CQC report explained · a nursing home
What the CQC found at Oak Farm
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, December 2022
Oak Farm is rated Good and has left special measures; inspectors found safer, kinder and better-managed care, with occasional medicine-record gaps.
This was an unannounced focused inspection. The inspector visited on 18 October 2022, spoke with people, relatives and staff, and reviewed care records, medicine records, staff records and other documents.
Inspectors found improvements in risk assessments, care planning, record keeping and management oversight. Medicines were stored and given safely, people were treated respectfully, and staff supported people's choices and independence.
The home had previously been rated Requires Improvement and had been in special measures since January 2020. The provider was no longer in breach of regulations, and the home was no longer in special measures.
The overall rating is Good. Safe, Effective, Caring and Well-led were each rated Good. Responsive was not inspected in this visit, so its previous rating was used in calculating the overall rating.
Improved safety records
The new electronic care planning system held key risk information and daily support records. Staff said it helped them support people safely.
“This was found to contain key information about people and ensured where risks were identified these had been adequately mitigated.” from the report
Safe medicines practice
Medicines were kept securely and staff used an electronic medicines system confidently. People received medicines on time and as prescribed.
“Medicines were stored securely in locked cabinets within a locked medicines room.” from the report
Respect and independence
Staff supported people respectfully and encouraged them to make choices and do as much as they could for themselves.
“Care plans detailed what areas of a person's support they could complete themselves, and what level of support they required and by how many staff.” from the report
Good rehabilitation support
The home worked with healthcare professionals and had its own physiotherapists and occupational therapist to support rehabilitation and independence.
“This allowed the service to review moving and handling techniques and support people with specific exercises to support them in their rehabilitation to maintain or strengthen their levels of independence.” from the report
Stronger management oversight
Management had acted on earlier inspection findings. Daily meetings, handovers and record checks helped staff monitor changes in people's wellbeing.
“There was a closer monitoring of peoples well-being on a daily basis since our last inspection.” from the report
Occasional medicine-record gaps
minorInspectors found occasional gaps in records for topical medicines. The management team had identified this and said records would be changed and completed electronically.
“We identified there were occasional gaps on topical medication records.” from the report
- 01How do you now check that every topical medicine is recorded when it is applied?
- 02What changes have you made to care plans and risk records since the previous inspection?
- 03How are daily meetings and handovers used to spot changes in a person's health or wellbeing?
- 04How will you support my relative's rehabilitation goals and independence?
- 05What was the previous rating for Responsive, which was not inspected during this visit?
This was a focused inspection of Safe, Effective, Caring and Well-led; Responsive was not inspected and its previous rating was used for the overall rating. This explanation was written from the published report of 13 December 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, December 2021
Oak Farm is Rated Requires Improvement and remains in special measures; inspectors found repeated problems with records, risk management and leadership.
Inspectors visited on 19 and 25 October 2021. They spoke with people, relatives, staff and health and social care professionals. They reviewed care plans, daily records, medicines records, staff files and audits.
Some improvements had been made since the previous inspection. Medicines were managed safely, the home was clean, and staff were seen treating people kindly. People and families said they felt safe and communication had improved.
However, important care information was not always complete, clear or easy for staff to find. This affected risk management, nutrition and hydration monitoring, mental capacity assessments, personal goals and personalised care.
The overall rating was Requires Improvement. Safe, Effective, Caring and Responsive were all Requires Improvement. Well-led was Inadequate. The home remains in special measures because of repeated concerns about leadership and governance.
Kind interactions
Staff were seen knocking before entering rooms, offering choices and supporting people in a caring way. People and families described staff as approachable and kind.
“Staff were observed supporting people in a caring manner. Knocking on people's doors prior to entering the room and offering choice where this was possible.” from the report
Medicines and cleanliness
Inspectors found medicines were stored and administered safely. The home was clean and well maintained during the visits.
“Medicines were safely managed and the service was clean and well maintained when we visited.” from the report
Staffing and training
Recruitment checks had been completed, and staff had training relevant to their roles. People said staff were available when they needed help.
“Staff were safely recruited and checks were made on their suitability through references from previous employers and Disclosure and Barring Service (DBS) checks.” from the report
Working with professionals
Health and social care professionals gave positive feedback about communication and the home's response to changing support needs.
“External health and social care professionals were positive about the service.” from the report
Incomplete risk records
seriousCare plans and risk assessments did not always describe the risks people faced or the action staff should take. Important information was sometimes locked away or difficult to find.
“Care plans and risk assessments had not highlighted all risks relating to the people supported and given clear instructions to staff to ensure consistent safe support could be offered.” from the report
Weak management oversight
seriousAudits and action plans did not identify repeated problems with records and care planning. This continued breach of good governance contributed to the Inadequate Well-led rating.
“At the last four inspections the provider has failed to show there was an effective governance systems at the service.” from the report
Mental capacity records
needs fixingCapacity assessments did not clearly record the discussions with people or show that information had been retained. Inspectors said this could lead to unnecessary restrictions.
“These did not detail the conversation that had taken place to assess capacity, nor that this conversation had been repeated to determine if information had been retained.” from the report
Care plans hard to follow
needs fixingPlans were large and not always personalised. Staff gave different answers about some people's support, creating a risk of inconsistent care.
“Care plans were large, not personalised and difficult to follow,. or locate the essential information required.” from the report
Privacy and dignity
needs fixingA privacy screen did not fully protect one person's dignity during support in a communal area.
“On one occasion it was possible to see the support being completed to this person and thus not protecting their dignity.” from the report
- 01How do you now make sure staff can quickly find accurate information about each person's risks and support needs?
- 02How are nutrition, hydration and skin-care records checked each day, and what happens when a concern is found?
- 03How do you make sure mental capacity assessments record the person's involvement and support the least restrictive decision?
- 04What has changed in the management audits since this inspection, and how do you know the changes are working?
- 05How are care plans kept personalised and updated when a person's mobility, health or communication needs change?
This was a follow-up inspection of all five key questions after the previous inspection, including infection prevention and control under Safe; the report also considered the provider's progress against earlier required improvements. This explanation was written from the published report of 23 December 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.
Every inspection of Oak Farm
6 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- December 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- December 2021Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementWell-led: Inadequate
- March 2021Requires improvementup from InadequateSafe: Requires improvementWell-led: Inadequate
- January 2020Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- October 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2017Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- October 2016
Registered with the Care Quality Commission on 18 October 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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