We carried out a review of the data available to us about Oak Trees (Respite) on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Oak Trees (Respite), you can give feedback on this service.
Oak Trees (Respite) is a residential care home which provides accommodation and personal care via a short break (respite) service to people with a learning disability. The service is registered to provide this regulated activity to up to four people at a time. At the time of the inspection three people were staying at the service and 33 people were using the service on a regular basis.
Oak Trees (Respite) is also registered to provide personal care to people living in their own homes. At the time of the inspection the service was providing support to 21 people with a learning disability across ten supported living locations. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
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.
There were deliberately no identifying signs, intercom, cameras, or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People’s experience of using this service and what we found
Everyone we spoke with praised the high quality of the service provided. People, relatives, and professionals were keen to tell us about the support provided and the positive difference it made. There was a deeply embedded person centred, open, and inclusive ethos. People were fully consulted about their care arrangements and involved in the operation of the service.
People, relatives, and staff worked together to support and develop the service. There was a strong sense of ownership and investment amongst everyone involved with the service. There were strong links to the local community which were utilised to benefit people using the service and this enhanced their daily lives and provided them with equal opportunities. Everyone we spoke with praised the dynamic leadership in the service, notably the registered manager’s passion and dedication. The provider was committed to developing and improving their service. They looked across the social care sector at best practice and considered how this could be implemented within their own service. Robust quality assurance systems underpinned the continual development and improvement in the service leading to positive outcomes for people. Throughout the service we found creative ideas and actions that had helped put people at the heart of their care and decision making.
People were exceptionally safe using the service. There were established relationships of trust and support between staff which enabled people to stay safe. People were empowered to make decisions about their safety, which helped avoid unnecessary restrictions being placed on people and maximised their control over their lives. Staff were very sensitive to the vulnerabilities of people living in the community. They acted proactively when concerns were identified and supported people to protect themselves. A strong sense of security and safety had been created for people by the use of the respite service location as a flexible and accessible space. One relative likened the service location to ‘a crisis centre’ offering a safe space and support for people to stay safe whenever they needed it. People were supported by a creative and inclusive approach which helped them understand potential risks and make decisions in respect to this. Best practice guidance was utilised and adapted to support people’s individual needs and circumstances.
People were supported by a stable and consistent staff team. People were allocated core groups of staff to aid continuity of care and ensure people felt comfortable and safe. If particular sensitive tasks or events took place, then people were supported to express which staff they might like to support them, which was accommodated. Each staff group’s training and skills reviewed in relation to the people they supported. The service understood the importance of empowering people so that they could understood how to live safely. Safety training, such as first aid and infection control, was offered to people alongside staff. People were supported by staff who understood the importance of safe medicine administration. This included ensuring people had regular reviews of their medicines and staff supported people to reduce their use of medicines when appropriate.
People were supported by very compassionate and dedicated staff who genuinely cared for them. Staff took great care and effort to ensure people were supported and their needs met, particularly during distressing or difficult times. Understanding and respecting equality and diversity were at the heart of the service. People’s rights were respected and encouraged. People were supported to lead fulfilling and rich lives by staff who had high expectations of their abilities and needs. This meant staff worked hard to support and increase people’s independence. The service was very inclusive, everybody we spoke with told us that the service felt like a big extended family. The service understood the importance of advocacy and worked hard to ensure people were provided with independent advocacy where necessary. In addition, staff spoke up for people and advocated for them to ensure they had the support and services they needed.
Peoples needs were assessed holistically across a wide range of areas. This included needs in relation to people’s protected characteristics such as gender and sexuality. People were supported by staff who had training and support to understand their needs. Staff were supported to professionally grow and develop, which included gaining nationally recognised qualifications.
