CQC report explained · a residential care home
What the CQC found at Oakley House Ltd
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 protected from abuse and risks were generally managed well. However, medicines guidance and records needed improvement, visitor infection checks were not always completed, and staff raised concerns about having only one worker at night.
- Effective?
- Good
- People had access to healthcare, food and support with nutrition. Staff had role-specific training, care was reviewed, and the home followed the principles of the Mental Capacity Act.
- Caring?
- Good
- Not assessed in this inspection.
- Responsive?
- Good
- Not assessed in this inspection.
- Well-led?
- Requires improvement
- Some audits did not identify shortfalls, and managers lacked understanding of the guidance about supporting people with learning disabilities to live ordinary, empowered lives. People and staff were involved through meetings, surveys and discussions.
What inspectors found, March 2022
Oakley House Ltd was rated Requires Improvement; inspectors found safe and effective care in many areas, but concerns about independence, medicines records and staffing at night.
This was an unannounced inspection on 31 January 2022. Inspectors spoke with five people, six staff and the provider and manager. They observed care and reviewed care plans, medicines records, safeguarding information, incidents, recruitment files, audits and policies.
The home was rated Good for Effective. People received their medicines as prescribed, had access to healthcare and were supported with food, drink and health needs. Staff had training, and the home followed the Mental Capacity Act principles.
Safe and Well-led were rated Requires Improvement. Some medicines records did not contain enough guidance, visitors were not checked in line with the required COVID-19 guidance, and there was only one staff member at night for nine people. Inspectors also found that care did not always promote people's independence, choice and quality of life.
The previous overall rating was Good, published on 11 March 2020. This inspection only assessed Safe, Effective and Well-led, while the other question ratings were carried over. The overall rating fell to Requires Improvement because of the findings at this inspection.
People felt safe
People told inspectors they felt safe, and staff knew how to respond to safeguarding concerns. Risk assessments gave staff guidance about supporting people safely.
“People told us they felt safe with staff.” from the report
Healthcare support
Staff arranged appointments, blood tests and referrals when needed. Changes made by healthcare professionals were acted on and recorded.
“People had regular appointments with mental health teams [CMHT] and were referred appropriately when staff were concerned” from the report
Good support with food
People were offered choices and alternatives at mealtimes. Staff supported people who needed help to eat and those at risk from poor nutrition.
“There were choices of meals and if a person did not like what was on the menu an alternative was offered.” from the report
Staff training and support
Staff completed an induction, received training linked to their roles and had supervision from the manager.
“Staff completed a full induction before they started caring for people.” from the report
Medicines records
seriousRecords for medicines taken when needed did not always explain what staff should try first. Medicines given by other healthcare providers were also not added to the medicines administration records.
“Records for medicines given to people that were prescribed 'as required' were not complete” from the report
Independence and choice
needs fixingStaff often completed tasks such as preparing meals and drinks instead of supporting people to develop or use their own skills. Inspectors said the care was not always person-centred.
“There was a culture of staff undertaking all care for people including preparing meals and drinks” from the report
Visitor infection checks
seriousVisitors were asked for evidence of a negative lateral flow test, but vaccination status was not checked as required. The infection control policy did not include the actions needed for visitors.
“We were not always assured that the provider was preventing all visitors from catching and spreading infections.” from the report
- 01What has changed about staffing at night since inspectors found there was one staff member for nine people?
- 02How are medicines taken when needed now recorded, including the alternatives staff should try first?
- 03How do you support each person to prepare meals, make drinks and carry out other tasks independently?
- 04What action have you taken to follow the Right Support, Right Care, Right Culture guidance?
- 05How do you now check visitors' vaccination or testing status and keep the infection control policy up to date?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not assessed and the other ratings were carried over from the previous inspection. This explanation was written from the published report of 23 March 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, March 2020
Rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
This was an unannounced planned inspection by three inspectors on 12 February 2020. They spoke with six people, two relatives and four staff. They checked care records, staff files, medicines, incidents, audits, the building and people's rooms.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people felt safe, staff knew them well, medicines were managed safely and people were treated with dignity and respect.
People had choice over their care, food and activities. They were supported to use the community and develop independence. Complaints were dealt with in a timely way, and easy-read information was available.
The previous inspection, published in February 2019, rated the home Requires Improvement and found multiple breaches. Inspectors found enough improvement this time, and said the home was no longer in breach of regulations.
People feel safe
People told inspectors they felt safe and trusted staff. Staff understood safeguarding and how to respond to risks.
“People told us they felt safe living at Oakley House and that they trusted staff to keep them safe.” from the report
Personalised care
Care plans included people's histories, preferences, interests and communication needs. Staff knew people well and adapted support to them.
“Care plans were person-centred and had been developed with people.” from the report
Kind and respectful staff
Inspectors observed friendly, calm interactions. Staff encouraged people to do as much as possible for themselves.
“Staff always treated people with dignity and respect.” from the report
Improved oversight
The provider had introduced quality audits after the previous inspection. These audits identified issues and helped the management team complete improvements.
“Since the last inspection the provider has implemented robust quality audit processes.” from the report
Manager registration
minorThere was a manager in post, but the home did not have a registered manager at the time of the inspection. The manager was applying to register with the CQC.
“At the time of the inspection the home did not have a registered manager.” from the report
- 01What is the current progress of the manager's application to register with the CQC?
- 02How are people's personalised care plans reviewed when their needs, medicines or behaviour change?
- 03How do you make sure people continue to have their chosen activities and access to the community?
- 04What checks are carried out now to make sure medicines, infection control, housekeeping and fire safety remain safe?
- 05How are people's wishes and family contacts recorded and kept up to date for future end of life care?
This was an unannounced planned inspection covering all five key questions and both the care provided and the care home premises. This explanation was written from the published report of 11 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 Oakley House Ltd
3 rated inspections over 3 years: the service has held its Requires improvement rating throughout.
- March 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2020Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- February 2019Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- January 2018
Registered with the Care Quality Commission on 15 January 2018.
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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