Archived: Oaktree Care Home

Updated 10 April 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

On the first day of the inspection there were two inspectors, along with 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 second day was announced and carried out by one inspector.

Service and service type:

Oaktree Care Home is a care home. People in care homes receive accommodation and nursing or personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection: This inspection was unannounced. The provider, registered manager and staff team did not know we would be visiting. We carried out the site visit of the inspection on 5 and 7 March 2019.

What we did:

We reviewed information we had received about the service since the last inspection in April 2018. This included details about incidents the provider must notify us about. We emailed five health and social care professionals to gain their views on care provided. On this occasion, we received one response.

We assessed the information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

We spent time in all areas of the home. The upstairs was home to people living with dementia. There were two units upstairs called Primrose and Snowdrop. Primrose provided support to people living with dementia with nursing needs. Snowdrop was a residential unit. The unit downstairs was called Bluebell and was for people with nursing needs.

We looked at five people's care records to see if they were accurate and up to date and a further four files that were kept in people's bedrooms. We also looked at records relating to the management of the service. These included staff rotas, recruitment and audits that had been completed.

We spoke with the registered manager, the deputy manager, three unit managers, five care staff, the activity co-ordinator, three nurses, eight people who used the service and eight relatives and visitors.

Updated 10 April 2019

About the service: Oaktree Care Home is registered to provide personal and nursing care for up to 78 people. The service is divided over two separate floors. The ground floor, called Bluebell is for those who require nursing care and the upper floor is dedicated to those people living with dementia and has two units called Primrose and Snowdrop. Snowdrop, provides support to people living with dementia but do not need nursing care. There were 59 people living at Oaktree Care Home when we inspected.

People’s experience of using this service:

Since our last inspection, improvements had been made to ensure complaints were dealt with promptly with feedback given to the complainant. It was evident people felt their concerns were listened too and acted upon swiftly.

As seen at the last inspection, there was a heavy reliance on agency staff whilst the registered manager was recruiting to the vacant posts. This was having an impact on the delivery of care. People were not receiving the care when they needed or wanted it. This was in part due to the high agency usage and many of the people needing two staff to support them, which was not taken into account when calculating the staff on the nursing unit.

Staff were not being fully supported thorough regular supervisions and annual appraisals. Whilst staff had received training on a variety of topics, overall the home had not achieved the provider’s own internal compliance figures. Staff had not received training relevant to the needs of people they were supporting, such as diabetes.

Care was planned and delivered but not always in a person centred way in line with people’s preferences. This was being addressed by the registered manager, who was reviewing practice around the times when people were supported to get up for the day.

People felt safe living at Oaktree and risks to people were minimized through risk assessments. There were plans in place for unforeseeable emergencies. However, some people felt safer when supported by regular and familiar staff.

We have recommended the service review their menu planning to ensure it includes variety and all the food groups. There was a vacant chef post which was impacting on the quality of the food provision. Agency catering staff were covering the vacant hours.

People were consulted about their care and support needs and involved in decisions about their care. Staff had a good understanding of the legislation to protect people where they lacked capacity involving family and other professionals. People and their relatives told us the staff were kind and caring. Feedback was complimentary about the regular and familiar staff.

There was an ongoing decoration programme in place. The home was clean and free from odour.

There were systems in place to monitor the quality of the care and support. However, there were no improvement plans in place to ensure ongoing compliance from findings of the provider visits.

Rating at last inspection: Requires Improvement. (Report published June 2018).

Why we inspected: This was a planned inspection based on the rating at the last inspection. We saw improvements had been made since our last inspection. Our findings at this inspection have meant the rating remained Requires Improvement. This is the second time this service has been rated Requires Improvement.

Follow up: We will meet with the provider following this report being published to discuss how they will make changes to ensure the provider improves the rating of the service to at least Good. We will revisit the service in the future to check if improvements had been made.

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