Oak Tree Lodge

Updated 13 January 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by five inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Oak Tree Lodge is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Oak Tree Lodge is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced. Inspection activity started on 18 October 2022 and ended on 25 October 2022. On 18 October 2022 four inspectors visited the service, and on 25 October 2022 an Expert by Experience and two inspectors, which included a medicine inspector visited. An inspection feedback meeting was held with the provider on 31 October 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, Healthwatch and professionals who work with the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We observed how people were being cared for to help us understand the experience of people who could not tell us about their experience. We spoke with 13 people who used the service, 4 relatives and 12 members of staff including representatives of the provider, registered manager, team leaders, care assistants and chef. We reviewed a range of records. This included 9 people's care records and multiple people's medicine records. We looked at 4 staff recruitment files. A variety of records relating to the management of the service were reviewed.

Updated 13 January 2023

About the service

Oak Tree Lodge is a residential care home providing accommodation and personal care for up to 60 older people. At the time of our inspection there were 56 people using the service. Oak Tree Lodge is a purpose built home and accommodates people over three floors.

People’s experience of using this service and what we found

People were not always safe. People were at risk of harm because the provider did not always identify or mitigate risks. This included risks relating to people's health and care needs. Medicines were not managed safely. Accidents and incidents were recorded but actions to prevent repeat events were not always followed up. Staff were often stretched and felt they did not always have time to deliver quality care. Staff were recruited safely. Systems were in place to safeguard people from abuse and control infection.

Staff received the training and formal support they needed for their role. The service worked in partnership with other professionals and supported people to access appropriate healthcare. People had pleasant dining experiences and enjoyed the food. The environment was comfortably furnished and suitable to meet people’s needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were always treated with kindness. Feedback was consistently positive from people who used the service and their relatives. Everyone was complimentary about the staff. The service understood when people needed help from their families and were supported to maintain contact. Staff had the right skills to make sure good care principles were followed; they were sensitive and responsive.

Care was usually planned and delivered in a person-centred way. People told us the care they received met their needs and preferences. People had opportunities to engage in a range of activities. Relatives told us they felt listened to and could raise concerns and complaints.

Governance and performance management were not always effective because checks did not always identify learning and secure improvement. Records about people’s needs were not always accurate. The service was introducing an electronic care recording system which they felt would improve the care planning process. People who used the service, relatives and staff were very complimentary about the registered manager who had been in post 4 months. We received consistent feedback they were making positive changes and had already made improvements.

The registered manager was responsive to the inspection findings and sent information to show they were taking action to address shortfalls identified at the inspection.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 6 May 2021 and this is the first inspection. The last rating for the service under the previous provider was good, published on 1 December 2020.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement

We have identified breaches in relation to safe care and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.