CQC report explained · a nursing home
What the CQC found at Oak House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Some people missed prescribed medicines because there was not enough stock. Inspectors also found that repositioning was missed or recorded inaccurately, and a broken call device had not yet been replaced.
- Effective?
- Requires improvement
- Staff were trained and understood people's care needs, but oral health reviews were not always kept up to date. Staff supervision was not regular, and people's views about food choices were mixed.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Staff knew people's preferences and supported them to make everyday choices.
- Responsive?
- Good
- The home offered a wide range of activities and responded to individual wishes and interests. Inspectors found that complaints were managed appropriately and that end of life wishes were considered.
- Well-led?
- Requires improvement
- Audits did not identify the problems inspectors found with medicines, repositioning, oral health reviews and records. There had also been several management changes and some staff did not feel supported.
What inspectors found, June 2019
Rated Requires Improvement; inspectors found kind and responsive care, but medicines, staffing and records were not always safe or reliable.
This was a planned, unannounced inspection on the first day, carried out over 29 March, 1 April and 2 April 2019. Inspectors reviewed medicines, care plans, recruitment and supervision records. They looked around the home, observed care and mealtimes, and spoke with people, relatives and staff.
The home was caring and responsive. People were generally treated with kindness, dignity and respect. There were many activities, links with the local community and support for people's interests and end of life wishes.
However, inspectors found important safety and management problems. Some people missed prescribed medicines because supplies were not available. Repositioning was not always carried out or recorded correctly, staffing levels were not enough for people's needs, and some care records were inaccurate. The home was also changing managers at the time of the inspection.
The overall rating was Requires Improvement. Safe, effective and well-led were rated Requires Improvement, while caring and responsive were rated Good. The home had been rated Good at the previous inspection, published in August 2016. Inspectors identified four breaches of regulations and said they would monitor the home and return to inspect it again.
Skilled staff
Inspectors found that staff were competent and knowledgeable. Staff had completed required training in areas such as safeguarding, moving and handling, first aid and fire safety.
“Staff we spoke with were competent, knowledgeable, and skilled.” from the report
Kind and respectful care
People spoke positively about staff. Inspectors observed staff protecting people's privacy and dignity and taking account of their preferences.
“People's choices, privacy and dignity were respected and maintained at all times, staff knocked on doors, addressed people by their preferred name, carried out personal care in private and welcomed and encouraged their families and visitors.” from the report
Activities and community links
The home offered varied activities and supported people to follow their interests and take part in the wider community. It responded to individual wishes, including outings and visits.
“The home responded to these wishes to ensure each person had a fulfilling life.” from the report
Health and care partnerships
The home worked with health and social care professionals. Inspectors noted projects aimed at improving hydration, reducing infections and managing skin tears.
“The service took part in a Clinical Commissioning Group (CCG) initiative to improve hydration and reduce urine infections.” from the report
Missed medicines
seriousTwelve people had not received medicines because supplies were unavailable. One person went without pain relief for four days, while other medicines were unavailable for five days.
“we found a total of 12 people had not received their medicines due to insufficient stock.” from the report
Repositioning and inaccurate records
seriousPeople at risk of skin damage were not always repositioned as their care plans required. Inspectors also found records stating that care had taken place when it had not.
“Records were not always accurate, complete and contemporaneous in relation to people's care delivery.” from the report
Oral health reviews
needs fixingSome people's oral health needs had not been reviewed as often as their care plans required. This could mean problems were not identified promptly.
“five people's oral health needs had not been reviewed or updated for several months.” from the report
Restricting access to a walking stick
seriousOne person's walking stick was taken away when they became angry, even though they relied on it to move around. Inspectors were unsure how long it had been withheld.
“staff 'took the person's stick away' if the person became angry.” from the report
- 01How do you now make sure medicines are in stock and that nobody misses prescribed doses?
- 02How are repositioning schedules checked, and how do you make sure records show what actually happened?
- 03What staffing levels are in place on each unit, including when medicines are being given and at night?
- 04How often are oral health needs reviewed and recorded now?
- 05What has changed in management and staff supervision since the inspection?
This was a planned inspection of the care home, including the premises and care provided, and it assessed all five CQC questions. This explanation was written from the published report of 11 June 2019 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 House
2 rated inspections over 3 years: the service has slipped, from Good to Requires improvement.
- June 2019Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2014
Report published without a new overall rating.
- August 2014
Report published without a new overall rating.
- July 2014
Report published without a new overall rating.
- June 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 11 January 2011.
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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