The Oaks

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

At our last inspection of the service, we found mealtimes were not planned in a way to ensure they were a relaxed, pleasurable experience. On both days of the inspection the lunch service took a long time to be served and people had become visibly hungry and impatient due to sitting around waiting for a long time. The failure to ensure food and drink provided met people’s individual needs was a breach of regulation 9 (Person-centred care) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found that enough improvement had been made at this inspection and the provider was no longer in breach of regulation 9.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us they were involved in planning for their care needs. One person said, “I tell them what I like, and they do it.” Another person told us, “I choose how I spend my time and what I eat, I am a vegetarian, and the staff really think it through and provide lovely meals.” A third told us, “My daughter helped me to plan for my care needs.”

A member of staff told us, “[Person] has a hearing problem; you have to go close to [person] to speak with them. [Person] can get agitated if you don’t hear properly. We [staff] can’t always understand [person], so we give [person] a pen and paper to communicate.”

Peoples care, and support needs were assessed before they moved into the service. Assessments covered all aspects of individuals care and support such as, mobility and moving and handling, nutrition and hydration, personal care, communication, mental health and medicines management amongst others. Care plans were developed and documented within the providers electronic care planning system in line with people's assessed needs. Care plans documented people’s assessed needs so staff could provide person centred care. For example, one care plan documented a persons preferred food choices and that they enjoyed drinking tea with milk and sugar. Another documented, “When speaking with me, please do not speak loudly, speak clearly, and give me time to process what you have told me to do at all times. I can understand the choices through verbal or written communication as long as it's kept simple and clear.” Senior staff conducted regular reviews of care plans to ensure they remained reflective of people's changing needs. The provider had embedded a ‘resident of the day’ scheme which ensured care plans and records were reviewed frequently with people, and their relative’s participation where appropriate. We spoke with the registered manager who told us they had plans to introduce a more ‘dementia friendly’ care plan tool to enhance people living with dementia involvement in their care. This would include the use of more pictures and large fonts to aid understanding and comprehension. The registered manager also told us they were currently recruiting 2 senior staff to become ‘dementia leads’ for the service.

People told us they were involved in planning for their care needs. One person said, “I tell them what I like, and they do it.” Another person said, “I am well, Im happy and just had my breakfast which I enjoy.” A third told us, “My daughter helped me to plan for my care needs.” A fourth person commented, “I choose how I spend my time and what I eat, I am a vegetarian, and the staff really think it through and provide lovely meals.”

Staff told us that they would benefit from additional support at lunchtime (and breakfast) as the periods of eating took a long time to ensure that people had the opportunity to eat in a calm way. One member of staff told us, “It’s important we don’t rush people. We need them to eat, otherwise their weight goes down and that brings with it other problems for them, and more work for us as we need to monitor all their food intake.” This was said in a positive, pragmatic way, as it reflected reality. We spoke with staff about people’s food preferences. One staff member commented, “[Person] likes porridge. [Person] has a cough, so currently we serve pureed foods. [Person] eats very well and writes what they want and we check again before the meal is served.” We spoke with the chef. The chef was knowledgeable of people’s dietary needs. They showed us a white board which detailed people’s individual dietary needs for example some had allergies and had modified textured diets where they were at risk of choking. They told us there was a resident of the day system where they met with individuals to discuss their dietary likes and dislikes. At a residents and relatives meeting in May 2024 they had made some taster portions of some of the new foods and invited everyone to try. There was very positive feedback on these.

