CQC report explained · a residential care home
What the CQC found at High Oaks
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found people were protected from abuse and avoidable harm, with enough staff, suitable recruitment checks, safe medicines support and effective infection control. They did find that some fire doors were not being used safely.
- Effective?
- Good
- This area was not inspected during this focused inspection. The previous rating was used in calculating the overall rating.
- Caring?
- Good
- This area was not inspected during this focused inspection. The previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This area was not inspected during this focused inspection. The previous rating was used in calculating the overall rating.
- Well-led?
- Good
- Inspectors found supportive management, good communication, regular staff support and systems to monitor quality, incidents and feedback.
What inspectors found, May 2021
Rated Good; inspectors found safe, well-managed care, but some fire doors were not being used safely.
The home provides accommodation and personal care for up to 18 people with mental health needs. There were 16 people living there when inspectors visited.
This was first a targeted infection control inspection. After concerns about one person, it became a focused inspection of Safe and Well-led. Inspectors visited on 16 February and 9 April 2021, spoke with staff, relatives and professionals, observed the home and checked care, recruitment and management records.
Inspectors found enough staff, safe medicines support, appropriate infection control and suitable safeguarding processes. They found two bedroom doors propped open and an external fire door that did not close fully. The home remained Good for Safe and Well-led, and the overall rating stayed Good.
Enough staff
Staffing was based on people's needs. Staff and professionals told inspectors there were enough staff to support people with personal care, mental health needs and daily running of the home.
“Staffing levels there always seem appropriate for the need of [people].” from the report
Safeguarding
Safeguarding concerns were referred appropriately. Staff understood how to reduce risks and how to report concerns.
“Safeguarding concerns were appropriately referred to the local authority safeguarding team.” from the report
Infection control
Inspectors were assured that the home used protective equipment, followed distancing and shielding arrangements, supported testing and had an up-to-date infection control policy.
“We were assured that the provider was using PPE effectively and safely.” from the report
Strong management
The home had a registered manager, a regular staff team and systems for checking quality, learning from incidents and gathering feedback.
“The registered manager and Director had implemented a range of assurance systems to monitor the quality and effectiveness of the service provided.” from the report
Fire doors
needs fixingTwo bedroom doors had been held open in a way that stopped them closing automatically. An external fire door also failed to close fully, which could increase risk during a fire.
“Two bedroom doors had been propped open with items that prevent automatic closure of the doors and an external fire door failed to close fully.” from the report
Medicines records
minorPeople received their medicines and staff were trained, but audits found some recording errors. The home addressed these errors.
“These were mostly recording errors, which were addressed by the service.” from the report
Weekend kitchen cover
minorThe home did not have kitchen staff at weekends. Inspectors were told that extra meals were prepared during the week and stored for weekends.
“Information sent to us shows there were enough staff to cover all of these areas except kitchen staff at weekends.” from the report
- 01Have all bedroom and external fire doors been checked, repaired and kept clear so they close properly?
- 02How are medicines recording errors checked, followed up and prevented from happening again?
- 03How are meals prepared, stored and served safely when there is no kitchen staff at weekends?
- 04What were the ratings for Effective, Caring and Responsive at the previous comprehensive inspection?
- 05How will the home continue to involve people and families when people's views are difficult to obtain?
This was a focused inspection of Safe and Well-led, including infection control; Effective, Caring and Responsive were not inspected and their previous ratings carried over. This explanation was written from the published report of 27 May 2021 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, May 2018
High Oaks was rated Good overall; inspectors found kind, safe and well-managed care, but noted pressure on staffing and some limited activities.
Inspectors visited the home without notice on 10 November 2017. They spoke with five people, managers and staff, observed care, and checked care plans, medicines and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People were supported with medicines, healthcare, food and drink, mental health needs and personal plans.
This was an improvement from the previous inspection in December 2016, when the home was rated Requires Improvement overall. The earlier concerns about the building, equipment and reporting safeguarding incidents had been addressed, and no breaches were found at this inspection.
Kind and respectful care
Inspectors saw patient and calm support. People said staff were approachable and helped them with their individual needs.
“People were treated with kindness and respect and we observed a good rapport between the staff and the people who used the service.” from the report
Safe medicines
Medicines were stored securely and records showed they were given as prescribed. Staff had training and regular checks were completed.
“All charts were fully completed, signed, timed and dated.” from the report
Detailed care planning
Care plans described people's needs, preferences, risks and ways to support them. They were reviewed regularly and included professional input.
“Care plans were comprehensive, consistent and clearly laid out.” from the report
Improved management
The home had responded to the previous inspection. Inspectors found stronger oversight of maintenance, incidents, risks and quality.
“At our most recent inspection, we found the service compliant.” from the report
Staffing pressure
needs fixingThere were fewer staff in the evening and only one waking night staff member. This could restrict outings and make it harder to meet people's needs when support was needed at the same time.
“Staffing levels did not enable people to go out in the evening unless this had been planned in advance” from the report
Recruitment records
needs fixingRecords did not always show how the home had checked whether applicants were suitable and of good character. The provider sent evidence of actions taken after the inspection.
“Recruitment records were not fully robust to demonstrate that the risks associated with employing unsuitable staff had been mitigated.” from the report
Training gaps
needs fixingOne newer staff member had not completed all mandatory training, including training linked to difficult behaviours and manual handling. They were still within their probationary period.
“One member of staff had not completed all their mandatory training but were still within their probationary period.” from the report
Limited activity and community access
minorSome people were inactive, bored or reluctant to join activities. The remote location, limited public transport and need to plan staffing and cars in advance also restricted outings.
“There was a lot of inactivity in the service with some people not engaging in planned or spontaneous activity.” from the report
Dining support
minorAt the start of lunch, the chef was the only staff member supporting people in the dining room. Inspectors said this did not improve the dining experience.
“This did not enhance people's dining experience.” from the report
- 01How many staff are on duty in the evening and overnight, and how do you provide one-to-one support when several people need help at once?
- 02What action has been taken to make recruitment checks and decisions about applicants fully clear in staff records?
- 03Has all mandatory training now been completed by every staff member, including training about difficult behaviours and manual handling?
- 04How do you support people who feel bored or lack motivation to take part in activities and outings?
- 05How do you make sure people receive enough support during meals and that their individual dietary or weight-management goals are followed?
This was an unannounced follow-up inspection covering all five CQC areas, after the previous inspection found concerns with Safe and Well-led. This explanation was written from the published report of 31 May 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.
Every inspection of High Oaks
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- May 2021Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2018Goodup from Requires improvementSafe: GoodWell-led: Good
- March 2017Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 2 December 2010.
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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13 live-in carers within about an hour of Norfolk
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Most charge £990 to £1,120 a week. 9 can care for a couple. 14 years' experience on average.
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