CQC report explained · a residential care home
What the CQC found at Oakhurst Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, August 2023
Overall Requires Improvement; inspectors rated Safe Inadequate and found serious problems with risk management, safeguarding and staff training.
This was an unannounced inspection on 17 and 18 May 2023. Inspectors observed care, spoke with staff, managers, relatives and professionals, and reviewed care records, medicines records, staff files and management records.
The home was not consistently safe. Inspectors found incomplete or inaccurate risk plans, poor records of restraint, gaps in staff training and concerns about safeguarding investigations. Risks linked to seizures, choking, medicines, cleaning products, fire safety and hot water were not always properly managed.
Care was kind and the home was generally clean. People had access to healthcare and staff supported some daily choices. However, support was not consistently based on best practice, consent records were incomplete, and people did not always receive enough meaningful activities or support to achieve their goals.
The overall rating fell from Good at the previous inspection in February 2018 to Requires Improvement. The home was in breach of six regulations. The provider was required to submit an action plan, and CQC said it would monitor progress and return for another inspection.
Kind staff
The culture was described as kind and caring. Inspectors saw positive interactions, including staff using active support in a structured and enjoyable way.
“The culture within the service was a kind and caring one and staff in all roles spoke passionately about their role” from the report
Healthcare support
People were supported to access healthcare services, including vaccinations, screening and specialist appointments. A professional said staff noticed changes in people's health and acted on medical advice.
“A healthcare professional told us staff recognises changes in people's health or wellbeing and sought and acted on medical advice in a timely way.” from the report
Clean environment
The home was generally clean and maintained, and inspectors were assured that infection prevention arrangements were in place.
“Overall, the home appeared visually clean and there were no mal odours.” from the report
Information about medicines
People were given medicines information in an accessible form, and relatives said calming medicines were used only when necessary after other approaches had been tried.
“Staff had ensured people received information about medicines in a way they could understand.” from the report
Risk and restraint records
seriousSome incident and restraint records were incomplete or conflicting. On two occasions, staff involved in advanced safety interventions did not have the correct training.
“On 2 occasions, staff had been involved in supporting people with advanced safety interventions without having the correct level of training.” from the report
Health risks
seriousPlans for seizures and choking were not always clear or up to date. Records suggested that one person's checks were happening less often than their risk assessment required.
“The measures in place to monitor 3 people who experienced seizures were not sufficiently robust and did not fully mitigate the known risks, particularly during the night.” from the report
Staff training
seriousNot enough staff had current training in dysphagia support, Makaton or advanced safety interventions for the people they supported.
“People's care was being provided by staff who did not consistently have the necessary skills to meet the needs of the people they were supporting.” from the report
Meaningful activities
needs fixingCommunity hours were not fully used and records did not show consistent support with people's goals, hobbies and aspirations.
“The care and treatment did not always reflect people's needs and preferences.” from the report
Consent records
seriousMental capacity assessments were not consistently followed by inclusive best-interests decisions. Some DoLS applications had not been renewed promptly.
“Legal frameworks regarding consent were not consistently being followed.” from the report
- 01What action has been completed to improve risk assessments for seizures, choking and other health risks?
- 02How do you now record and review restraint or other advanced safety interventions?
- 03How many staff currently have the required training in advanced safety interventions, dysphagia support and Makaton?
- 04How are safeguarding allegations investigated and reported to the local authority and CQC?
- 05How will you make sure each person receives regular meaningful activities and support to achieve their individual goals?
This was a focused inspection of Safe, Effective and Well-led, prompted partly by concerns about record keeping, incident management and possible restrictive practices; the other key question ratings were not inspected in this report. This explanation was written from the published report of 15 August 2023 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 2018
Rated Good overall; inspectors found kind, person-centred care, but safety, especially medicines records, Requires Improvement.
Inspectors made an unannounced, comprehensive visit on 23 and 24 January 2018. They observed care, spoke with managers, staff, parents and health and social care professionals, and checked care records, medicines, recruitment files and other records.
The home supported seven young adults with autism and severe learning difficulties. Inspectors found enough staff, good relationships between staff and residents, suitable care plans, and support for health, communication, choice and independence.
The overall rating was Good. However, Safe was rated Requires Improvement because some medicines were not managed or recorded correctly, food safety records were incomplete, and some incidents and care records needed better oversight.
The other four areas were rated Good: Effective, Caring, Responsive and Well-led. The report also noted concerns from some parents about communication and the range of activities.
Enough staff
Inspectors found staffing levels were usually sufficient to keep people safe and support daily activities and outings.
“There were sufficient numbers of staff to meet people's needs.” from the report
Kind and respectful care
Staff built strong relationships with residents and supported their dignity, independence and privacy.
“Staff interacted with people in a kind and caring manner.” from the report
Individual support
Care plans described people's routines, preferences, communication methods and things that could cause anxiety. Staff understood how to support each person.
“Support plans detailed the support people needed and this was personal to them.” from the report
Accessible communication
The home used signing, pictures, communication boards, audio labels and other tools to help people understand information and express choices.
“the service had taken innovative steps to provide information to people in a way in which they could understand” from the report
Medicines management
seriousSome medicines had no opening date, one had passed its shelf life, and records did not always explain medicines that were not given. One medicine was not clearly confirmed as current or stopped.
“We found two 'as required' medicines prescribed for one person in August 2016 in the medicines cabinet.” from the report
Food safety records
needs fixingThe home was clean, but food safety records were not completed consistently. Fridge and freezer temperatures were not always recorded.
“records used to demonstrate that the service was complying with food standards regulations were not being consistently completed” from the report
Family communication
needs fixingMost parents said communication could improve. Some messages were not answered, information from staff conflicted, and weekly home contact letters had stopped.
“Communication is my small complaint; [the registered manager] doesn't always get my messages” from the report
Activities
needs fixingSome relatives felt their family members needed more varied and person-centred activities. Records did not always show that alternatives had been offered when planned activities were declined.
“We found that improvements could be made to ensure that records demonstrated more clearly that staff have tried to offer a range of alternatives when activities were declined” from the report
- 01What changes have been made to check medicine expiry dates, opening dates, disposals and reasons when medicines are not given?
- 02How are fridge and freezer temperatures and other food hygiene checks now recorded and monitored?
- 03How will you keep families informed, including returning calls and providing regular updates about their relative?
- 04How do you make sure each person is offered activities that match their interests and goals, including when they decline a planned activity?
- 05How do you track DoLS expiry dates and make sure renewals are requested on time?
This was an unannounced comprehensive inspection covering all five key questions and was the first comprehensive inspection under this provider. This explanation was written from the published report of 27 February 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 Oakhurst Lodge
2 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- August 2023Requires improvementcurrent ratingdown from GoodSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2018GoodSafe: Requires improvementEffective: GoodWell-led: Good
- October 2016
Registered with the Care Quality Commission on 14 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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