CQC report explained · a nursing home
What the CQC found at Oaklands
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found safer risk management, improved medicines administration, enough staff and appropriate infection control arrangements. Minor problems with waste bins and cleaning were corrected during the inspection.
- Effective?
- Good
- This key question was not covered by this focused inspection. The previous rating was carried forward when calculating the overall rating.
- Caring?
- Good
- This key question was not covered by this focused inspection. The previous rating was carried forward when calculating the overall rating.
- Responsive?
- Good
- This key question was not covered by this focused inspection. The previous rating was carried forward when calculating the overall rating.
- Well-led?
- Requires improvement
- The new manager had made positive changes and audits were more thorough, but the service needed to show stable leadership and that improvements would continue.
What inspectors found, March 2021
Listed as Good overall, with safe care improved, but well-led Requires Improvement and leadership stability still needs to be shown.
This was an unannounced focused inspection. Inspectors visited on 9 and 11 December 2020, reviewed records and spoke with people, relatives, staff and other professionals. They looked only at Safe and Well-led, including infection control during COVID-19.
The home had improved since its previous inspection. Inspectors found safer risk management, better medicines systems, enough staff and improved care for people at risk of pressure sores. The manager was also communicating openly with people, families and staff.
The main remaining concern was whether the improvements would last. There had been several changes in managers, and the new manager was still applying to register with CQC. The front page lists the overall rating as Good, but the report also says the overall rating changed from Inadequate to Requires Improvement. Safe was rated Good and Well-led Requires Improvement.
The home had been in Special Measures since May 2020. Inspectors decided it was no longer Inadequate and no longer in Special Measures. They said the provider was no longer in breach of the regulations checked at this inspection.
Safer medicines
Medicines were being given as prescribed. Only trained senior staff administered them, and records and checks had improved.
“People received their medicines as prescribed. Only senior staff who were fully trained administered medicines and checks were in place to ensure staff remained competent.” from the report
Enough staff
Inspectors found enough staff to keep people safe. Staff checked people regularly and inspectors did not see people waiting for help.
“At no time did we observe people having to wait any length of time for staff to attend to their needs.” from the report
Open communication
The manager was communicating regularly with relatives and keeping them informed about changes and COVID-19 restrictions.
“Relatives told us management were accessible and they were informed of any important changes or incidents at the service.” from the report
Better quality checks
Audits were more detailed than at the previous inspection. Actions were recorded, followed up and used to help staff learn from incidents.
“Audits were clear and concise with actions clearly documented and signed off.” from the report
Leadership stability
needs fixingSeveral managers had changed, and inspectors had not yet seen whether the new manager would stay and maintain the improvements. The new manager was still applying for CQC registration.
“More time was needed to be sure the provider could achieve a period of stable leadership and maintain recent improvements.” from the report
Waste bins and cleaning
minorThere were not enough bins for contaminated personal protective equipment, and some equipment in a staff changing room needed cleaning. The manager dealt with both issues during the inspection.
“However, we did find that there were insufficient waste bins to dispose of contaminated PPE.” from the report
- 01Who is currently managing the home, and has the manager's CQC registration now been completed?
- 02What evidence can you show that the recent improvements have been maintained since the December 2020 inspection?
- 03How are medicines now checked, and what happens if there is a medicines error?
- 04How do you check that staffing levels remain enough for people to receive help promptly?
- 05What arrangements are in place for infection control, including PPE waste bins and cleaning of equipment?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 4 March 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, March 2020
Oaklands was rated Inadequate and placed in special measures after inspectors found unsafe care and weak management systems.
This was an unannounced, focused inspection on 14 January 2020. It was carried out after concerns about people's safety, pressure care and medicines. Inspectors spoke with people, a relative, staff and managers, and checked care records, medicines records and management systems.
Inspectors found that medicines were not always given safely. Some people missed medicines because they were asleep or refused them, but staff did not always try different times or ask the GP for advice. Care plans did not give staff enough information about pressure ulcers, choking, diabetes and falls. Inspectors also found that staff did not always follow care plans.
The systems used to check quality had not found or fixed these problems. The overall rating fell from Good at the previous inspection to Inadequate. The home was placed in special measures, meaning CQC said it would keep the home under review and normally re-inspect within six months.
Enough staff
People said there were enough staff, and inspectors' observations supported this. Staff spent time talking with people and offering company.
“People told us they felt there were enough staff to meet their needs and this was confirmed by our observations.” from the report
Clean environment
Inspectors found the home hygienically clean and free from odours. Infection control audits and protective equipment were in place.
“We observed that the service was hygienically clean and free from odours.” from the report
Staff recruitment checks
The home had procedures to check that staff were suitable to work with vulnerable people.
“The service had robust procedures in place to ensure staff were suitable to work with vulnerable people.” from the report
People felt safe
Despite the risks identified by inspectors, people spoken with said they felt safe living in the home.
“Despite our findings, people told us they felt safe living in the service.” from the report
Pressure care
seriousCare plans did not clearly explain how to prevent pressure ulcers. Inspectors found that repositioning records and pressure-relieving equipment were not used consistently.
“Staff told us that there were no charts in place and they had not been repositioning the person routinely.” from the report
Missed medicines
seriousSome people missed prescribed medicines or dietary supplements. Staff did not always try another administration time or seek medical advice.
“Medicines were not managed and administered safely.” from the report
Confusing care plans
seriousSome care plans lacked important instructions or gave conflicting information, including about modified diets and thickener for drinks. This could leave staff unclear about how to provide safe care.
“Their care planning was conflicting, and in the 'care actions' part of their care plan it did not reflect their modified diet and thickener.” from the report
Weak quality checks
seriousThe home's audits and improvement plan had not identified or fixed important problems. Managers were not checking care plans, repositioning records or medicines records effectively.
“The management team had failed to identify many of the shortfalls we identified at the inspection.” from the report
Limited accountability
seriousInspectors found that staff did not always take responsibility for making sure care was delivered correctly. Senior staff were not seen to lead by example.
“There was a lack of accountability among the staff team and therefore no one took responsibility for ensuring that appropriate care was delivered.” from the report
- 01What has changed to make sure people at risk of pressure ulcers have clear repositioning, skin-care and pressure-relieving equipment plans?
- 02How do you now check that medicines are given when people are asleep, refuse them or have preferred bedtimes?
- 03How are care plans checked to make sure instructions about choking risks, food texture and thickener are accurate and consistent?
- 04What evidence can you show that daily medicines audits and repositioning-record checks are now being completed?
- 05How have you checked staff competence in pressure care and made sure staff follow people's care plans?
This was a focused inspection of Safe and Well-led only; the other key questions were not inspected and earlier ratings were used in calculating the overall rating. This explanation was written from the published report of 7 March 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 Oaklands
5 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- March 2021Goodcurrent ratingup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2020Inadequatedown from GoodSafe: InadequateWell-led: Inadequate
- October 2018Goodstayed GoodSafe: GoodWell-led: Good
- January 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- September 2014
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- June 2012
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 19 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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