People were supported to plan and cook their meals, information was given to people on healthy eating. The service took a proactive and creative approach to helping people understand their health care needs. People were supported to make decisions and feel in control of their own lives. Staff worked with specialist professionals to help support people’s decision making. Where staff had identified concerns around people’s ability to make particular more complex decisions they had requested specialist support, such as a psychologist, to support people’s understanding and decision making. 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 provided with flexible, responsive, person centred care. Staff knew people well. This helped them deliver care that met people’s individual needs and preferences. People’s needs, interests, and backgrounds were taken in to account when supporting people to access the community and take part in social activities. The service thought creatively about how people could be supported to understand information. The service provided face to face information and training sessions to people using the service. A wide range of information, including the service’s policies and procedures, were provided to people in an easy read format.
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 (published 07 June 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.
Oak Trees provides accommodation and support in the form of short respite stays, for a maximum of four people with a learning disability. Visits are normally for up to two weeks in duration. The service also provides support and personal care for people with a learning disability who are living in their own homes or shared tenancies. At the time of our inspection, there were three people using the respite service and 20 people receiving support in their own homes.
A new service provider had registered with us the year before our inspection took place. There was a registered manager in place who had been in post for a long time, and under the previous provider. 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.
Staff were trained to recognise signs that might show someone was at risk of abuse or harm. They knew the importance of reporting their concerns to promote people’s safety. The management team took action to reinforce this with staff when they needed to.
Staff had guidance about how to minimise risks to people’s safety and welfare. Staff supported people to understand risks themselves and to learn what they could do to promote their own safety and welfare. This included encouragement for people to manage their own medicines fully or in part, if they were able to and wished to do so. Where staff supported people with their medicines, they did so in a safe way.
Although staff turnover had increased following a change of ownership of the service, this had stabilised and there was a core of long-standing, experienced staff. There were enough staff on duty, who were trained to meet people’s needs and recruited in a way that contributed to promoting people’s safety.
Staff understood the importance of seeking consent and encouraging people to make their own decisions. If someone’s capacity to make an informed decision was in doubt, staff consulted others who knew the person well. They involved the person, professionals and families to help determine what was in the person’s best interests. This included when people needed appointments to maintain their health or receive treatment. Staff incorporated professionals' views into the way that they offered support. Staff enabled people to access health care professionals to promote their wellbeing if they needed assistance in this area.
People using the care home service had a choice of enough to eat and drink to ensure their wellbeing. Where people needed support in their own homes with food and drink as part of their care package, they received it. The management team planned to introduce a more formal and consistent assessment in future.
There was a friendly and cheerful atmosphere between staff and people using the service, both in the care home and in their own homes. People’s privacy and dignity was promoted and staff treated people with warmth and respect. People were encouraged to say how they wanted staff to deliver their care and, in some cases, to draw up their own guidance for their support staff.
The management team took account of people’s support needs when they were planning respite stays and the mix of people who would be using the care home service. They reviewed people’s needs each time they came to use the respite service to see whether anything had changed. Staff knew about people’s individual needs and preferences. They knew how to meet these and had guidance within care plans focused on each person. Staff acknowledged that it was sometimes difficult to meet the recreational and social needs of people when they were receiving respite care. This was in part due to a lack of transport, which staff and people using the service were working to address.
People were confident that they could raise any concerns or complaints they had with the management team and have them addressed. They were also encouraged to express their views on a regular basis. This happened formally through surveys at the end of respite stays, and informally at meetings with people and their staff teams. Others connected with the service, such as family members and health professionals were encouraged to say what they thought about the service. The management team reviewed where the service was performing well and what improvements they could make because of the views they obtained.
The ownership of the service had changed a year before this inspection. The registered manager acknowledged that this had created some anxiety among staff and that new systems needed time to bed in following the change. This had affected morale to a degree but it was improving and almost all of the staff were very positive about the way the service was managed. They had a clear understanding of their roles and what was expected of them.
The registered manager had been in post for a long time and had a good understanding of her role and responsibilities. The management team had developed a range of audits to look at the quality and safety of the service people received and how this could be improved. They had developed action plans to address their findings and had a clear understanding of where they could act to deliver higher standards of care.