We carried out a review of the data available to us about Four Oaks Healthcare Ltd on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Four Oaks Healthcare Ltd, you can give feedback on this service.
Four Oaks Healthcare Ltd is a community based care provider that provides personal care to people living in their own homes. At the time of inspection 60 people were receiving a service and all were in receipt of the regulated activity of personal care.
CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they did, we also consider any wider social care provided.
People’s experience of using this service and what we found
Staff had received training in safeguarding and knew how to keep people safe. The registered manager understood their legal requirements within the law to notify us of all safeguarding incidents. However, the provider’s use of the electronic system had failed to ensure statutory notifications had been sent to CQC as required by law in a timely manner.
Staff had been recruited safely and were trained and supported to provide the best possible care for people. Medication was administered safely.
People's support needs were assessed regularly and planned to ensure they received the support they needed. Some care plans were very detailed whilst others required further information to guide staff. The provider carried out regular audits of the service to ensure people received good quality care and to drive forward improvements.
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 December 2019).
Why we inspected
We undertook this focused inspection to check on specific concerns we received about the support people experienced. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We found no evidence during this inspection that people were at risk of harm from these concerns. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Four Oaks Healthcare Ltd is a domiciliary care service providing personal and nursing care to 90 people at the time of the inspection. There were two parts to the service; standard domiciliary care which involved staff attending to people living in their own homes periodically throughout the day or week. The other part was a more intensive support which involved staff living in people’s own homes 24 hours a day. People were living all over the country, and it was not only based in one area. Those who needed support included older people and younger adults.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
Risks were not always assessed and planned for which may lead to inconsistent care. Staff knew how to recognise safeguarding concerns, however we have made a recommendation about staff knowing to report their concerns to the local safeguarding authority. People were supported to have their oral prescribed medicines. We have made a recommendation about ‘when required’ medicines and topical medicines. There were enough staff to support people and recruitment checks were made on staff. Lessons were learned when things had gone wrong and action was taken to protect people. People were protected from the risk of cross infection as staff used correct procedures.
Systems were not always effective at identifying omissions and ensuring the quality of care was improved. The electronic system being used was still relatively new so was not fully embedded and improvements were still being made. People and staff felt positive about the management team. People and staff were asked for their feedback. The registered manager was aware of their responsibilities with duty of candour, notifications and displaying the previous rating. People and staff were asked for their feedback. The service also worked in partnership to ensure effective outcomes for people. The service was continuously learning and implementing new ways of working.
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. Our feedback about capacity assessments was acted upon. People had access to a range of other health professionals and were supported to have food and drinks that were appropriate for their needs. Staff received training to be effective in their role.
People felt staff were kind and felt they were treated with respect. People were supported to maintain their dignity and be involved in decisions about their care. People were supported to maintain their independence.
People were supported in a way that matched their preferences and staff had care plans to follow. People felt able to complain and had been satisfied with the response had they needed to raise concerns. People could access information in a way that suited their needs. End of life plans were not always in place or detailed, however no one was imminently at the end of their life at the time of our inspection.
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 good (published 21 March 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
People were safe because staff had received training and understood the different types of abuse and knew what actions they should take if they thought that someone was at risk of harm.
Staff were knowledgeable about the actions to take in the event of emergencies and about how the risks to people in respect of their care should be managed.
There were sufficient numbers of safely recruited staff to provide people with regular staff to support them.
People were happy with the support they received and were encouraged to make choices. Staff understood the requirements of the Mental Capacity Act so that people were supported to consent to their care and make choices about how they were supported.
People felt staff had the skills and knowledge to care and support them in their homes. Staff were trained and supported so that they had the knowledge and skills to enable them to care for adults in a way that met their individual needs and preferences. Where appropriate people were supported to access health and social care professionals.
Staff was caring and treated people with dignity and respect. People’s choices and independence was respected and promoted and staff responded to people’s support needs.
Staff told us that they felt supported by the registered manager and felt able to speak with him if they needed to.
There were systems in place to gather the views of people and to monitor the quality of the service. Some people shared with us what the service could do better which we told the registered manager about. The provider was open and transparent and will use the information as a learning curve