United Response - 74 Oaklands

United Response - 74 Oaklands is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The home is registered to accommodate four people with a learning disability. At the time of the inspection, three people were living at the home. United Response - 74 Oaklands, is a semi-detached house within a housing estate, close to local amenities. There were four bedrooms, one of which was used when staff completed a 'sleeping in' shift. There was a lounge, separate dining room and central kitchen. There was a bathroom on the first floor and a downstairs toilet.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was a registered manager in post although at the time of this inspection, they were on a period of extended leave. 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 provider notified the Care Quality Commission of the registered manager's extended leave and the cover arrangements in place. The manager providing oversight of the service and the registered manager when in post, were based at the organisation's office rather than the service. They visited when needed and were contactable at any time. However, their limited presence in the service, increased the risk of things being missed.

The service was homely but did not always promote the prevention and control of infection. This was because for example, there was debris on the chairs in the dining room and clothing had been placed on the floor in the laundry room.

There was a programme of audits to check the quality of the service. These were undertaken at various frequencies and addressed areas such as health and safety, equipment and the management of medicines. The audits had not however, identify the shortfalls such as the prevention and control of infection found during this inspection.

The environment was comfortable and homely. However, whilst the temperature control was set at 22 degrees, people's bedrooms and the dining room felt cold. Once brought to their attention, staff adjusted the thermostat and the heating came on. The visitor's log showed an engineer had looked at the boiler but there was no documentation to evidence what work had been completed.

All staff had worked at the home for many years and knew people well. There were established relationships and a mutual fondness between people and staff. Throughout the inspection, the atmosphere was lively but relaxed and there were many positive interactions. People were fully involved in all conversations and daily activities. This included answering the door to visitors, making drinks and preparing food. People were supported to complete housekeeping tasks and help with the home's shopping.

People enjoyed a range of social activity both at home and within the community. This included local groups such as Zumba, church and various social groups. People were encouraged to develop and maintain relationships with family and friends. Two people undertook voluntary work, which they enjoyed.

People's medicines were safely managed. Information showed clear details of each medicine and their instruction for use. Staff had signed the medicine administration records to show they had administered people's medicines appropriately.

There were enough staff to support people effectively. Staff enjoyed their role and were caring in their approach. They encouraged people to make decisions and gained consent before providing support. Staff ensured people's rights to privacy and dignity were maintained.

There was a small, cohesive staff team. Staff supported each other well and received a range of training to develop their knowledge and skills. Monthly staff meetings were held to discuss people's needs and share information such as policies and procedures.

The five questions we ask about services and what we found