had been registered in March 2015. 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. The provider told us the regional manager had registered and they were overseeing the service until the newly appointed manager commenced in the role on 30 March 2015 had completed their induction and probationary period. The new manager had previously been the deputy manager at the service. The provider told us the new manager would submit an application to register with the Care Quality Commission within the next three months and the regional manager would then de-register.
People we spoke with told us they felt safe living in the home and said staff were very good to them. One person told us, “I am definitely safe here.” We saw there were systems and processes in place to protect people from the risk of harm. Staff we spoke with were knowledgeable in safeguarding procedures and were able to explain what was required should an allegation of abuse be made. Assessments identified risks to people and management plans to reduce the risks were in place to ensure people’s safety.
Medicines were stored safely and procedures were in place to ensure medicines were administered safely. A new audit systems to monitor this was in the process of being implemented.
The requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) were in place to protect people who may not have the capacity to make decisions for themselves. The Mental Capacity Act 2005 (MCA) sets out what must be done to make sure that the human rights of people who may lack mental capacity to make decisions are protected. The provider and the new manager demonstrated a good awareness of their role in protecting people’s rights and recording decisions made in their best interest. They were also aware of the new requirements in relation to this legislation. However not all staff we spoke with had a clear understanding of the requirements under this legislation The manager was aware of this and was accessing training.
We found people were cared for, or supported by, sufficient numbers of suitably qualified, skilled and experienced staff. However the training programme had not been fully implemented at the time of our visit. Staff told us they were supported; however, they had not received formal supervision since the new provider had registered.
Robust recruitment and selection procedures were in place to ensure appropriate checks had been undertaken before staff began work.
Suitable arrangements were in place and people were provided with a choice of healthy food and drink ensuring their nutritional needs were met. Most people we spoke with told us they enjoyed the food and there was always a choice. However the service we observed was slow and not all people were served their meal together.
People’s physical health was monitored as required. This included the monitoring of people’s health conditions and symptoms so appropriate referrals to health professionals could be made. People’s needs were assessed and care and support was planned in line with their individual care needs. For example we saw referrals had been made to various health care professionals, including speech and language therapists. However we found reviews of people’s needs had not always been documented appropriately in the care files.
We saw interactions between staff and people living in the home were kind and respectful to people when they were supporting them. Staff were aware of the values of the service and knew how to respect people’s privacy and dignity. People spoke very highly of the staff and the care they received.
Activities were provided. We saw people were involved in activities on the day of our visit.
We saw that complaints had been dealt with appropriately. People we spoke with did not raise any complaints or concerns about living at the home. Relatives we spoke with told us they had no concerns but would speak with the staff, the manager or the provider if they needed to raise any issues.
We found some issues relating to care records, that had not been identified thorugh an effective monitoring system. The provider had introduced new systems to monitor and improve the quality of the service provided. We saw copies of reports produced by the provider and the registered manager. The reports included any actions required and these were checked weekly to determine progress. Once fully implemented, the monitoring systems would cover all aspects of the service to identify any areas that required improvement.