CQC report explained · a residential care home
What the CQC found at The Oaks Residential Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, March 2024
The Oaks Residential Care Home is rated Inadequate and is in special measures; inspectors found serious concerns about safety, staffing, hygiene and management.
This was an unannounced focused inspection on 16 and 27 February 2023. Two inspectors and an Expert by Experience visited, spoke with people, relatives and staff, observed care and checked care records and management records.
The home was unclean and some facilities were poorly maintained. Inspectors found risks from uncovered radiators, an unsafe window and incomplete fire evacuation information. There were not always enough skilled staff, and staff did not have all the training needed for dementia care or swallowing difficulties.
Staff were often kind and compassionate, and medicines were generally managed safely. However, care was not consistently based on good practice, some language used about people was disrespectful, and relatives received mixed information.
The overall rating changed from Good to Inadequate. Safe and Well-led were rated Inadequate, while Caring was rated Requires Improvement. Effective and Responsive were not inspected, so no new ratings were given for those areas.
Kind interactions
Inspectors saw staff being warm and compassionate when interacting with people.
“Although staff showed compassionate care and warmth when interacting with people, care was delivered intuitively and not driven by best practice.” from the report
Medicines usually managed safely
People received their prescribed medicines supportively, and a sample check, including controlled medicines, was correct.
“A sample check of people's medicines, including controlled drugs was carried out and was found to be correct.” from the report
Mental capacity processes
The home completed capacity assessments and involved relevant people in best-interest decisions. Required authorisations were in place where needed.
“We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty.” from the report
Partnership working
Records showed the home worked with health and care professionals, including speech and language, dietetic, dementia and GP services.
“Information in people's care records confirmed the service worked well in partnership with professionals, including SaLT, dieticians, dementia services and the GP to ensure people's health needs were met.” from the report
Poor infection control
seriousThe premises and bathrooms were dirty, and laundry and protective equipment arrangements increased the risk of infection.
“Infection prevention and control (IPC) measures were poor, which placed people at risk of acquiring infections and associated implications to their health.” from the report
Too few staff and training gaps
seriousThere were not always enough staff to provide personal care, supervise communal areas and keep the home clean. Staff lacked training in dementia care and swallowing difficulties.
“Systems to assess numbers of suitably qualified, competent, skilled and experienced staff have not ensured there are sufficient staff deployed to meet people's needs.” from the report
Recruitment records incomplete
seriousSeven staff files did not contain evidence of all required checks, including identity, employment history, references or up-to-date DBS information.
“Review of 7 staff files found they lacked evidence to show all the required recruitment checks had been made to ensure the member of staff was fit to be employed.” from the report
Weak management oversight
seriousThe home's audits were mainly tick-box checks and did not identify serious problems or track trends and causes of incidents. Staff morale was also reported to be low.
“Systems to assess and monitor the quality and safety of the service were ineffective.” from the report
Dignity and communication
needs fixingThe condition of bedrooms and bathrooms affected dignity, and some staff used disrespectful terms about people. Relatives gave mixed feedback about updates and access to information.
“Staff were not always respectful towards people referring to them as 'kicking off', wanderers, double ups, and singles.'” from the report
- 01What has been done to make the home clean and hygienic, and how are cleaning standards now checked?
- 02How many staff are on duty during mornings, evenings and nights, and how is this matched to people's care needs?
- 03What training have all staff and the cook completed on dementia care, swallowing difficulties and choking risks?
- 04How have the risks from radiators, windows and fire evacuation been fixed, and can we see the updated risk assessments and evacuation plans?
- 05What evidence can you show that recruitment checks, incident reviews and quality audits are now complete and effective?
This was an unannounced focused inspection of Safe, Caring and Well-led; Effective and Responsive were not inspected and their previous ratings were carried over. This explanation was written from the published report of 23 March 2024 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
Rated Good; inspectors found improved safety and leadership, with some care records and infection guidance still being updated.
This was an unannounced focused inspection on 17 March 2021. One inspector reviewed records, observed care, spoke with five relatives, six staff and two professionals, and checked staffing, medicines, recruitment, training and management systems.
The home was rated Good for Safe and Well-led. Inspectors found that risks were assessed, staffing levels were monitored, medicines records were accurate, and staff had suitable training. Relatives and staff spoke positively about the improvements and the atmosphere.
Some information in care plans was not easy to follow. The infection prevention and control policy was not fully up to date with the latest government guidance, although the provider said this was updated after the inspection.
This inspection checked Safe and Well-led only. The other ratings from the previous comprehensive inspection were carried forward. The overall rating improved from Requires Improvement to Good, and the previous breach of Regulation 17 was no longer in place.
Improved safety systems
The provider had improved how it monitored safety and quality. Risks were assessed and reviewed, and an improvement plan was being used.
“The provider had made improvements to the systems in place to monitor the safety and quality of the service.” from the report
Enough staff
A dependency tool was used to calculate staffing levels. Relatives and staff told inspectors there were enough staff to meet people's needs at the time.
“Relatives told us there was enough staff available.” from the report
Safe medicines management
Medicines were given as prescribed, records were accurate, stock was checked and staff competency was reviewed.
“Medicines administration records were completed accurately, and staff kept a running balance of the medicines in stock.” from the report
Improved oversight
The registered manager had introduced audits and clearer actions when improvements were needed. Training and staff development were also monitored.
“The registered manager had implemented a range of audits to monitor the quality and safety of the service.” from the report
Care plans were not always clear
needs fixingCare plans contained risk information, but inspectors found that it was not always clearly recorded or easy to follow. The home was transferring information to a new electronic system.
“People's care plans contained information about what the risks to people were; however, information was not always clearly recorded or easy to follow.” from the report
Infection policy needed updating
needs fixingInspectors were only somewhat assured that the infection prevention and control policy was fully up to date. The provider said it had updated the policy after the inspection.
“Some information had not been updated to reflect the most recent government guidance.” from the report
Staffing may need review if occupancy rises
minorStaff said current staffing was adequate, but more staff would be needed if more people moved into the home.
“At the moment there is enough staff and we're managing but if more people moved in, we would need more staff.” from the report
- 01Has the new electronic care planning system been fully introduced, and how do you check that risk information is clear and easy to follow?
- 02Has the infection prevention and control policy been updated, and how do you make sure it reflects new government guidance?
- 03How would staffing levels change if more people moved into the home?
- 04What audits are now carried out, and how do you make sure actions identified by audits are completed?
- 05How will you support my relative's involvement in day-to-day decisions and activities?
This was a focused inspection of Safe and Well-led, including infection prevention and control; the other ratings from the previous comprehensive inspection were carried forward. This explanation was written from the published report of 1 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 The Oaks Residential Care Home
8 rated inspections over 9 years: the service has slipped, from Good to Inadequate.
- March 2024Inadequatecurrent ratingdown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
Read what inspectors found at The Oaks Residential Care Home →
- April 2021Goodup from Requires improvementSafe: GoodWell-led: Good
Read what inspectors found at The Oaks Residential Care Home →
- September 2019Requires improvementstayed Requires improvementSafe: Requires improvementCaring: GoodWell-led: Requires improvement
- July 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2018Inadequatestayed InadequateSafe: InadequateWell-led: Inadequate
- January 2018Inadequatedown from Requires improvementSafe: InadequateEffective: InadequateCaring: InadequateResponsive: InadequateWell-led: Inadequate
- August 2016Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- January 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 13 December 2010.
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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