CQC report explained · a nursing home
What the CQC found at Oaktree Court
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Medicines, safeguarding, risk management, recruitment and infection control had improved and were managed safely. Three people reported waits for staff, usually at busy morning or evening times, although inspectors observed call bells being answered quickly.
- Effective?
- Good
- People's needs were assessed before they moved in, and staff worked with health professionals to support people's health. Staff training was available, but the training matrix showed 82% compliance with the provider's requirements.
- Caring?
- Good
- Staff were kind, respectful and attentive. People were involved in decisions, treated with dignity and supported to remain as independent as possible.
- Responsive?
- Outstanding
- Care was exceptionally personalised. People had flexible routines, detailed care records, meaningful activities and support to achieve individual wishes, including outings and special experiences.
- Well-led?
- Good
- The new management team had made significant improvements. Audits, feedback and meetings were used to identify and address problems, and staff turnover had reduced.
What inspectors found, April 2020
Rated Good, with Outstanding responsive care; inspectors found major improvements since the previous Requires Improvement rating.
Inspectors visited without warning on 17 and 20 February 2020. They spoke with people living in the home, relatives, staff and visiting professionals. They reviewed care plans, medicines records, recruitment files and management records.
The home was rated Good overall. Safe, Effective, Caring and Well-led were all rated Good. Responsive care was rated Outstanding because care was highly personalised, routines were flexible and people were supported to follow their interests and wishes.
The report says the home had improved since its previous inspection, especially in medicines management, safeguarding knowledge, staffing stability and management oversight. Inspectors found people felt safe, respected and well cared for.
Personalised care
Inspectors found that care was based closely on people's individual histories, preferences and routines. Staff knew what mattered to people and adapted their support.
“The attention to people's individual wishes and needs showed the service had developed a highly person-centred approach.” from the report
Activities and choice
People could choose how to spend their time and took part in varied activities, outings and community events. The home also supported people to pursue personal wishes.
“People had access to stimulating social and recreational activities, which enhanced their physical, mental and emotional wellbeing.” from the report
Kind and respectful staff
People, relatives and professionals described staff as kind, considerate and respectful. Inspectors saw warm and reassuring interactions.
“People were supported by staff who were kind, considerate and respectful towards them.” from the report
Safe and clean environment
The home was clean and infection control measures were in place. Equipment and fire safety systems were checked regularly.
“The home was clean and fresh throughout with no malodours.” from the report
Improved management
The report says the new management team had made significant improvements, including better medicines oversight, more stable staffing and stronger quality checks.
“At this inspection we found improvements had been made.” from the report
Laundry area needed refurbishment
needs fixingThe laundry was described as dilapidated and not yet a fully safe working environment. The provider had identified this as a high priority and planned improvements by 31 March 2020.
“The laundry was in a dilapidated state and in need of refurbishment to ensure it was a safe working environment.” from the report
Some waits for staff
needs fixingThree people said they had waited for staff, usually during busy morning or evening periods. Inspectors found most call bells were answered within five or 10 minutes and saw quick responses during the visit.
“Three people said they had experienced a wait for staff, usually at busy times in the morning or evening.” from the report
Training was not fully up to date
minorThe training matrix showed 82% compliance with the provider's training requirements. The home was taking action through reminders and a new training and development mentor.
“The training matrix showed the service was 82% compliant with the provider's training requirements.” from the report
- 01Has the laundry refurbishment been completed, and is it now a safe working environment?
- 02How long do people usually wait for call bells during busy morning and evening periods?
- 03What percentage of staff training is currently complete, and how are overdue refresher courses followed up?
- 04How are people's personal wishes, routines and activities recorded and reviewed?
- 05How does the home support people living with dementia to move around safely while retaining their freedom?
This was a planned, unannounced inspection covering all five CQC questions, with both the premises and the care provided examined; it was prompted by the previous Requires Improvement rating. This explanation was written from the published report of 1 April 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.
What inspectors found, February 2019
Rated Requires Improvement; inspectors found kind, responsive care but serious problems with medicines, risk management and oversight.
