Oakley Lodge Care Home (55)

We found the following examples of good practice.

The service had a robust process and policy to ensure safe visiting including; checking visitors temperatures, completing a survey of information to help identify risks related to COVID-19. Personal protective equipment such as masks, gloves and aprons (PPE) and hand sanitiser was also available for visitors and social distancing encouraged. Information about restrictions on visiting had been shared openly with all relatives. Garden and window visits were available and people were also supported to use Skype and Zoom for video calling with their relatives. The registered manager was researching more innovative ways of enabling safe indoor visiting and was aware of the latest government guidance on this issue.

The provider had detailed policies and procedures to cover all contingencies and the impact of COVID-19 on people, their relatives and staff. These were designed to ensure the minimal disruption to people's lives while aiming to keep them safe.

The registered manager and staff team had worked with the use of furniture placement to ensure natural social distancing for people. They also had agreements in place with people for self-isolating in their bedrooms if the need arose.

Staff had received training from the Infection Prevention and Control, (IPC) nurse on how to stay safe, use equipment and minimise risks of COVID-19. Staff were abel to explain the risks to inspectors showing they understood the risks and how to mitigate them. Staff knew how to safely use PPE and were observed to be following all guidance.

All people newly admitted must have had a negative COVID-19 test for those who could tolerate it. The registered manager had followed government guidance for people who were unable to consent for themselves to the test. People who did not tolerate the test and the full 14-day isolation period on admission were supported with additional staffing. Additionally, other techniques were used to help with early identification of symptoms such as the National Early Warning Sign tool, (NEWS2). This tool improves the detection and response to clinical deterioration in people and is a key element of people's safety and improving their outcomes.

Oakley Lodge Nursing Home is a care home that provides support and nursing care for up to seven people with physical and learning disabilities. At the time of the inspection, seven people were living at the service.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found:

People and relatives told us people’s needs had been met by skilled and attentive staff. They said people lived in a caring and supportive environment. Staff were kind and caring, and motivated to provide care in a way that ensured people could live happy and fulfilled lives. One relative said, “On the whole, I’m very happy with the care. It’s a lovely service really.”

People were protected from harm by staff who were trained to identify and report concerns. People were safe because potential risks to their health and wellbeing had been managed well. There were enough staff to support people safely. People were supported to take their medicines. Lessons were learnt from incidents to prevent recurrence. Staff followed processes to prevent the spread of infections.

Detailed care plans ensured staff had information to help them to meet people’s assessed needs. People had been supported to have enough to eat and drink. People had access to healthcare services when required, and this helped them to maintain their health and well-being.

Staff were respectful in how they interacted with people and supported them. They understood people’s individual communication methods and they ensured they gave people information in ways they could understand. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

The provider had systems to assess and monitor the quality of the service. The registered manager and staff were motivated to provide the best service they could for people and their relatives. There had been good transition arrangements to the new provider to ensure continuity of 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 good (published 9 June 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.

At the time of the inspection, there were seven people being supported by the service. There was a registered manager in post, who was also the provider of the service. 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.

People were safe and the provider had effective systems in place to safeguard them. There were risk assessments in place that gave guidance to the staff on how risks to people could be minimised. People’s medicines were managed safely and administered in a timely manner.

The provider had effective recruitment processes in place and there was sufficient staff to support people safely. Staff understood their roles and responsibilities in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff had supervision, support and effective training that enabled them to support people well.

People were supported to have sufficient food and drinks and were supported in a caring and respectful manner. They were also supported to access other health and social care services when required.

People’s needs had been assessed, and care plans took account of people’s individual needs, preferences, and choices.

People were supported to pursue their hobbies and interests.

The provider had a formal process for handling complaints and concerns. They encouraged feedback from people or their representatives, and acted on the comments received to improve the quality of the service.

The registered manager provided stable leadership and managerial oversight to staff who felt supported in their roles.

The provider’s quality monitoring processes had been used effectively to drive improvements.

We looked at the care records for four of the six people who used the service. We found people's needs had been assessed, and appropriate support plans and risk assessments were in place. Theywere reviewed regularly to reflect people's changing needs. Although most people were unable to give informed consent, we found they were supported in a way that promoted their rights.

People's nutritional needs were met and their food preferences respected. Appropriate systems were in place to support a person who required percutaneous endoscopic gastrostomy (PEG) feeding.

We saw that people were offered support at a level which encouraged their independence and ensured that individual needs were met. The atmosphere within the home was relaxed which meant that people were at ease in the presence of the staff supporting them. We observed that staff were polite and respectful in their approach to people and observant to the needs of the people they were supporting. There was evidence of people working together with staff in decorating the home for the Christmas period.

During our visit, we noted that people were involved in planning their care and made decisions about how they spent their free time. People were supported to leave the home to go shopping and were encouraged to participate in other activities within the home. One person said, "I'm happy here, I like my room and I like the staff." A relative told us, "I'm really pleased that she (speaking about the person using the service) came here, I have no complaints at all."