31 January 2019
During a routine inspection
People’s experience of using this service:
The systems and processes in place to monitor the quality and safety of the service were not always effective in identifying and driving up improvements in the service. This meant that the service was not always well led.
Medication administration was not always safe and the competency of staff to administer medication had not been checked regularly to ensure they were safe to undertake this task.
Staff had information on the different ways people could communicate their needs and indicate their consent. We also found evidence of good practice with regards to the application of the Mental Capacity Act 2005 for one of the people whose file we looked at. We found however that it had not been consistently applied to the other person whose care we looked.
For example, assessments made of people’s financial capabilities and risks had not always been properly completed or signed to show that consent for the financial arrangements in place had been obtained.
Statutory notifications relating to safeguarding incidents had not always been reported to CQC in accordance with the provider’s regulatory responsibilities.
People’s needs and risks were assessed and for most of the time staff had had clear guidance on how to provide people with safe and appropriate, person centred care. Improvements were required to the information and guidance staff had with regards to people’s identified nutritional risks.
Staffing levels were sufficient to meet people’s needs. The people and relatives we spoke with told us that at times the staff members supporting them were not always the same staff. This meant that at times people were not supported by staff who knew them best. They told us in recent months, this had improved.
Staff had access to a range of training to support them to be effective in their job role. Some of the training that the provider required staff to complete had not been fully completed. It was difficult to tell if this applied to new staff only, as the evidence provided to inspectors did not provide this level of detail.
People’s support was person centred. They told us that staff were kind, caring and respectful of their needs and wishes. People’s independence was promoted and people were supported to live active lives based on their social and recreational preferences.
People received enough to eat and drink and people told us their nutritional preferences were respected.
Regular meetings took place with people using the service and staff to ensure that their views and opinions with regards to the service were sought.
People’s needs were met by a range of health and social care professionals and staff supported people to attend external appointments in support of their mental and physical well-being.
People we spoke with were happy with the service and had no complaints.
Staff told us they felt supported by the provider and that managers were approachable if they needed support.
The culture of the service was open and transparent. The manager and staff were responsive to our feedback and committed to improving the service.
Rating at last inspection and why we inspected: This was the provider’s first scheduled inspection at Oak House.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.