We considered our inspection findings to answer questions we always ask;' Is the service safe?
' Is the service effective?
' Is the service caring?
' Is the service responsive?
' Is the service well-led?
This is a summary of what we found-
Is the service safe?
Staff felt they were up to date with their training in safeguarding, Staff told us they wouldn't hesitate to report any concerns to their line managers and were aware of their duty of care to protect vulnerable adults.
We noted some improvements in the management of safeguarding in that they now had the local authority safeguarding policy and that all staff were updated in safeguarding training.
We found continued risks and weaknesses with the overall support and management of medications for service users. People were at serious risk of medication errors which may affect their health and well-being.
Some people made comments that indicated that whilst the attitude of staff was good, there were issues relating to the numbers of staff available, their punctuality and the consistency of the service
Is the service effective?
Seventeen people living at Oakmere and three relatives told us they were mostly happy with the care that had been provided to them and their relatives. Staff were positive about the changes made to the service and the positive impact of having a deputy manager. Overall the majority of people using the service were positive about the staff.
Each person living at the service had a support plan in place to help to show how their needs were being met by the staff team. These records had been reviewed since our last visit. Out of date information have been removed.
Care records had consent forms that some people had signed regarding the management of their records. People told us they had discussed their care plans with staff and they had recently been included in discussions about their care plan.
There were various gaps in staff training needs in topics such as the Mental Capacity Act; infection control and food hygiene. The service had no overall plan to show what actions and dates were being planned to ensure all staff were fully trained and up to date in all other topics necessary for their role.
Is the service caring?
People living at Oakmere made general positive comments about the staff such as,
"I would trust most of the care staff with my life"; 'All very nice, feel safe here, like old friends'; 'They are a fine set of girls, cannot fault them'; 'Its fine' and 'Carers are alright, I know them all."
Two relatives and one person using the service were unhappy with various aspects of care provided. We have referred them to the provider to review their concerns. We have also discussed their concerns with the local authority commissioning team.
Is the service responsive?
We noted that some comments and concerns had been recently captured within the surveys sent out to everyone in August by the provider. However they had not analysed the results of the surveys as senior managers advised they were waiting for more to be submitted. There was no evidence that each person's concern had been dealt with and we noted similar comments shared with the inspection team during our visit by a small number of relatives and people using the service.
We spoke with two relatives who raised concerns about their family members care. Their concerns had not been documented as complaints. Their concerns had not been followed up or acknowledged by the manager.
Is the service well-led?
Staff told us they felt well supported by the managers from SOS Home care. A lot of people responded positively to the deputy in post who now worked 40 hours a week supernumerary.
The manager and provider quality checks at the service required further development. Improvements were needed in the present arrangements for monitoring of the service, specifically with the management arrangements and engagement with people using the service; safeguarding; complaints; medications and training and supervisions of staff. Both service users and relatives took the opportunity to express their opinions and suggestions for improvements to the service.
We noted continued concerns with the management, non-reporting and lack of transparency in notifications regarding safeguarding and incidents involving the police. The service had not reported a number of incidents to the Care Quality Commission (CQC) which is a legal requirement to ensure transparency of the management of the service.