Oak Farm

During our assessment of this key question, we found concerns relating to the management of medicines and of safeguarding. These concerns constituted breaches of Regulations 12 and 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can find more details of our concerns in the evidence category findings below. We identified concerns with the security of medicines, dating and labelling of medicines, family medicines being administered without prescription or GP agreement, failure to risk assess homeopathic medicines and inaccurate stock control and auditing. Individual staff were clear about their safeguarding responsibilities, but the provider needed more robust systems regarding the use of volunteers and sub-contractors. Risks were mostly well managed, but some staff were unclear on fire procedures. The environment itself was not fully secure which placed people and their possessions at risk. Staffing was mostly in line with the service’s dependency tool but deployment of staff did not always ensure staff could be easily located. Staff were safely recruited and received good training and ongoing support.

Most people told us they were routinely asked for their consent before care and support was provided. However, some records did not evidence the correct processes had always been followed in relation to establishing people’s capacity to consent and ensuring their rights. The provider has assured us they will review people’s Mental Capacity Act 2005 assessments in the light of our findings.

People’s needs were assessed before they were placed at the service to ensure the service could meet them. Where other healthcare providers, such as spinal injury units, had put care plans in place for people’s recovery and ongoing rehabilitation, the service aimed to follow these. Feedback about this was mostly very positive, although we did also receive some negative feedback. Care was regularly reviewed, and most people were involved in care planning and review. There was good oversight of people’s complex healthcare needs.

Most people who used the service, and their relatives, told us they were able to exercise choice and control in relation to their care. Care plans contained specific details about how people wished their care to be delivered and staff aimed to respect this. Although people praised the healthcare provided, some expressed a wish for a more flexible approach which supported their independence. We observed kind and caring interactions from staff providing health and care support.

People were consulted about their care, although some people, and their relatives, had not had been offered recent reviews of people’s needs and goals. People received person centred care but the service needed to be more proactive in increasing people’s independence and ensuring they exercised control over all aspects of their care. Feedback was very mixed.

Systems and processes designed to oversee the safety and quality of the service needed some review to address the concerns we identified. Leaders were present at the service and acted as role models. The Registered Manager was held in high regard by people who used the service, relatives, staff and most healthcare professionals. The registered manager told us they are committed to working on relationships where needed, in order to ensure the best outcomes for people who use the service.