CQC report explained · a nursing home
What the CQC found at Four Oaks Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors were assured that infection prevention measures, PPE, testing, vaccination checks and outbreak plans were in place. They also reviewed how the home was managing COVID-19-related staffing pressures.
- Effective?
- Requires improvement
- This was not assessed in this targeted inspection.
- Caring?
- Good
- This was not assessed in this targeted inspection.
- Responsive?
- Good
- This was not assessed in this targeted inspection.
- Well-led?
- Good
- This was not assessed in this targeted inspection.
What inspectors found, February 2022
Inspected but not rated; inspectors found well-managed infection control, visiting arrangements and COVID-19 safety measures.
Inspectors visited the home on 28 January 2022. The visit was announced and focused on infection prevention and control, visiting arrangements and COVID-19-related staffing pressures.
Inspectors were assured that the home used personal protective equipment safely, carried out testing, managed admissions and monitored vaccination. They also found plans for preventing and managing outbreaks.
People could receive visitors through pre-booked visits, with visitors going directly to residents' rooms. Visits were also possible in the gardens when the weather allowed.
This was a targeted inspection. The service was inspected but not rated, so the report does not provide a full current rating of the home's care.
Infection control
Inspectors found that staff used PPE correctly and that supplies were well maintained. Staff had also received infection control training.
“Stocks of appropriate personal protective equipment (PPE) were well-maintained and staff used and disposed of it correctly.” from the report
Visiting arrangements
People could have pre-booked visits in their rooms, with visitors going directly there. Garden visits were also available when the weather allowed.
“People were able to spend time seeing and speaking to their visitors in different ways.” from the report
Pandemic planning
Inspectors found detailed procedures for managing COVID-19 risks, including support for people who needed to isolate.
“There were management plans for those people required to self-isolate and additional support available for people who may struggle with isolation.” from the report
Inspectors raised no specific concerns in this report.
- 01What are the current visiting arrangements, and can visits take place in residents' rooms and the gardens?
- 02How often are staff currently tested for COVID-19, and what happens before each shift?
- 03How does the home manage staffing pressures and keep agency staff use to a minimum?
- 04What support is provided to residents who need to self-isolate?
- 05What are the home's current ratings and arrangements for care areas that this inspection did not assess?
This was a targeted inspection of infection prevention and control, visiting arrangements and COVID-19-related staffing pressures; it did not assess the other four key questions or provide a full service rating. This explanation was written from the published report of 8 February 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, September 2018
Rated Good and out of Special Measures; inspectors found major improvements, but the dining experience still required improvement.
Inspectors visited unannounced on 2 and 3 August 2018. They spoke with people, relatives and staff, observed care and meals, and checked care records, medicines, recruitment and quality checks.
The home was rated Good overall and for Safe, Caring, Responsive and Well-led. Effective was rated Requires Improvement because meals were not always well organised, lunch was late and some menu items were missing.
This was a substantial improvement from the previous inspection in December 2017, when the home was rated Inadequate and was in Special Measures. The home had addressed serious safety concerns and was no longer in Special Measures.
Improved safety
Falls risks were assessed in more detail, with sensors, mats and regular checks used where needed. Staff also understood how to support people at risk of choking.
“At this inspection, we found that significant improvements had been made to mitigate risks to people living at the home.” from the report
Better care records
The new electronic care planning system gave staff quick access to people's needs, preferences and risks. Records could be updated in real time.
“The system was easy to use and staff could record onto the system in real time which had improved daily recording for people.” from the report
Kind and respectful care
Inspectors saw staff being patient, encouraging and respectful. People were given choices and their privacy and dignity were maintained.
“We observed kind, dignified and positive interactions between staff and people living at the home.” from the report
End-of-life support
Care plans recorded people's and families' wishes about end-of-life care. People could be supported to remain at the home if that was their preference.
“People and their families were included in end of life planning and staff were clear on what people's preferences were.” from the report
Stronger leadership
Management had better oversight of the home, with audits and action plans used to track improvements. Staff said morale and teamwork had improved.
“At this inspection, we found the registered manager had complete oversight of the service and additional support had been given to the home” from the report
Meals needed better organisation
needs fixingThe dining experience was not consistently well organised. Lunch was late on the first inspection day, and some items shown on the menu were missing from the food trolley.
“Improvements were needed to enhance people's dining experience.” from the report
Some care plans were delayed
needs fixingMost new care plans were completed promptly, but one person had no new care plans by their third day. The home was employing care co-ordinators to help address this.
“There were no time frames for the care plans to be written by and for three new admissions, care plans had been completed within one day while for another person, none had been completed by their third day” from the report
Medicine timing records
needs fixingThe recording system did not initially allow staff to record the time for some medicines given three or four times a day. Inspectors said this could have led to doses being given too close together, and the issue was corrected on the second day.
“This meant that people were at risk of having their does too close together.” from the report
- 01How are menus now planned in advance, and how do you check that every meal item reaches the correct person?
- 02How do you support people who need soft, blended or culturally specific food, and how is the quality and presentation checked?
- 03What staffing levels do you provide at weekends, and how do you cover sickness or short-notice absences?
- 04How do you make sure new care plans are completed promptly after someone moves in?
- 05How are medicine administration times recorded and checked to prevent doses being given too close together?
This was an unannounced inspection of the overall service, including all five key questions, care, premises, records, medicines, staffing and management systems. This explanation was written from the published report of 20 September 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of Four Oaks Care Home
3 rated inspections over a year: the service has improved, from Requires improvement to Good.
- February 2022Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- September 2018Goodup from InadequateSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- March 2018Inadequatedown from Requires improvementSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- September 2017Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2016
Registered with the Care Quality Commission on 13 July 2016.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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