Archived: Mr R Jeffries t/a Oaklea House Limited

Oaklea House is a residential care home providing personal care to ten people at the time of our inspection. The service is registered to support up to 12 people, in one adapted building.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 12 people. Ten people were using the service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size and staff were discouraged from wearing anything that suggested they were care staff when coming and going with people.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.

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

People’s end of life wishes were not recorded, however the registered manager stated they were aware of people’s wishes and they would record these in people’s care plans. People received personalised care responsive to their needs and the service was meeting people’s communication needs. People were supported to take part in activities that were of interest to them and people told us they felt able to complain should they need to.

Systems were in place to ensure people were protected from the risk of potential abuse. Staff were safely recruited and there were enough staff to meet people’s needs. People could be assured they received their medication safely and staff had access to personal protective equipment such as gloves and aprons. Risks were assessed and planned for and lessons were learned when things had gone wrong.

People had their needs and choices assessed and were supported to maintain their nutritional needs. The service had been adapted to meet the needs of the people who lived there, and people were able to personalise their bedrooms as they wished. Staff received training in order for them to support people effectively and people had access to healthcare.

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.

People were supported by kind, caring staff who knew them well and they felt able to express their views. People’s dignity was respected, and their independence was promoted by staff.

The service promoted a positive, person-centred culture and engaged people using the service. Managers and staff were clear about their roles and regulatory requirements were met. The provider was aware of their duty of candour and worked in partnership with others.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 (29 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

There was a registered manager in post. 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.

People were supported to make decisions about their care. However, when people were not able to make specific decisions about their support, the provider had not followed the guidance available to them. We have made a recommendation about working in accordance with the Mental Capacity Act.

People were safe receiving support from staff who had the knowledge and skills needed to protect them from harm and abuse. Risks to people were assessed and managed to keep them safe at home and in the community. There were enough staff available to meet people’s needs and the provider had safe recruitment processes in place. People were supported to have their medicines safely and as prescribed.

Staff were equipped with the knowledge and skills to carry out their roles. People received food and drink that met their nutritional needs and were referred to other healthcare professionals to maintain their health and wellbeing.

People were supported by staff who were caring and kind. Staff understood how people communicated so they had control in their lives. Their independence was promoted and their dignity and privacy respected. Relationships were maintained and families were able to visit when they chose.

People were involved in the planning and reviewing of their support, and their care was individual to them. They were supported to take part in activities they enjoyed. People knew how to raise concerns and were encouraged to give feedback about the support they received.

There was a positive, open culture within the service. Staff felt supported by the management team and people found them approachable. People and staff were involved in making decisions about the service. The registered manager had systems in place to monitor the quality of the service and they used these to drive continuous improvement.

Staff supported people to go out and do the things they enjoyed. People told us, 'We're always busy either doing things here at home or going out. We all like going out to eat and some people go to college or to clubs.'

We saw that people using the service were encouraged to be independent and they told us they were responsible for looking after and tidying their rooms. People told us they helped with cooking, and making drinks, and we saw people helping with domestic chores and preparing lunch during our inspection.

We saw people received the care and support that met their individual needs. People had care records which informed staff of how people wanted to be supported.

People told us they felt safe living at the home and would talk to staff or their family if they had any concerns. People told us that they knew how to complain if they were unhappy but had not needed to do this.

People were happy living at the home. Comments included, "It is my home" and "I like it here. I would recommend it". People were supported to have their health and social care needs met.They had chances to take part in educational and social activities.

People told us they felt safe living at the home. Care staff were trained in adult abuse and were aware of signs of abuse and how to act upon any concerns they had.

The provider had an effective recruitment process in place to make sure that care staff were suitable to work with the people that lived at the home. The provider made all the required checks before people started work.

People felt able to raise complaints and felt that they were acted upon. The provider had a complaints procedure and this was available in an easy read format.