Background to this inspection
Updated
16 November 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection visit took place on 01 August 2017 and was unannounced.
The inspection team consisted of an adult social care inspector 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. The expert by experience for Oaklands had experience of services for people with physical disabilities.
Before our inspection on 01 August 2017 we reviewed the information we held on the service. This included notifications we had received from the provider, about incidents that affect the health, safety and welfare of people the service supported. We checked to see if any information concerning the care and welfare of people who were supported had been received. We did this to gain an overview of what people experienced in the home. We saw where there had been any issues the manager had informed CQC and the local authority safeguarding team promptly and had taken appropriate action.
We reviewed the Provider Information Record (PIR) we received prior to our inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This provided us with information and numerical data about the operation of the service. We used this information as part of the evidence for the inspection. This guided us to what areas we would focus on as part of our inspection.
Some people at Oakland’s had limited verbal communication and were unable to converse with us. However we spoke with nine people who lived there. We also observed staff interactions with people who lived at the home. We spoke with, the manager and six staff members. Prior to our inspection visit we contacted the commissioning department at the local authority. This helped us to gain a balanced overview of what people experienced accessing the service. They had no concerns about care at Oaklands.
During our inspection we used a method called Short Observational Framework for Inspection (SOFI). This involved observing staff interactions with people in their care. SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.
We looked around the building to ensure it was clean, hygienic and a safe place for people to live. We looked at care and medicine records of three people and arrangements for meals. We looked at staff rotas to check staffing levels, looked at staff recruitment, and training records and records related to the management of the home. This helped us to gain a balanced overview of what people experienced whilst living at the home.
Updated
16 November 2017
This inspection visit took place on 01 August 2017 and was unannounced.
Oaklands is a Leonard Cheshire Foundation home providing care and support for adults with physical disabilities. The home is an adapted property situated in extensive grounds on the outskirts of Garstang. It is registered to accommodate a maximum of 30 persons needing nursing or personal care. The home provides short to long term care. At the last comprehensive inspection on 22 April 2015 the service was rated overall as good.
At this inspection we found the service had improved and was outstanding overall.
At this inspection visit there 30 people lived at Oaklands.
There was a registered manager registered with CQC. However the registered manager had been promoted with the company and was cancelling their registration. The deputy manager had become the new manager of Oaklands and was applying to become registered with CQC. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People we spoke with said staff were kind and caring and they felt safe and well supported. One person said, “The staff are marvellous.” Another person told us, “The care is very good in fact just fantastic. The staff are all extremely kind.”
Staff were exceptional in the way they respected people’s family and personal relationships and encouraged and supported contact with families and friends. We saw people were supported to attend important events in their lives.
The manager told us, “The staff care not because they are paid to care but because they really do care.” They told us staff visited people in hospital, particularly those with limited family contact. They made sure the person was clean and comfortable made sure they had drinks, snacks and toiletries and things to do and knew they were not forgotten.
Staffing was sufficient to meet people’s care needs and provide activities. Staff were recruited safely and had the skills, knowledge and experience to provide safe and effective support. We saw staff interacted with people in ways that showed their well-being and happiness mattered to them. They helped them to live meaningful lives and be as independent and active as was possible for them.
There were frequent and varied social and leisure activities and opportunities for socialising. Staff made huge efforts to meet people's wishes and aspirations. Staff supported people's individual interests and were innovative in how they helped them meet these. They supported people on more unusual activities such as a sky diving experience, co-piloting a small plane and going to the Northern Lights. These improved the well-being of the individuals and gave other people ideas of what they could do. One person said, "I like fishing and I go out fishing with staff who also like fishing. We sit and chat while we fish or just relax.” Another person said, “I play wheelchair tennis, I go to the gym, trampolining and bowling. I enjoy sport and it keeps me fit and active.”
We found examples of exceptional end of life care. Staff were exceptionally compassionate and proactive in meeting people’s wishes. People’s end of life wishes were recorded so staff were aware of and went out of their way to meet and exceed these. Staff supported people to spend time with loved ones and spend special moments with them.
There were procedures in place to protect people from abuse and unsafe care. Staff were familiar with these and had received training in safeguarding adults. We saw risk assessments were in place which provided guidance for staff. These measures minimised risks to people. Care plans were personalised detailing how people wished to be supported. They were fully involved in planning their care and their consent and agreement were sought before providing care.
People who received support or where appropriate their representatives were involved in planning and making decisions about their care. Their consent and agreement to provide care were sought. Where people were unable to make their own decisions independent advocates were available. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.
Staff managed medicines safely. Medicines were stored securely, administered as prescribed and disposed of appropriately.
Oaklands was clean and hygienic and met the needs of people who lived there. Staff used protective clothing such as disposable aprons and gloves. They also washed their hands before caring for each person to reduce the risk of passing germs from one person to another. Equipment was maintained and the environment regularly checked for safety.
People told us they were pleased with the variety and choice of meals available to them. Staff knew people’s food likes, dislikes and any allergies people had. The food was well presented and people said they enjoyed it. One person told us, “Most of the time the food is very good but occasionally it is just good.” Staff assisted people chatting with them as they helped them with their meal, making meals a pleasant and social experience.
The training staff received assisted them in providing effective, caring support to people. They received regular support and supervision from senior staff to help them develop additional skills. Staff were pleased to work for the service and felt they worked well as a team. They felt listened to and well supported through supervision and training.
People knew how to raise a concern or to make a complaint and were encouraged to raise any concerns they had. They said any concerns were listened to and acted on. People told us they were encouraged to voice their views and opinions about the service provided. They told us the manager and staff team were approachable and supportive and listened to their views.
Systems were in place to effectively govern, assess and monitor the quality of the service and the staff.