Oakwood Court

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

People’s experience of using this service:

People told us they were very happy living at the service.

¿ Whilst the provider had quality assurance systems to review the support and care provided, the systems did not pick up some areas of record keeping we identified. Person centred aspects of some people’s care plans had been missed. Actions points from weekly medicine audits had not been followed up and a fluid chart for one person did not demonstrate they always received enough to drink.

¿ There was a delay between day one and two of inspection. This was a result of a virus which meant the home was closed to visitors. During this time the provider had addressed all matters raised on the first day of inspection. Following the inspection, we received actions plans that detailed the actions taken and to be taken in relation to matters raised on day two of our inspection. As a result, there is no breach of regulation, but further time will be needed to embed the changes made and ensure they become part of everyday practices.

¿ There were safeguarding systems and processes that protected people from harm. Staff knew the signs of abuse and what to do if they suspected it. A staff member told us, “I would report it to a senior or manager and they would deal with it. If they didn’t I would use the whistleblowing procedure.”

¿ People and relatives provided very positive feedback about the care, staff and management. One visitor told us, their relative had improved so much since moving to the home and was now eating better and taking more interest in life. This was put down to staff understanding and encouragement and attention to good care.

¿ All fire safety equipment was serviced and checked at regular intervals. Regular water testing was completed, and a risk assessment had been completed in relation to Legionella.

¿ All areas of the home were clean and there were effective systems to audit in relation to infection control.

¿ There were enough staff to meet people’s individual needs. People told us they felt safe and people were seen to be comfortable in their surroundings. Staff knew how to safeguard people from abuse and what they should do if they thought someone was at risk. Incidents and accidents were well managed.

¿ People’s needs were effectively met because staff had the training and skills to fulfil their role. This included training to meet people’s specialist needs in relation to living with dementia.

¿ Staff attended regular supervision meetings and received an annual appraisal of their performance.

¿ People were treated with dignity and respect by kind and caring staff. Staff had a good understanding of the care and support needs of people and had developed positive relationships with them.

¿ Staff were aware of their responsibilities under the Mental Capacity Act (MCA) and Deprivation of Liberties Safeguards (DoLS).

¿ People were supported to attend health appointments, such as the GP or dentist.

¿ People had enough to eat and drink and their menus were varied and well balanced. People’s meals were served in a way that respected their specific needs.

¿ People were supported to take part in a range of activities to meet their individual needs and wishes.

¿ There was a detailed complaint procedure, and this was displayed so that anyone wanting to raise a concern could do so.

¿ The provider had embraced new developments in technology. For example, a new electronic care planning system was being introduced. The new system included portals that enabled people and where appropriate, their relatives to comment on the care plans. Alexa, a voice-based electronic device that enables you to instantly connect to play music had been installed in the lounge.

¿ The service demonstrated they listened to people and staff. Feedback received had highlighted that people and staff felt there were shortages in staff at key points in the day. Agreement had been reached to provide an extra care staff member in the afternoons and in addition a general assistant and part time activity coordinator.

Rating at last inspection:

At the last inspection the service was rated Good. (published 9 August 2016).

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

Oakwood Court provides accommodation for up to thirty-three older people, some of whom are living with mental and physical health needs and who may need support with their personal care. On the day of our inspection there were thirty-one people living at the home. The home is a large property, spread over two floors, with two communal lounges, a dining area and extensive gardens. It is situated in Haywards Heath, West Sussex.

The provider is a not-for-profit housing association providing sheltered housing, independent living and care homes. Oakwood Court is one of four care homes owned by the provider. The management team consisted of a registered manager, a deputy manager and senior care staff. A registered manager is a ‘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’s safety was maintained as they were cared for by staff that had undertaken training in safeguarding adults at risk and who knew what to do if they had any concerns over people’s safety. Risk assessments ensured that risks were managed and people were able to maintain their independence. There were safe systems in place for the storage, administration and disposal of medicines. People told us that they received their medicines on time and records and our observations confirmed this.

Sufficient numbers of staff ensured that people’s needs were met and that they received support promptly. One person told us “I feel safe, they check on me throughout the night without disturbing me, I have an alert button that I can use and they always come quickly”. There were suitably qualified, skilled and experienced staff to ensure that they understood people’s needs and conditions. Essential training, as well as additional training to meet people’s specific needs, had been undertaken and used to improve the care people received. People and relatives told us that they felt comfortable with the support provided by staff. One relative told us “The staff do an excellent job, I’ve never had a problem with my relative, they are looked after excellently - day or night”.

People’s consent was gained and staff respected people’s right to make decisions and be involved in their care. Staff were aware of the legislative requirements in relation to gaining consent for people who lacked capacity and worked in accordance with this. People confirmed that they were asked for their consent before being supported. One person told us “They always ask me before they do anything, they respect my wishes and I’m able to say yes or no”.

