The Care Quality Commission

Archived: Oakhurst Grange Nursing Home

Goffs Park Road, Crawley, West Sussex, RH11 8AY

Provided and run by:
Bupa Care Homes (CFHCare) Limited

All Inspections

23, 24 April 2013

During an inspection in response to concerns

Due to the nature of people's disabilities we were not able to speak to them. In order to understand the care and treatment people received we spent time observing interactions between people and staff who were supporting them. Some people that we were able to speak with told us that they were happy with the service they received. During our inspection we spoke with the relatives of people. The majority expressed dissatisfaction with the service their family members received. Most people's complaints centred around staffing. These included both permanent and agency staff not understanding their family members needs and staffing levels impacting on the delivery of care. The majority of people also raised concerns about the management of the service and expressed the view that this also impacted on the care their family members received. For example, one person said, "All the problems here steam from a lack of leadership and management". Our findings supported the concerns raised by people. We found that some people's nursing needs were not managed safely. We found that staff were not suitably qualified and did not have sufficient knowledge to care for people. Staff were not supported through training, supervision and appraisal. There were no systems in place that were being used to evaluate nursing practices and this placed people at risk. Management of the service placed people at risk of harm.

12 February 2013

During an inspection looking at part of the service

During this inspection we focused on how people were cared for in Copthorne, Balcombe and Charlwood bungalows. These were three of the four bungalows that form this location. The people who lived in these bungalows had a range of needs that included high level nursing interventions and advanced dementia. We spent time observing how people were cared for. We spoke with eight people who lived in the bungalows, two of the bungalows managers and eight staff. We also spoke with the relatives of three people and managers employed by the provider who are based at the location due to no registered manager being in post.

People who lived in Copthorne bungalow told us they were offered choices with regard to personal care and activities. For

example, one person told us, 'I usually have showers; they can whip you through pretty quickly and activities you can go in it or not as the case may be'.

Our evidence found that for people who lived in Balcombe and Charlwood bungalows their dignity, respect and independence was not always promoted. We also found that records did not demonstrate people received the appropriate care and treatment.

17 December 2012

During an inspection looking at part of the service

During this inspection we spent time in Balcombe and Rusper bungalows. These were two of the four bungalows that form this location. The people who lived in these bungalows had a range of needs that included high level nursing interventions and advanced dementia. The majority of people were not able to verbally express their views on the service they received. We gathered evidence of people's experiences of the service by observing the care they received from staff. We also listened to how staff spoke to people. In the main, staff acted promptly to meet people's care needs. Staff spoke to people in a kind and respectful way. We spoke with four people who lived in the bungalows and the acting manager of the location, the two bungalow managers and five care staff. We also spoke with the relative of one person.

People told us that they were happy with the service they received. The relative told us, "I am more than happy with the care my mother receives. The manager and staff are excellent. If I do raise concerns they get them sorted".

Our evidence gathered during this inspection supports the comments made by people.

22 October 2012

During an inspection looking at part of the service

During this inspection we spent time observing how people were cared for in Copthorne, Balcombe and Rusper bungalows. These were three of the four bungalows that form this location. The people who lived in these bungalows had a range of needs that included high level nursing interventions and advanced dementia. We also spoke with seven people who lived in the bungalows and the acting manager of the location, the three bungalows managers and five care staff. We also spoke with the relatives of two people.

In the main, people told us that they were happy with the service they received. People who lived in Copthorne bungalow told us that the care they received had improved and that they were now offered choices with regard to personal care and activities. For example, one person told us, 'They have singers come here with guitars. At Christmas they have children come and sing to us which is good fun'.

People also told us that the quality of food and meals provided had improved since our last inspection. For example, one person told us, "Things have certainly improved. They have a new chef". Our evidence supported their comments.

Our evidence found that people who lived in Balcombe and Rusper bungalows received inconsistent care that at times placed them at risk. When giving feedback to the acting manager we explained that where appropriate we would make referrals to other agencies in line with our responsibilities.

29 August 2012

During an inspection in response to concerns

Two people we spoke with told us how the nurses gave them their medicines, they were happy with the support they had.

We also used a number of different methods to help us understand the experiences of people using the service, because many of the people using the service had complex needs which meant they were not able to tell us their experiences relating to this outcome. We looked at the records that the service kept, talked to staff and observed people being given their medicines.

2 July 2012

During a routine inspection

The home is divided into four bungalows which each provide accommodation for up to thirty people. We had intended to visit all the bungalows to speak with people but the concerns raised by people living in the first bungalow 'Copthorne' and their relatives were such that we amended our plans and spent our time listening to what these people wanted to say to us.

People told us the home was 'mainly O.K but that there were lots of little things that were not done and that the bungalow was desperately short of staff.'

People told us that they did not want to move homes and that overall they were reasonably happy at Oakhurst Grange but that the food was 'disgusting' and 'inedible'.

Many people told us that the call bells took a very long time to answer. We asked about their expectations of how long it should take staff to respond to call bell. Most people we asked told us between 20 minutes and half an hour.

One person summed it up by saying 'There is not much choice about how you live your life. They are understaffed and you have to take what they are able to provide.'

Some visitors that we spoke with told us that they had raised concerns with the staff in the bungalow and the manager but that the problems continued.

1 February 2011

During a routine inspection

In summary, we found that people were telling us that the needs of residents were being met by a caring, committed, skilled and well-trained staff team. They told us that every effort is made by the staff to help people maintain their independence and freedom of choice.

External agencies told us that the provider is receptive to suggestions on improving the service and responds in a positive way to reviews undertaken when safeguarding issues are identified.

People we spoke to said they thought the service was being well managed and systems were in place to ensure that their needs and those of their relatives were being identified and addressed. There were opportunities for people to express their views on how the service is run. We were also able to see that people were given opportunities to express their preferences especially regarding choices in daily living and what food they ate or if they wanted to join in with any activities.

We talked to many people during our visit and some said that although they were not always aware of the formal complaints processes, they did feel able to raise with staff any concerns that they had. Relatives told us that they felt the care at Oakhurst Grange was very good and did not think their relative could be better cared for.

People talked to us about how they were able to be involved in the running of the home and how the unit newsletter had been developed to make everyone feel more included. They spoke about how they were able to talk to staff about any concerns or things they wanted doing and it would happen. They also said that the Manager was approachable and helpful with new systems introduced so they could make comments about the care and service.

Suitable and effective arrangements are in place to ensure that people accommodated at Oakhurst Grange receive individually assessed care and support. Wherever possible we could see that people are consulted about their care, involved in the planning processes and their consent is obtained before a care plan is followed through. People are treated as individuals and their human rights are respected. Relatives that we spoke to said they were aware that care plans were in place outlining arrangements for care and that they were able to be involved if they wanted. These plans reflected peoples' likes, dislikes, preferences and specific personal needs and were reviewed regularly.