CQC report explained · a residential care home
What the CQC found at Oaklands – Residential
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found medicines were not always managed safely, recruitment checks were incomplete and there were concerns about fire safety and premises maintenance. These issues placed people at risk of harm, although inspectors found no evidence that anyone had been harmed.
- Effective?
- Good
- This question was not inspected during this focused visit. The previous rating was used in calculating the overall rating.
- Caring?
- Good
- This question was not inspected during this focused visit. The previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused visit. The previous rating was used in calculating the overall rating.
- Well-led?
- Requires improvement
- There was not enough auditing or reliable record keeping to show that the provider understood risks and acted on problems. The manager was creating an action plan and had started addressing some concerns.
What inspectors found, September 2021
Rated Requires Improvement; inspectors found risks in medicines, recruitment, fire safety and management oversight.
This was an unannounced focused inspection over two days. Inspectors spoke with five people living at the home and eight staff. They reviewed care records, medicines records, recruitment files, training information and quality checks.
The home was not always safe. Inspectors found problems with medicines, staff background checks, fire safety, electrical work, water safety checks and the maintenance of the building. One person did not have a care plan, and there was no clear process for reviewing changing needs.
Management oversight was not strong enough. Records of incidents, accidents, medicines errors and safety checks were incomplete or not consistently reviewed. Some actions were taken during or after the inspection, including fire safety work and new protocols for medicines given as needed.
The overall rating changed from Good to Requires Improvement. This inspection looked only at Safe and Well-led. The other three ratings were carried forward from the previous comprehensive inspection.
Positive views of staff
People told inspectors that staff were supportive and could meet their needs.
“People told us they liked the staff and that they could support their needs.” from the report
Some action was taken
The manager had started making changes during the inspection and was preparing an action plan.
“The manager told us they were committed to making changes at the home and had taken action to address some of our concerns by the second day of inspection.” from the report
Infection arrangements
Inspectors were assured about several infection prevention arrangements, including preventing visitors from spreading infections and facilitating visits.
“We were assured that the provider was preventing visitors from catching and spreading infections.” from the report
Medicines and recruitment
seriousSome medicines were not given at the right time, errors were not reliably recorded and one staff member worked unsupervised without the required checks, induction or mandatory training.
“Medicines were not managed safely. People who were prescribed medicines to be given at a specific time did not receive their medicines in line with guidance.” from the report
Fire safety and building maintenance
seriousInspectors found overdue electrical work, missing water safety checks, fire safety concerns and no fire evacuation plan at the time of inspection.
“At the time of inspection, there was no fire evacuation plan for people living at the home and the fire alarm was not routinely tested.” from the report
Weak oversight
seriousAudits and records were not reliable enough to identify problems or show what action had been taken after incidents and medicines errors.
“There was no evidence of regular auditing of records including accidents and incidents, medicines, supervisions and safety records, resulting in a lack of oversight by the provider.” from the report
Incomplete care planning
needs fixingThere was no clear process for reviewing care when people's needs changed, and one person did not have a care plan.
“One person living in the home did not have a care plan in place.” from the report
Infection control records
needs fixingSome infection control arrangements were only partly assured. Masks were not being worn on the first day, cleaning was not documented and COVID-19 risk assessments for staff had not been completed.
“On the first day of inspection, staff were not wearing personal protective equipment i.e. masks, this was resolved by the second day of inspection.” from the report
- 01What has been done to fix the fire safety concerns, complete the evacuation plan and ensure the fire alarm is tested routinely?
- 02How are medicines now checked, including medicines given at specific times and medicines taken as needed?
- 03How do you make sure every staff member has completed background checks, induction and mandatory training before working unsupervised?
- 04What regular audits are now carried out for medicines, incidents, accidents, care plans and building safety?
- 05How do you review a person's care plan when their needs or preferences change?
This was a focused inspection of Safe and Well-led only; the Effective, Caring and Responsive ratings were carried over from the previous comprehensive inspection. This explanation was written from the published report of 8 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, May 2018
Oaklands House was rated Good; inspectors found safe, kind and person-centred care, with only minor gaps in records and access.
Inspectors visited without warning on 16 April 2018. They spoke with people living in the home, staff, managers and visiting professionals. They observed care and checked care files, medicine records, staff records, meetings and quality checks.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe recruitment, well-managed medicines, detailed risk plans and clean, secure surroundings.
People were involved in their care and daily choices. Inspectors found kind and respectful staff, good links with health professionals, activities that supported independence, and systems for handling complaints and checking the quality of care.
The rating remained Good, as it had been at the previous inspection in October 2016. Inspectors said they found no serious risks or concerns during this inspection or through ongoing monitoring.
Safe medicines
Inspectors checked medicine records for four people and found them accurate, with no unexplained gaps or omissions.
“We looked at four medicines administration records (MARs) and found they had been completed accurately.” from the report
Kind and respectful staff
Staff knew people well and supported them in a patient, respectful way that protected privacy and dignity.
“Staff were caring and kind and provided support in a way which reflected people's wishes.” from the report
Individual care
Care assessments and plans covered people's history, health, preferences, relationships, interests and support needs.
“Prior to their admission, the registered manager would complete a preadmission assessment.” from the report
Support for independence
People were encouraged to take part in cooking, shopping, laundry, hobbies and activities outside the home.
“The staff also arranged trips out on a regular basis.” from the report
Quality monitoring
The home used regular audits, meetings and surveys to monitor care and identify improvements.
“The registered manager had developed a system to audit all aspects of service on a daily, weekly monthly or longer basis.” from the report
Menu records had gaps
minorInspectors found some gaps in the weekly menu. They were told this was open to discussion and suggestions from people living in the home.
“We saw the weekly menu had some gaps.” from the report
One supervision record was incomplete
minorStaff had formal supervision every three months, but one record had not been dated.
“Records showed staff received a formal supervision every three months, although one record had not been dated.” from the report
Garden access
needs fixingAt the inspection, access to the rear garden was restricted for people with mobility difficulties. Plans had been made to build a ramp.
“However access at the time of our inspection was restricted for people who had difficulty with mobility.” from the report
- 01Has the planned ramp to the rear garden now been fitted, and can everyone use the garden safely?
- 02How are medicine self-administration arrangements assessed and reviewed for each person?
- 03How does the home make sure supervision and training records are complete and dated?
- 04How are people involved in updating the weekly menu when choices change?
- 05How are behavioural contracts and support plans reviewed when someone's behaviour may affect other people?
This was an unannounced inspection covering all five CQC questions and the overall rating; the previous inspection in October 2016 was also considered. This explanation was written from the published report of 31 May 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 Oaklands – Residential
3 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- September 2021Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2018Goodstayed GoodSafe: GoodWell-led: Good
- March 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- April 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- February 2012
Registered with the Care Quality Commission on 16 February 2012.
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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