CQC report explained · a nursing home
What the CQC found at Oakland House Nursing Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- People were not consistently protected from known environmental risks. Risk assessments were missing, water temperature records were inconsistent, and high recorded temperatures were not checked promptly.
- Effective?
- Good
- This area was not inspected during this visit. The previous comprehensive inspection rating was used in calculating the overall rating.
- Caring?
- Good
- People described staff as caring and inspectors saw positive relationships, a calm atmosphere, choices being offered, and respect for privacy, dignity and independence.
- Responsive?
- Good
- This area was not inspected during this visit. No concerns were identified in the information reviewed, so the previous comprehensive inspection rating was used.
- Well-led?
- Requires improvement
- Management systems did not reliably identify, assess and reduce risks. The home did have evidence of partnership working, staff support, complaints handling and engagement with people.
What inspectors found, September 2021
Requires Improvement; inspectors found kind care and safe medicines, but risks in the environment were not always identified or managed.
This was an unannounced inspection on 7 and 12 July 2021. One inspector spoke with nine people, a relative and seven staff. They also reviewed care records, medicines records, staff recruitment files and management records.
The home was caring, clean and following infection control guidance. People spoke highly of staff. Medicines were managed safely, staffing and recruitment checks were suitable, and accidents were recorded and reviewed.
However, environmental risks had not been fully assessed. Water temperature checks were incomplete, and recorded high temperatures were not checked promptly. The quality monitoring systems had not found these problems. This led to breaches of Regulations 12 and 17.
The overall rating changed from Good to Requires Improvement. Safe and Well-led were rated Requires Improvement, while Caring was rated Good. Effective and Responsive were not inspected during this visit, so earlier ratings for those areas were used.
Kind and respectful care
People spoke highly of staff. Inspectors saw relaxed relationships, a calm atmosphere and support that respected people's choices, privacy and dignity.
“People spoke very highly of staff and said staff were caring.” from the report
Infection control
Inspectors were assured that the home was following COVID-19 infection prevention guidance, using protective equipment and facilitating visits in line with guidance.
“We were assured that the provider was using PPE effectively and safely.” from the report
Staffing and recruitment
Recruitment checks were completed, people said there were enough staff, and extra staff were arranged when one-to-one support was needed.
“People told us there were enough staff to meet their needs. When a person required 1 to 1 support this was arranged, and additional staff were deployed.” from the report
Environmental risks were not fully assessed
seriousRisk assessments for the environment had not been completed for people living in the home. This included risks in bedrooms and communal areas for people with more complex needs.
“People were not consistently protected from known risks. Risk assessments in relation to the environment had not been undertaken for people living at Oakland House.” from the report
Water temperature checks were inconsistent
seriousSome checks had not been completed, and five bedrooms had recorded temperatures of 44 degrees or above. The temperatures were not checked promptly after this was raised.
“Temperatures of 44 degrees and above were recorded in five people's bedrooms on this date. We spoke to the registered manager about this on 12 July 2021 and asked what action had been taken.” from the report
Quality checks did not find the problems
seriousThe home's monitoring systems were not robust enough to identify and manage all risks to people's health, safety and welfare.
“Systems and processes were not effective in ensuring all risks to people had been identified, assessed and mitigated against.” from the report
- 01What environmental risk assessments have now been completed for each person, including bedrooms and communal areas?
- 02How are water temperatures checked, recorded and acted on if they are 44 degrees or above?
- 03What changes have been made to the quality monitoring system since the two Regulation 12 and Regulation 17 breaches?
- 04What progress has been made on the action plan requested by CQC, and when will the improvements be reviewed?
- 05How will you maintain the positive care relationships and support for people's independence described in the report?
This was a focused, unannounced inspection prompted in part by a serious incident; Effective and Responsive were not inspected, and their previous ratings were carried over. This explanation was written from the published report of 16 September 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, April 2021
Oakland House Nursing Home was inspected but not rated; inspectors found good infection control arrangements during the COVID-19 pandemic.
The inspection took place on 10 March 2021. It was announced and targeted infection prevention and control because of COVID-19 outbreaks in care homes.
Inspectors found that the home had arrangements for visitors, social distancing, admissions, testing, PPE, cleaning and managing infection outbreaks. They said they were assured these arrangements were in place.
Staff had refresher infection control training and clear guidance about using and changing PPE. Equipment used to check oxygen levels and temperatures had also been checked.
This was not a full inspection of the home. The service was inspected but not rated overall, and the safe question was also inspected but not rated.
PPE guidance and training
Staff had clear instructions about using PPE and when it should be changed. All staff had received refresher infection prevention and control training.
“Staff were provided with clear guidance on the correct use of personal protective equipment (PPE) and how often this should be changed.” from the report
Checked medical equipment
Equipment used to monitor oxygen levels and temperatures was checked by a specialist company to make sure it worked properly.
“Medical devices used for monitoring oxygen levels and temperatures were checked by a specialist company to ensure they were working correctly.” from the report
Support for people lacking capacity
Individual COVID-19 care plans were used to explain the effect of restrictions and support people's understanding of them.
“Individual care plans to mitigate the impact of Covid-19 had been implemented for those people who lacked capacity.” from the report
Coordination with GPs
The home worked with local GPs to coordinate care and support the COVID-19 vaccination programme.
“The care home worked closely with local GP's resulting in effective coordination of care and strengthened professional relationships.” from the report
Inspectors raised no specific concerns in this report.
- 01What infection prevention and control arrangements are in place now?
- 02How often do staff receive refresher infection prevention and control training?
- 03How are PPE use and changes checked in practice?
- 04How are people who lack capacity supported to understand restrictions and changes to their daily lives?
- 05How does the home currently work with GPs and provide access to independent advocacy?
This was an announced targeted inspection of infection prevention and control practices during the COVID-19 pandemic; it was not a full inspection and the service was not rated. This explanation was written from the published report of 30 April 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 Oakland House Nursing Home
5 rated inspections over 6 years: the service has held its Requires improvement rating throughout.
- September 2021Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2021Inspected but not ratedSafe: Inspected but not rated
- September 2020Inspected but not ratedSafe: Inspected but not rated
- July 2019Goodup from Requires improvementSafe: GoodCaring: OutstandingWell-led: Good
- April 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 4 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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