People had a positive dining experience and were happy with the choice, quality and quantity of food. The registered manager was mindful of the importance of ensuring that people had sufficient hydration and nutrition. The home was involved in a ‘hydration project’ to encourage people to drink more. Staff had encouraged people to participate in various activities to increase their fluid intake.

People’s healthcare needs were met. People were able to have access to healthcare professionals and medicines when they were unwell and relevant referrals had been made to ensure people received appropriate support from external healthcare services.

Positive relationships between people and staff had been developed. There was a friendly, caring and relaxed atmosphere within the home and people were encouraged to maintain relationships with family and friends who were able to visit the home and join their relatives for meals if they wished. People were complimentary about the caring nature of staff, one person told us “I’m happy here, they’re kind, and it is a very good place”.

People’s privacy and dignity was respected and their right to confidentiality was maintained. People were involved in their care and decisions that related to this. Regular care plan reviews as well as residents meetings enabled people to make their thoughts and suggestions known. People told us that these meetings were effective. One person told us “There are two meetings, you can make your point known and things happen as a result, they look into things and make things happen”. People’s right to make a complaint was also acknowledged. The registered manager welcomed feedback and used these as opportunities to develop the service provided.

People received personalised and individualised care that was tailored to their needs and preferences. Person-centred care plans informed staff of people’s preferences, needs and abilities and ensured that each person was treated as an individual. One person confirmed this, they told us “The staff are efficient, friendly, effective and understanding, I think they’re very good here. Although they deal with people like me every day they listen to me and do what I want”.

The home was well-led and managed well. People, relatives, staff and healthcare professionals were complimentary about the leadership and management of the home and of the approachable nature of the registered manager. One person told us “The manager is very good, she joins in with things, she’s not difficult, far from it, and you can approach her and speak to her about anything and everything”. There were quality assurance processes in place to ensure that the systems and processes within the home were effective and ensured that people’s needs were being met and people were receiving the quality of service they had a right to expect.

Is the service safe?

People told us that they felt safe. Safeguarding and whistleblowing procedures were robust and staff understood how to safeguard the people they supported.

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the provider to maintain safe care. The provider had robust policies and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

Is the service effective?

People's health and care needs were assessed with them and they or their representatives were involved in the compilation of their care plans. People said that they had been involved in the process and that care plans reflected their current needs.

Visitors confirmed they were able to see people in private and that visiting times were flexible.

Is the service caring?

We spoke with four people who live at the home. We asked them for their opinions about the staff that supported them. Feedback from people was positive, for example one person said, "It's lovely here. The staff are wonderful". Another told us, "It's like a home from home. I can't fault it".

People who live at the home and their families were asked to complete a satisfaction survey. These were used to help improve the service in the future.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

The home worked well with other agencies and services to make sure people received care in a coherent way.

People knew how to make a complaint if they were unhappy. There had been no recent complaints made.

People engaged in a range of activities both in the home and in the wider community.

Is the service well-led?

The service operated a quality assurance system which identified and addressed shortcomings. As a result, a good quality of the service was maintained.

The staff we spoke with were clear about their roles and responsibilities. They had a good understanding of the needs of the people they were looking after and were properly trained and supported to carry out their duties.

People consistently told us that they felt safe living at Oakwood Court. Our observations showed that people were treated in a kind and respectful way by staff. They were given choices about their meals and what activities they would like to participate in. We saw many positive interactions between staff and people who lived at the service which people benefitted from. Staff responded to people's needs promptly and were knowledgeable about their individual needs.

A person told us: 'I have been here for 10 years, if you have to live in a care home then you could not find a better one'. A relative told us 'Staff seem to understand mum's dementia and they take their time with her so she does not get anxious.'

People described their meal as 'Nice' 'Ok' and Lovely'. The meal time was relaxed and we observed people being supported to eat their meals in a dignified and timely manner. A person told us 'Although there is an alternative you can basically ask for what you want'.

People who lived at the service benefited from good care that was monitored and regularly reviewed by competent people so that any areas for development or improvement were identified and addressed. People and their representatives had many ways that they could feedback about their experiences and we saw many examples of how practices had changed in response to feedback.

People lived in a safe, homely, well maintained and decorated environment that met their individual needs and the collective needs of people who lived at the service. A person told us 'I have absolutely everything I need in this one room, it's marvellous how accommodating they are'.

Staff were described as: 'Simply delightful' 'Friendly helpful and they understand what help I need' and 'Staff are all so very kind they will do anything for you'.

We looked at the care files for five people who used the service. Two of the five files contained care plans that were well written and person centred. The other three files did not contain any information regarding the care people needed or any assessment of risks. This meant that staff did not have clear written guidance to ensure that care was delivered and managed appropriately and consistently.

We found the home had a good system in place to manage medication, with clear guidance for staff to ensure that medicines were managed appropriately and consistently.

During our visit we looked at the staff recruitment files of six of the care staff employed by the service. We found that appropriate checks were undertaken before staff began work. This meant that people received support from staff whose conduct and experience was adequately checked.