Four Oaks Care Home

This assessment was prompted in part by information of concern, safeguarding activity, statutory notifications and the length of time since the previous assessment. Historical concerns had included medicines incidents, nutrition and hydration safeguarding concerns, governance weaknesses and a period of leadership instability. We found the provider had recognised these concerns and taken action to improve the quality and safety of care. Leaders demonstrated an understanding of previous weaknesses and could explain the measures introduced to address them.

People were supported by staff who were caring, respectful and familiar with their needs. During the assessment we observed positive interactions between staff and people using the service. People and their relatives generally spoke positively about the quality of care provided and the relationships they had developed with staff. The home was clean, well maintained and provided a calm and welcoming environment. Staffing arrangements were sufficient to meet people's needs and support the safe delivery of care.

People benefited from care that was supported by governance, monitoring and risk management arrangements. Improvements to medicines management, nutritional oversight, safeguarding review processes and clinical monitoring had strengthened the provider's ability to identify concerns, respond to risks and support people's safety and wellbeing. Staff worked effectively with healthcare professionals and specialist services to ensure care reflected people's changing needs and circumstances.

Although improvements were evident, some areas remained under development. Medicines governance continued to require close oversight, and the quality of documentation was not always consistent. The provider was continuing to embed improvements following recent leadership and workforce changes.

Overall, people received safe, effective, caring, responsive and increasingly well-led care. Risks were generally recognised, monitored and managed appropriately, and improvements introduced by the provider were helping to strengthen oversight, safety and quality across the service. While further work was required to embed some improvements fully, this did not detract from the positive care and support people were receiving.