Background to this inspection
Updated
12 March 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
Two inspectors visited the home on both days of the inspection. A specialist advisor joined the team for the first day of the inspection.
Service and service type
Oakland Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used this information to plan our inspection.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with four people who used the service and three relatives about their experience of the care provided. We spoke with ten members of staff including the registered manager and registered provider, the clinical manager, the quality assurance lead, a nurse and five care staff. We also spoke with two healthcare professionals.
We reviewed a range of records. This included five people’s care records and multiple medicine records. We looked at three staff files in relation to recruitment. In addition, we looked at a variety of records relating to the management of the service.
After the inspection –
We received information requested from the registered manager to validate the evidence found. In addition, we received details of actions taken because of our findings.
Updated
12 March 2020
About the service
Oaklands Nursing Home provides personal and nursing care for up to 39 people. At the time of the inspection 37 people were living at the home.
The home is an adapted house with extensions. Accommodation is provided on the ground and two additional floors. Communal facilities such as lounges, and dining areas are on the ground floor.
People’s experience of using this service and what we found
People were not always supported to remain safe. For example, people had not been protected from very hot radiators, fire safety was not always robustly managed, and identified risks were not always consistently monitored to ensure people were safe and not at risk of harm.
Risk assessment tools gave staff differing findings and improvement was needed in relation to the recording of cream application. Infection control risks were in need of improvement to ensure people were not at risk.
Sufficient staff were available and recruitment procedures were in place to safeguard people. The registered manager and staff were aware of safeguarding procedures to protect people from potential abuse. Staff received training and felt supported by the management.
People’s needs were assessed prior to moving into the home and healthcare needs were met by visiting professionals. Staff received training to provide them with knowledge to be able to support people. People had their dietary needs met.
The provider was aware of improvements they could make to ensure all areas of the home were dementia friendly in providing people with signage to assist finding their way around. Outside areas were available for people to enjoy warm weather.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People were supported by kind and caring staff who respected them and up held their privacy and dignity. People and their family members were able to express their views of the care provided. People were able to participate in fun things to do.
Care plans were in place however these did not always cover all aspects of people’s needs and how staff should ensure people’s care and support needs were to be met.
People and their relatives were positive about the management of the home. Improvements were needed to ensure governance arrangements were fully effective to provide high quality care and person-centred care.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (published 24 October 2018). This service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
This was a planned inspection based on the previous rating.
We have found evidence that the provider needs to make improvements. Please see the safe, responsive and well led sections of this full report.
Following the inspection, the provided supplied evidence of actions there had taken to mitigate areas of risk identified during this inspection. We will assess these as part of future inspections.
Enforcement
We have identified a breach good governance at this inspection. This was in relation to the monitoring of the service and ensure people were not placed at risk of harm.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.