The Oaks Residential Care Home

The rating for the key question of Safe has improved to Requires Improvement. Managing risk was still not always seen a as priority, by the provider. Where people communicated resistance to care through agitation or distress, staff lacked knowledge and guidance on how to support them to manage their anxieties in a positive way. Improvements had been made to the process of reporting and managing safeguarding concerns, but further staff training was needed to ensure they knew how to report concerns outside of the organisation. There were enough staff to meet people's needs during daytime hours, however further work was needed to ensure there were sufficient staff at night. Overall people’s medicines were managed well. Significant improvements had been made to infection prevention and control (IPC) resulting a cleaner and safer environment. New systems had been introduced to monitor the safety and upkeep of the premises and equipment. Staff had been recruited safely and their training had improved. New staff had received an induction and their skills had been assessed.

The key question of Effective was last inspected in September 2019. The rating for the key question of Effective has improved too Good. People’s health, care, wellbeing, and communication needs had been assessed. Introduction of a new communication and handover book had improved sharing of information with health professionals. This had led to improvements in the continuity of people’s care. Managers, staff, and health professionals worked together to support people to live healthier lives. A new chef, improved training, and input from speech and language therapy team (SaLT) had led to improved processes ensuring people’s nutrition and hydration needs were being met. People’s rights around consent to care and treatment had been assessed, and their views considered when planning their care. MCA assessments and best interest decisions were in place but needed more detail to reflect how the assessor had determined the person lacked capacity.

The key question of Caring has improved too Good. Staff treated people with kindness and respected their privacy and dignity. Improved access to activities, within the home and local community promoted people’s independence, health, and wellbeing. Where people chose to stay in their rooms, or were cared for in bed, time was allocated to ensure they received individualised activities in their rooms to reduce isolation and loneliness. People were supported to maintain relationships and networks important to them, including religious communities. Staff wellbeing had improved. Staff felt supported and valued by their leaders and colleagues. Staff were able to raise concerns, and felt their concerns would be listened too, and acted on. Further work was needed to ensure managers and staff acted quickly to identify where people maybe in discomfort or distress. Additional training was needed to ensure staff were able to effectively communicate with people where their ability to verbally communicate had diminished due to advancing dementia.

The key question of Responsive was last inspected in September 2019. The rating for the key question of Responsive has improved too Good. People and their relatives were involved in planning and making shared decisions about their care and treatment. Care plans were basic and lacked guidance for staff on how to provide care and support to people. These needed further development to ensure people were at the centre of their care. Managers and staff worked well with other healthcare professionals. Improvements were needed to ensure the communication needs of people with a disability or sensory loss were met, including access to information in a format suited to their needs. Managers and staff were aware of people’s protected characteristics and knew how to tailor their care and support to meet their individual needs. Systems in place to listen, involve people and respond to complaints had improved. However, further action was needed to reflect how the outcome of complaint investigations were used to improve the service. Refurbishment of the premises was in progress. Equipment needed to ensure people’s safety was available and accessible. The registered manager recognised improvements were needed in relation to end of life care documentation. Work was in progress, in conjunction with the hospice to ensure people and their relatives were involved in making important decisions about their end-of-life care.

The rating for the key question of Well Led has improved too Good. The recruitment of an operations manager, area manager, deputy manager and an administrator to support the registered manager had created a clear management structure, previously lacking. Systems to assess and monitor the quality and safety of the service had improved. New checks and audits had been introduced to ensure safety and compliance. However, these needed further development to ensure they identified and managed risks. The service was moving in the right direction. The provider and management team understood what was needed to ensure the improvements made were sustained and built on. Policies had improved and now reflected procedures which related directly to the service, in line with current legislation. Staff were aware of the shared vison and values of the service. These had been used as benchmark to improve the quality of the service people received, and increased staff morale. Staff were aware of the providers whistle blowing policy, the process to follow to raise concerns and were confident their voices would be heard. The registered manager was visible and led by example; they were supportive and had built a good strong staff team. The registered manager worked well with other professionals and had developed a good relationship with local authority quality improvement team. The provider employed a multi-cultural and diverse workforce. Robust measures were in place to ensure staff were treated fairly.