Oaklands Nursing and Residential Home

Updated 17 November 2022

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors, a medicine inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Oaklands Nursing and Residential home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Oaklands Nursing and Residential home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had been in post for over one week and had submitted an application to register. We are currently assessing this application.

Notice of inspection

This inspection was unannounced.

We visited the location’s service on 5 and 10 October 2022

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 8 people who used the service, 2 relatives and 1 visiting professionals. We spoke with 9 staff members. These included, 1 nurse, 1 activities co-ordinator, 4 carers, the nominated individual, clinical manager and the manager. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We looked at 7 people’s care records, associated documents, medicines records and medicines related documentation. We also looked at 3 staff files, training and supervision records. As well as records relating to the operation and management of the service. We undertook a tour of the building, observed medicines administration and their storage, and completed observations in the communal areas.

Updated 17 November 2022

About the service

Oaklands Nursing and Residential Home is a residential care home providing personal and nursing care to up to 44 people. The service provides support to older people and people living with a dementia across a two-storey building. At the time of our inspection there were 41 people using the service.

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

Medicines were not always managed safely and in line with prescribers’ directions. System were not robust enough to identify and reduce risk. Individual risk assessments were not always detailed enough or in place. People felt safe in the service. Staff were recruited safely and knew how to report and recognise safeguarding concerns. There were sufficient staffing levels in the service to meet people’s needs, although people told us that at times, they felt there were not enough staff. The service had recently been separated into units and staff told us that this has helped to organise shifts and response times. Infection prevention and control measures were in place and being followed.

Staff were not consistently receiving training in key areas. We recommended that training compliance levels were improved. Supervisions were occurring. People’s diet and nutritional needs were met, and they told us they enjoyed the meals. The provider worked in partnership with other agencies to maintain people’s health and wellbeing.

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.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

People’s individuality was being respected. People were being treated with dignity and respect and had choices over their care. People and relatives told us they felt supported and were involved in meetings at the service.

People were supported to have person centred care. We made a recommendation about people and their families being involved in the care planning processes. Activities were being offered at the service and processes and systems were in place to respond to complaints. End of life care was being considered and planned for.

Systems and processes were not always effective to oversee and manage risk in the service. The views of people, families, staff and professionals were being sought and analysed. Staff and residents’ meetings were regularly occurring. Staff and people felt the home was well managed and the new manager was bringing positive change. The manager and provider were aware of their duty of candour responsibilities and had taken appropriate steps to register the new manager at the service.

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 the service under the previous provider was good published on 28 December 2018.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

The provider has taken immediate action address the issues identified and provided an action plan.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Oaklands Nursing and Residential home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe medicine management, the management of risks within the environment and individual risk assessments, and the operation and oversight of the service at this inspection. We have also made recommendations on improving training compliance and ensuring people and relatives are involved in care planning.

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 from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.