We carried out an unannounced inspection of the service on 10 December 2015. The Oaklands is registered to accommodate up to twenty people and specialises in providing care and support for people who live with a learning disability. The service also offers a short break service. At the time of the inspection there were twenty people using the service.
On the day of our inspection there was a registered manager in place. 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.
During our previous inspection we identified concerns that people were not protected from the risks associated with financial abuse. This was because robust processes to monitor the way people’s money was spent and then recorded were not in place. During this inspection we found improvements had been made and people were now protected from the risks of financial abuse.
The risk to people’s safety was reduced because staff had attended safeguarding adults training, could identify the different types of abuse, and knew the procedure for reporting concerns. Risk assessments had been completed in areas where people’s safety could be at risk. Staff were recruited in a safe way and there were enough staff to meet people’s needs and to keep them safe.
Accidents and incidents were investigated; however the registered manager did not record their recommendations or check to see whether they had been implemented. Assessments of the risks associated with the environment which people lived were carried out; however people did not have personal emergency evacuation plans (PEEPs) in place. People’s medicines were stored and handled safely, however protocols to protect them from the risks associated with the administration of ‘as needed’ medicines were not in place. Records of people’s allergies and how they liked to take their medicines were not recorded.
We have made a recommendation about the management of some medicines.
People were supported by staff who received an induction, were well trained and received regular assessments of their work.
The registered manager ensured the principles of the Mental Capacity Act (2005) had been applied when decisions had been made for people. People told us they were free to do as they wanted and to go where they wanted. However we identified people that may require Deprivation of Liberty Safeguards to be applied for and the registered manager had not done so.
People spoke highly of the food and were supported to follow a healthy and balanced diet. People’s day to day health needs were met by the staff and external professionals. Referrals to relevant health services were made where needed.
Staff supported people in a kind and caring way. Staff understood people’s needs and listened to and acted upon their views. Staff responded quickly to people who had become distressed.
People felt able to contribute to decisions about their care and support needs. People were provided with information about how they could access independent advocates to support them with decisions about their care. Staff understood how to maintain people’s dignity. People’s friends and relatives were able to visit whenever they wanted to.
People’s care records were person centred and focused on what they wanted. Care records were regularly reviewed and people and their relatives where appropriate attended meetings to review them. Staff knew people’s personal preferences and what interested them. People were encouraged to take part in activities that were important to them and were provided with the information they needed if they wished to make a complaint.
People spoke highly of the registered manager. The registered manager understood their responsibilities and had a clear focus on improving people’s lives. Staff understood their roles and felt able to contribute to the development of the service by giving their views which were welcomed and valued by the registered manager. People who used the service were encouraged to provide their feedback on how to improve the quality of the service they received.
There were a number of quality assurance processes in place that regularly assessed the quality and effectiveness of the support provided. However, these had not identified the concerns raised within this report.