This inspection took place on 09 June 2017 and was announced. The provider was given 24 hours’ notice of the inspection to ensure minimal disruption to the daily routines of the people using the service.Oakdene House provides care and support for up to six men with learning disabilities, autistic spectrum disorder, mental health needs or sensory impairment. There were four people using the service at the time of our inspection. There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
At the last comprehensive inspection in March 2016 we found a breach of regulation 12 because people's medicines were not safely managed which resulted in our serving a warning notice on the provider and registered manager. We found further breaches of regulations 17 and 18 because staff were not always up to date with training in areas considered mandatory by the provider and staff had not always received regular supervision in line with the provider’s policy. We also found that quality assurance systems used within the service were not very effective because they did not always identify areas of risk to people’s health and safety so these could be addressed.
We carried out an announced focused inspection on 27 July 2016 and found the provider had met the requirements of the warning notice and people received their medicines as prescribed. Records of the administration of people's medicines were accurate and up to date. We therefore amended the rating for the key question 'Is the service safe?' to ‘Good’; however the overall rating for the service remained as 'Requires Improvement'.
At this inspection people continued to receive their medicines appropriately and staff knew how to manage medicines safely. We saw that medicines were stored appropriately.
Also at this inspection we found the provider was meeting the breaches of Regulations 17 and 18 we had identified at our March 2016 inspection because they had implemented new systems to audit and monitor the quality of the service people received. There were also new systems in place to ensure staff received appropriate training and supervision thereby meeting their needs for improved and effective support with their professional development and their work.
Relatives told us they felt people were well cared for and living safely at the service. This view was confirmed by the health and social care professional we spoke with. Staff knew how to help protect people if they suspected they were at risk of abuse or harm. Risks to people’s health, safety and wellbeing were assessed. Staff knew how to minimise risks and manage identified hazards in order to help keep people safe from harm or injury.
There were sufficient numbers of staff to meet people’s needs. Relatives of people and staff we spoke with confirmed this view.
Staff had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). DoLS provides a process to make sure people are only deprived of their liberty in a safe and correct way. There were policies in place in relation to this and appropriate applications were made by the provider to the local authorities for those people who needed them. Staff supported people to make choices and decisions about their care wherever they had the capacity to do so.
People had varied and nutritious diets and a choice of meals. They were supported to stay healthy by staff who were aware of their healthcare needs and through regular monitoring by healthcare professionals.
Relatives and professionals told us staff were consistently kind and caring and established positive relationships with people and their families. Staff valued people, treated them with respect and promoted their rights, choices and independence.
Comprehensive care plans were in place detailing how people wished to be supported. They had been produced jointly with relatives and where possible people using the service. Relatives told us they agreed the care plans and were fully involved in making decisions about their family member’s support.
Staff helped people with their support to enjoy the activities they were able to participate in both within the home and in the community.
There was a complaints procedure in place and relatives felt confident to raise any concerns either with the staff or the registered manager if they needed to. The complaints procedure was available in different formats so that it was accessible to everyone.
We found there was an open and transparent culture in the home where staff were encouraged to share in the development of the home for the people living in it. Staff we spoke with described the registered manager as approachable and responsive to their own and to people’s needs.
We saw staff were motivated in their work and were keen to improve their learning. They told us and we saw they had access to good and relevant training. Staff had started to receive regular and effective supervision. The registered manager supported a culture where staff training, support and development was emphasised.