This was an unannounced, comprehensive inspection on 2 and 3 January 2019. Inspectors spoke with people living in the home, relatives, staff and a visiting health professional. They reviewed care plans, medicines records, staffing, training, incidents and management checks.
The home had enough staff and people generally said they felt safe. Staff were kind and respectful, care was personalised, and people had access to activities and health professionals. However, medicines were not managed safely, some risks were not properly assessed, and catheter care practices could increase the risk of infection.
The home was rated Good for Effective, Caring and Responsive. It was rated Requires Improvement for Safe and Well-led, giving an overall rating of Requires Improvement. This was a fall from Good at the previous inspection.
Kind and respectful staff
Inspectors saw warm relationships between staff and people. Families and residents described staff as kind and welcoming.
“Staff treated people with kindness, respect, and compassion.” from the report
Enough staff
Inspectors found enough staff to meet people's needs. Recruitment checks included references and DBS certificates.
“There were sufficient numbers of staff available to keep people safe” from the report
Personalised daily life
People could choose when to get up, go to bed and spend their time. Staff supported independence and access to the community.
“People's day to day care was responsive to their needs and personalised to their wishes and preferences.” from the report
Activities and relationships
The home offered a wide range of activities and supported contact with family and friends.
“People had access to a full activities program.” from the report
Access to healthcare
Care records showed that people received health checks and could see relevant healthcare professionals.
“People were supported to access health and social care professionals as required.” from the report
Medicines were not managed safely
seriousInspectors found unclear instructions, undated opened insulin devices and more than 100 recorded non-administered medicines that had not been explained. This could put people's health at risk.
“Medicines management was not robust.” from the report
Important risks were not always assessed
seriousThere were no risk assessments for two people using oxygen. A person at risk of choking did not have the required suction unit in their room.
“the provider had not completed any risk assessments which meant staff had no guidance to follow to ensure people remained safe within the home.” from the report
Catheter care training and practice
seriousStaff had not received catheter care training, and some catheter bags were left in beds rather than draining properly. Inspectors said this increased the risk of urinary tract infections.
“The lack of training and inappropriate cleaning of catheter bags meant people were at risk of urinary tract infections (UTI).” from the report
Specialist training gaps
needs fixingStaff did not have specialist training for oxygen, Parkinson's or enduring mental health needs, despite people at the home requiring this support.
“staff did not have specialist training in areas such as managing oxygen and supporting people with Parkinson's” from the report
Management checks missed problems
seriousThe provider had audits, but they did not identify the medicines and other safety shortfalls found during the inspection. The home had also lacked a registered manager since March 2018.
“some checks were not effective and not identified the shortfalls identified at this inspection.” from the report
Limited involvement in care plans
needs fixingPeople and relatives were not consistently involved in care plan reviews. The home recognised that involvement was not always recorded clearly.
“people were not involved in these reviews” from the report
- 01What has changed to make sure all medicines, including insulin and 'when required' medicines, are administered and recorded safely?
- 02Are there now completed and regularly reviewed risk assessments for people using oxygen or at risk of choking?
- 03Have all staff who provide catheter care completed suitable training, and how is their practice checked?
- 04What specialist training do staff now receive for Parkinson's, oxygen use and enduring mental health needs?
- 05Who is currently managing the home, and how are audits now checked to make sure they identify and fix problems?
This was an unannounced comprehensive inspection covering all five key questions and the overall rating. This explanation was written from the published report of 16 February 2019 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 Oaktree Court
3 rated inspections over 4 years: the service has held its Good rating throughout.
- April 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- February 2019Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- September 2011
Registered with the Care Quality Commission on 21 September 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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76 live-in carers within about two hours of Somerset
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,370 a week. 62 can care for a couple. 12 years' experience on average.
“She looked after my mum, who can be incredibly challenging, so well and so gently, and we always felt confident that my mum was getting the best care available.”
“She was not phased by anything, she was adaptable, kind & gave us complete confidence to go away & not worry about a thing!”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.