At our last inspection there were concerns relating to hydration, in particular the recording of people’s fluid intake. At this assessment we saw the service had implemented a digital platform for recording people’s fluid intake over a 24-hour period from midnight. It was difficult to analyse when people were drinking their fluids over the period. Whilst jugs of water and juice were placed in people’s rooms and in communal areas, it was unclear how the intake of this fluid output was monitored for people with a catheter in place, increasing the risk of dehydration and avoidable harm, which could lead to other complications from developing being missed. We discussed concerns with this process with the registered manager. People's nutrition and hydration needs; preferences and cultural needs were assessed and safely met. Care plans were developed to ensure people’s nutrition and hydration needs were met and people were supported to eat a healthy diet. Care plans documented people’s nutritional needs which detailed their levels of diet and appetite, allergies, food intolerance’s, cultural preferences, special requests and dining preferences including drinking utensils and cutlery. At the time of our assessment there was no one who had pressure wounds. We observed that pressure reliving equipment was in place for people at most risk of developing pressure areas, and air mattresses were in place and regularly monitored to ensure they were working correctly. At our last inspection of the service, we found some issues around the documentation of repositioning charts. At this assessment of the service this had improved with extensive records on people’s repositioning to ensure good skin integrity.

People told us they had access to health care professionals when they needed them. One person told us, “The GP and chiropodist are organised for me.” Another person told us, “If I need to see a health professional, they sort it out.”

The registered manager told us they worked with various professional teams to support people with their care needs. These included tissue viability nurses and speech and language therapists. These professionals had provided staff with dysphagia and wound care training. The community mental health team attended the service regularly to review people's needs.

The service received GP visits every Monday to support people with their health care needs. We spoke with the GP; they told us they found no issues. They said, “It’s the most organised home I come to. There is good communication with the nurses. They have a list of patients they want me to see, and they have the records ready when I come. The nurses are competent, they stay on their unit which helps with consistency of care."

People’s needs were assessed, and care and support were delivered in line with current best practice guidance and standards to achieve effective outcomes.

People told us they had access to health care professionals when they needed them. One person told us, “The GP and chiropodist organised for me.” Another person told us, “If I need to see a health professional, they sort it out.”

The registered manager told us they worked with various professional teams to support people with their care needs. These included tissue viability nurses and speech and language therapists. These professionals had provided staff with dysphagia and wound care training. The community mental health team regularly attended to people at the home to review people’s needs.

People were supported to live healthier lives, access healthcare services and support. People were supported to access health and social care services when required. Referrals to additional support services such as speech and language teams and dieticians were made promptly by staff when required. People's health needs were recorded within their care plans detailing any support required from staff to meet their needs. Records showed regular multi-professional working with professionals such as, GP’s and community mental health teams ensuring people’s needs were met appropriately. People were supported and encouraged to access recommended vaccinations. This included staff access to national guidance on recommended vaccination programmes and providing reasonable support to enable staff to access recommended vaccinations.

People told us they had access to health care professionals when they needed them.

The registered manager told us they worked with various professional teams to support people with their care needs. These included tissue viability nurses and speech and language therapists. These professionals had provided staff with dysphagia and wound care training. The community mental health team regularly attended to people at the home to review people’s needs.

People were supported to access health and social care services when required. Referrals to additional support services such as speech and language teams and dieticians were made promptly by staff when required. People's health needs were recorded within their care plan detailing any support required from staff to meet their needs. Records showed regular multi-professional working with professionals such as, GP’s and community mental health teams ensuring people’s needs were met appropriately.

People told us their consent was sought and their views were respected. One person told us, “If I don’t want to do something the staff let me do what I want to do.” Another person said, “If I want to be alone that is respected and I can choose what to wear and enjoy my day in my own way.” A third person commented, “The staff always ask if it is ok before doing something for me.”

Staff described how they made sure that people's dignity and privacy was maintained. One member of staff said, “I helped [person] with their personal care this morning. [Person] is kind and non-verbal. I always ask [person] before I support with personal care and close the door.” Another member of staff commented, “I let people do what they can do for themselves.”

People were supported to express their views and make decisions about their care. People and their relatives where appropriate, were involved in making decisions about their care. People and their relatives were supported to be involved in reviews of their care, during which they had the opportunity to share their views and wishes. Resident and relatives’ meetings were held to seek people’s feedback on the service and to help drive service improvements.