The Oaklea Trust (Durham & Northumberland)

The Oaklea Trust is a domiciliary care agency that provides personal care and support to people in their own homes and also in supported living and shared lives schemes. At the time of our inspection there were 63 people receiving support from the service.

At our last inspection we rated the service good. At this inspection we found some low-level concerns which have resulted in a rating of requires improvement in one area. However, our findings continued to support the overall rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People were cared for safely by staff who understood safeguarding procedures and knew how to raise any concerns. Individuals risks were assessed and plans put in place to minimise them. Accidents and incidents were recorded and monitored to reduce future risk.

People received their medicines as prescribed, however, medicines records and stock control was not always well managed. We have made a recommendation about this.

Staff had access to a wide range of training to ensure they had the necessary skills and knowledge to support people effectively. Specialist training was available to help staff meet the specific needs of the people they supported. People were supported to access healthcare and encouraged to have a healthy diet appropriate to their needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff were passionate about their work and promoted dignity and independence. People who used the service and their relatives were all very happy with the support they received and told us staff were friendly.

Support plans contained very detailed information about people, their likes and dislikes and how best to meet their needs. People were engaged in a variety of activities and supported to access the community they lived in. There was a procedure in place to deal with concerns or complaints and records we saw showed this was followed appropriately.

The service was led by a management team who supported staff well. Feedback was sought from people using the service and staff and this formed part of the provider’s improvement plan. A comprehensive system of audits was in place to monitor the quality of the service. However, the medicines audit was to be reviewed to ensure any future discrepancies were identified.

Further information is in the detailed findings below.

The service was registered at the current location with CQC on 14 January 2015 and had not previously been inspected at this location. The service was inspected at a previous location in July 2013 and found to be compliant in all regulatory standards inspected.

The Oaklea Trust (North East) is a domiciliary care provider based in Durham providing personal care and support to people in their own homes throughout the north east. It provides support to people with learning disabilities and is registered with the Care Quality Commission to provide personal care. There were 53 people using the service at the time of our inspection.

The service had 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. The registered manager had worked for the provider since 2011.

We found the service took safeguarding training, concerns and notifications seriously to ensure people who used the service were protected. Where concerns were raised, we saw evidence staff and management had acted promptly to protect people. Staff we spoke with had a good understanding of safeguarding principles and procedures and we found these were clearly communicated through organisational policies and staff meetings.

We found that risks were managed and mitigated well through pre-assessment and ongoing assessment of people’s environment and needs. People using the service told us they felt safe, whilst family members visiting healthcare professionals and local authority commissioning professionals raised no concerns about the safety of the service.

We saw people who used the service had individualised emergency and evacuation plans in place.

Medicines were managed and administered safely and we found no errors with the service’s medicines record-keeping. Medicines records were regularly audited and the competence of people administering medicines was reviewed annually.

We found there to be sufficient numbers of staff on duty to meet the needs of people who used the service.

Staff underwent a range of pre-employment checks, including checks against the Disclosure and Barring Service (DBS) barred lists and references from previous employers, to ensure they were suitable for the role.

We found that staff received an induction and a range of training the provider considered mandatory, such as safeguarding, moving and handling, infection control and health and safety. Staff also received training relevant to supporting the individual needs of people who used the service. Training needs were effectively managed and monitored by the Human Resources manager.

We saw that personal sensitive information was stored securely.

We found there to be consistent and comprehensive liaison with external healthcare professionals and other agencies in order to ensure people’s healthcare needs were met.

People who used the service had developed trusting relationships with those who provided care and we observed a rapport between staff and people who used the service. Relatives told us without exception that staff displayed caring attitudes and treated people in a dignified manner.

We saw consent was integral to care plans and when we spoke with staff and the registered manager about their understanding of people’s capacity, they were able to give detailed answers. The registered manager had liaised with the relevant local authority department to clarify their understanding of the impact of the Mental Capacity Act (MCA) on people who used the service.

Staff supervisions, appraisals and staff meetings all happened regularly and staff gave examples of the professional and personal support they received from immediate management and more corporately.

We saw that people were encouraged and supported to contribute to their own care planning and review, with family members similarly involved. Person Centre Plans (PCPs) were in place, specifically for people to set and achieve their own goals.

PCPs took whatever format the person wished and were tailored to people’s individual interests. A range of hobbies, interests and aspirations were supported by staff and we saw numerous examples of people achieving a wide range of goals, which had significant positive impacts on their wellbeing and independence.

Staff supported people to achieve goals through helping them access the local community, volunteering opportunities, sporting endeavours and accessing an in-house charitable fund to further their independence. Staff were passionate about the achievements they could support people to make, in line with the service’s stated visions and values and we saw staff put in additional effort to ensure people were able to achieve their aspirations. People who used the service took pride in their achievements and were supported to celebrate them and think of new goals.

Care plans were reviewed regularly and, where people’s medical needs changed, these reviews were brought forward and care provision amended accordingly. People who used the service and healthcare professionals told us staff were accommodating to people’s changing needs and preferences. We saw examples of care staff using innovative methods to support people to reduce potentially harmful behaviours.

The provider had a complaints policy in place. People who used the service and relatives were made aware of the complaints procedure and told us they knew how to make a complaint and who to. Complaints were considered and responded to in line with the policy.

People who used the service, relatives and healthcare professionals we spoke with were consistent in their praise of the leadership of the service. The registered manager and all staff we spoke with were consistent in their understanding of the principles of the service, as set out in the Statement of Purpose. All staff described the key objectives of their role as being to support people to be independent and to fulfil their own goals.

All people who used the service, relatives and external healthcare professionals we spoke with referenced positive interactions with the registered manager and team leaders, describing them as approachable and knowledgeable. We found this to be the case during our inspection.

An efficient auditing and quality assurance regime had been established organisationally and this had been welcomed and adapted by the registered manager, with improvements to the service instigated by audits and the annual report.