Oakleigh Lodge

About the service

Oakleigh Lodge is a residential care home which is registered to provide personal and nursing care for up to 3 people; and 3 people were living at the care home at the time of the inspection. Nursing care was not provided at the care home.

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

Right Support

People were not always protected from the potential risk of scalding, and safety measures to prevent the potential for legionella bacteria were not consistently carried out. People had choices about their living environment and were able to personalise their rooms. People benefitted from the interactive and stimulating environment. Staff supported people to take part in activities and pursue their interests in their local area and to interact online with their relatives. Staff enabled people to access specialist health care support in the community. Hygiene arrangements in the care home had improved. People received their prescribed medicines safely, from staff who had been appropriately trained.

People were not always supported to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care

People’s specific care plan information was not always easy for staff to find on the provider’s electronic care record system. Staff promoted equality and diversity in their support for people. Daytime staffing levels had been increased since the last inspection. Staff understood people’s cultural needs and provided culturally appropriate care. People received kind and compassionate care. People were supported to eat and drink enough and had a varied diet offered to them. Staff protected and respected people’s privacy and dignity. They understood and responded to people’s individual needs. Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it.

Right Culture

People were not always supported to achieve their individual goals and aspirations. People received good quality personal care from trained staff who could meet their care needs. Staff placed people’s needs, and rights, at the heart of everything they did. People’s relatives were enabled to be involved in the review of people’s care plans. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect, and inclusivity. People’s ability to access community activities had increased since the last inspection.

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

The last rating was Requires Improvement (published 25 August 2022) and there were breaches of regulations found. We also issued the provider with a Warning Notice in respect of issues which required improvements. 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 was still in breach of regulation.

Why we inspected

We undertook this focused inspection to check whether the Warning Notice we previously served in relation to Regulations 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. We also checked if the provider had followed their action plan and to confirm whether they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe, Effective, Responsive and Well-led which contain those requirements.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Responsive and Well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

For the key question not inspected, we used the rating 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 Oakleigh Lodge on our website at www.cqc.org.uk.

Enforcement

We have identified ongoing breaches in relation to safety management, and the provider’s quality monitoring of the service, at this inspection. 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.

About the service

Oakleigh Lodge is a residential care home which can provide personal and nursing care for up to three people. Oakleigh Lodge is a care home which does not provide nursing care. Three people were living at the care home at the time of the inspection.

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

People were not always supported by enough suitable staff to meet their individually assessed needs in a person-centred manner. This impacted some aspects of the care people received and their ability to engage in community-based activities which were meaningful to them.

People were supported by staff who had not all received specialist training in how to support people who had complex care needs.

Parts of the care home required refurbishment to enable effective cleaning and infection prevention and control.

People ate a varied diet, and mealtimes were relaxed and flexible. People’s weight had not been regularly monitored and action had not always been taken when a person lost weight unexpectedly.

People were not always supported to follow and achieve their goals and aspirations. Community based activities had reduced during the COVID-19 pandemic and were still limited due to staff shortages.

Relatives were not always involved in the development of people’s individual care plans and were not always informed about people’s activities.

The provider had quality monitoring processes in place but had not identified all the issues which we found during the inspection. The communication of important information, from the previous registered manager to the provider, was not always effective. The provider’s quality monitoring processes were not always effective, and this hampered the provider’s ability to understand what was happening in the care home.

The care home layout met people’s mobility support needs and people’s bedrooms were generally personalised. However, some areas of the care home needed redecoration.

People were supported by staff who knew how to protect them from potential abuse or neglect and the provider had procedures in place to support that. People had access to sensory activities in the care home and in the garden area, which they enjoyed.

People’s prescribed medicines were stored, administered, and recorded appropriately. People had health action plans in place and were supported to access specialist medical support services when needed.

Staff followed appropriate guidance in respect of the use of personal protective equipment and the care home had safe visiting arrangements in place.

People’s communication needs were met by staff who understood how each person communicated. People’s privacy and dignity was maintained. Staff were kind and compassionate when supporting people.

Right Support

People did not always receive person-centred care due to the provider not having enough staff. People had limited opportunities to engage in community-based activities which were meaningful to them. The service enabled people to access specialist health care support from the community health care teams when required. The service gave people care and support in an environment which met their sensory and physical needs. Staff communicated with people in ways that met their needs.

Right Care

Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care. People received kind and compassionate care. Staff protected and respected people’s privacy and dignity; and understood how to protect people from poor care and abuse.

Right culture

Staffing levels affected how the service could meet people’s needs and wishes. Not all staff had received the specialist training necessary to understand best practice; in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. However, staff knew people well and placed people’s wishes, needs and rights at the heart of everything they did.

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 20 August 2019).

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support right care right culture. The inspection was also prompted, in part, by our receipt of concerns relating to staffing levels and personalised care. This inspection examined those risks.

We also looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Responsive and Well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches of regulations 9, 15, 17 and 18 in relation to staffing levels, person centred care, hygiene, and governance processes, at this inspection. We have issued the provider with a Warning Notice.

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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Oakleigh Lodge provides accommodation and personal care for up to three people living with a learning disability, physical disability and complex healthcare needs. At the time of our inspection there were two people living at the service. The service can support up to three people.

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.

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

People were protected and kept safe from harm. Risks were assessed, monitored and managed. Staff were recruited in a safe way. Medicines were managed and administered safely. Infection control guidelines were followed by all staff. Systems were in place to monitor, analyse and take action when things go wrong.

People’s needs were assessed and delivered appropriately. Staff were supported to develop and improve their knowledge. People received enough to eat and drink and their dietary needs were accommodated. People accessed healthcare professionals when needed and in a timely manner. The environment of the home was appropriate for the people who lived there. Principles of the Mental Capacity Act were adhered to. 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 always treated with dignity and respect. People were supported to express their views in a way meaningful to them. Information was shared in a format people could understand. Peoples human rights were adhered to and care records were stored correctly.

Care was planned and personalised for people individual needs. A variety of activities were in place to stimulate and reduce isolation. Complaints were dealt with in line with the providers policies and procedures. Processes were in place for people and families to discuss end of life wishes.

Staff and the registered manager were approachable and proactive. The provider was following regulatory requirements. People, families and staff were involved and empowered to share their views on how the home was run. Best practice forums and meetings were attended by the registered manager to update their knowledge and understanding to ensure people received good outcomes.

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

Rating at last inspection

This service was registered with us on 30 April 2018 and this is the first inspection.

The last rating for this service was Good (published 6 April 2017). Since this rating was awarded the registered provider of the service has altered its legal entity. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

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.