21 & 22 July 2015
During a routine inspection
Our inspection took place on 21 and 22 July 2015 and was unannounced. At the end of the first day we told the provider we would be returning the next day to continue with our inspection.
This was the first inspection for Oban House under the new provider of Avery Homes (Nelson) Limited.
Oban House provides nursing care for up to 50 people, some of whom are living with dementia. Accommodation was located over three floors with a passenger lift. Bedrooms were single occupancy and had en-suite facilities. On the day of our inspection 38 people were using the service.
The service had a registered manager. A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run.
People were given their medicines at the right time by registered nurses. However, we found areas of concern with regard to how people’s medicine was being stored, recorded and managed.
Although staff had received training in safeguarding adults some staff we spoke with were unsure about the types of abuse people could face and what to do if they wanted to report their concerns. We found one example when an incident should have been reported as a safeguarding concern and was not. We were not assured that the systems and processes in place to prevent and detect potential abuse were effective therefore leaving people at risk of potential abuse.
The provider was aware of the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) to help ensure people’s rights were protected. However, staff training and knowledge were limited in this area. Some people’s mental capacity assessments were not fully completed or details were not clear. When a person was found to lack capacity there were no decision specific mental capacity assessments in place and the reasons for making decisions on people’s behalf were not clearly recorded
People told us they felt safe living at Oban House. They said staff were kind, caring and respected their privacy and dignity. They thought that the care they received was good and that staffing levels met their needs, although sometimes people felt staff did not have enough time to speak with them. The recruitment procedures were appropriate at the time of our inspection.
People were mainly positive about the meals served at the service and we observed how people were given a choice of something different if they asked for it. People’s specific dietary needs were catered for.
There was an activities programme at Oban House and the type of activities available for people were improving. We heard about the plans the service had to ensure people had the opportunity to be involved in meaningful pastimes to help stop them from feeling lonely or isolated.
People’s care records were person centred and focused on people’s individual needs, their likes, dislikes and preferences. People’s care was assessed and reviewed regularly and people and their relatives felt involved in this process.
We have recommended that the service refers to current best practice guidance around activities for people living with dementia.
We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to the management of medicines, safeguarding people from abuse and protecting their rights. You can see what action we told the provider to take at the back of the full version of this report.