CQC report explained · a residential care home
What the CQC found at Oakfield House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. Risks were assessed, medicines were managed safely, staff recruitment checks had been completed and there were enough staff to meet people's needs.
- Effective?
- Good
- People's needs were assessed using recognised tools. Staff had suitable training and supervision, and people were supported with food, drinks, healthcare and decisions about their care.
- Caring?
- Good
- This key question was not inspected during this visit. Its rating was carried over from the previous inspection.
- Responsive?
- Good
- This key question was not inspected during this visit. Its rating was carried over from the previous inspection.
- Well-led?
- Good
- Audits covered all areas of the service. When problems were found, there was an action plan showing who was responsible and when action should be completed.
What inspectors found, September 2022
Rated Good after improvements; inspectors found safe, effective and well-led care, but this was a focused inspection.
The inspection was unannounced. One inspector visited on 22 August 2022 and inspection activity continued until 26 August. Inspectors spoke with four people, one relative, four staff and one healthcare professional. They also observed care and checked care, medicines, recruitment and management records.
The home was rated Good for Safe, Effective and Well-led. Inspectors found enough staff, safer recruitment checks, accurate medicines records, suitable risk assessments and good infection control. People were supported with food, healthcare, choices and decisions about their care.
The previous inspection in February 2020 rated the service Requires Improvement and found breaches relating to staff recruitment and governance. Inspectors said the improvements had been made and the home was no longer in breach. The overall rating changed to Good, using this inspection and ratings carried over from the previous inspection.
Staffing and recruitment
The home had enough staff, and recruitment checks had improved since the previous inspection. Call bells were answered promptly.
“There were sufficient staff to meet people's needs.” from the report
Medicines
Medicines records were accurate, storage checks were completed and staff training and competency were checked.
“Records were now accurate, staff signed the records to confirm when medicines had been given.” from the report
Risk management
The home assessed risks such as falls, diabetes and catheter care. Accidents were reviewed and action was taken to reduce further risks.
“Accidents and incidents had been recorded and analysed to identify any patterns and trends, action had been taken to reduce the risk of them happening again.” from the report
Listening to people
The management team asked people, relatives and staff for their views and acted on suggestions about mealtimes and food choices.
“People and staff were asked their opinion of the service and suggestions made had been acted upon.” from the report
Choice and healthcare
People were supported to make decisions, choose meals and access health professionals when their needs changed.
“People were supported to have maximum choice and control of their lives” from the report
Inspectors raised no specific concerns in this report.
- 01How do you cover vacancies for permanent staff, and how do you make sure regular agency staff know each person's needs?
- 02How often are medicines records and storage temperatures checked, and what happens if a shortfall is found?
- 03Can we see how your current audits and action plans are being used to keep improvements in place?
- 04What is the timetable for improving the remaining communal bathrooms and renewing the floor coverings?
- 05How will you make sure care plans continue to reflect people's changing needs, choices and preferences?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their ratings carried over from the previous inspection. This explanation was written from the published report of 15 September 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, February 2020
Rated Requires Improvement; inspectors found kind, personalised care, but unsafe recruitment, incomplete medicine records and weak quality checks.
This was an unannounced inspection on 3 and 4 February 2020. The inspector spoke with six people, two relatives, six staff and one healthcare professional. They also observed care and reviewed care, medicine, recruitment and management records.
People said they felt happy and safe. Inspectors found caring and respectful staff, personalised care plans, suitable activities, good access to healthcare and support with food and drink. The caring and responsive areas were rated Good.
There were important shortfalls. Recruitment checks were not always completed before staff started work. Some medicine records were incomplete, new staff did not have a suitable ongoing training system, and audits had failed to find problems. Safe, effective and well-led were rated Requires Improvement.
The home must send CQC an action plan. CQC said it would work with the provider and local authority to monitor progress and return for another inspection. This was the first inspection since the current service was registered, although the previous service rating was also Requires Improvement.
Kind and respectful care
People said staff were caring and kind. Inspectors saw staff being patient, respecting privacy and supporting people without rushing them.
“People told us staff were caring and kind.” from the report
Personalised support
Care plans included people's routines, preferences, family information and interests. People were involved in developing their care where possible.
“Each person had a care plan which contained information about people's choices and preferences.” from the report
Good healthcare support
Staff monitored people's health and involved healthcare professionals when needs changed. They followed professional advice, including advice about eating and drinking.
“The district nurse told us, staff referred people quickly and followed the guidance they were given.” from the report
Activities and relationships
People could take part in activities they enjoyed and maintain relationships with visitors and friends in the home.
“There was a range of activities organised during the week.” from the report
Recruitment checks
seriousSome staff started work without a full employment history and two references. The home had not recorded why staff were allowed to start before checks were complete.
“There was not always a full employment history and two references available before staff started work at the service.” from the report
Medicine records
seriousSome records did not show the required two staff signatures. Audits had not identified these recording problems.
“Some records only had one signature and other records were blank except for the date and the running total of tablets.” from the report
Staff training
needs fixingThe training programme worked better for established staff than for new staff. There was no system to help new staff complete training quickly after induction.
“There was not a training system in place to support new staff, after their induction.” from the report
Assessing people's needs
needs fixingThe home had not used recognised tools or national guidance consistently to assess some health risks. Inspectors said there had been no impact on people's care at that time.
“People's needs had not been assessed following guidance from national organisations such as the National Institute of Clinical Excellence.” from the report
Weak quality checks
seriousAudits did not consistently find problems with records, recruitment and assessments. When problems were found, there was not always a clear plan to put them right.
“These had not consistently identified shortfalls including those found at inspection.” from the report
- 01Have all staff now had the required employment history and references checked before starting work?
- 02How do you check that medicine records have the required signatures and are complete every time?
- 03What training do new staff complete after induction, and how is their competence checked?
- 04Which recognised tools do you now use to assess risks such as malnutrition and skin problems?
- 05What action plan followed the two regulation breaches, and what evidence can you show that the changes are working?
This was an unannounced inspection covering all five key questions; the report says it was the first inspection since the service was registered, while the previous rating was also Requires Improvement. This explanation was written from the published report of 21 February 2020 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 Oakfield House
2 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- September 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2020Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- March 2019
Registered with the Care Quality Commission on 1 March 2019.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
39 live-in carers within about an hour of Kent
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 33 can care for a couple. 12 years' experience on average.
“Always on time and with a lovely smile for my mum. Theresa is kind and sensitive to my mum's needs.”
“Irene was a very kind and empathetic carer who knew just the right words to say to put a smile on my face.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.