The Oaks Care Home

Updated 24 August 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 1 inspector, I assistant inspector and 1 Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

The Oaks Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Oaks Care Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 12 July 2023 and ended on 20 July 2023. We visited the service on 12 July 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During the inspection we spoke with 6 people who used the service about their experience of the care provided and 14 relatives. Not everyone who used the service communicated verbally or wished to speak, therefore they gave us permission to speak with their relatives on the telephone. We spoke with 11 members of staff including the regional manager, the registered manager, 1 nurse, 6 care workers including 2 senior care workers, 1 domestic member of staff, 1 cook and 1 activities co-ordinator.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included 5 people’s care records and multiple medicines records. We looked at 4 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including training information and policies and procedures were reviewed.

Updated 24 August 2023

About the service

The Oaks Care Home is a care home providing accommodation and personal and nursing care to up to 45 older people, including people who may live with dementia, or a dementia related condition. At the time of our inspection there were 26 people using the service accommodated in one adapted building.

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

Some improvements had made to the management of risk, but there were still some risks to people’s safety and the management of distressed behaviour.

Improvements had been made to some records, however further improvements were needed. Care plans were not broken down to provide guidance for staff so people received personalised, consistent care for each identified care and support need.

A quality assurance system was in place, to assess the standards of care in the service. Improvements had been made to the running of the service since the last inspection to ensure people received safe care. However, further improvement was needed to ensure people received person-centred care.

There were sufficient staff to support people safely. Care was task-centred rather than person-centred. Due to staff being busy they did not have time to spend with people.

We have made a recommendation about ensuring staffing levels and staff deployment are kept under review so people are kept engaged and stimulated if they choose.

Improvements had been made to medicines management. Staff followed effective processes to assess and provide the support people needed to take their medicines safely. Staff contacted health professionals when people's health needs changed.

A programme of refurbishment was taking place to ensure the environment was safe and comfortable. The standard of hygiene was improving and there was more effective odour control.

We have made a recommendation about continuing the programme of refurbishment in a timely way and to ensure it is enabling to meet people’s needs.

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 and relatives had opportunities to give feedback about the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update and update

The last rating for this service was requires improvement (published 30 March 2023) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found some improvements had been made but the provider remained in breach of some regulations.

At our last inspection we recommended that records contain information, about people’s dietary likes and dislikes, in order to promote their nutrition. At this inspection we found the provider had acted on the recommendation and improvements had been made to people’s nutrition.

The last rating for this service was requires improvement (published 30 March 2023). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

We carried out an unannounced focused inspection of this service on 28 February 2023. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, premises and equipment and good governance. We made a recommendation about ensuring records contain information, about people’s dietary likes and dislikes, in order to promote their nutrition.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe, effective and well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Oaks on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified continued breaches in relation to safe care and treatment and good governance.

We have made recommendations about staffing levels and staff deployment, timely refurbishment of the environment and environmental design.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.