Archived: Oakley House

Updated 31 August 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 focused inspection took place on 10 August 2017 and was unannounced. The inspection was carried out by a single inspector.

The inspection was carried out to follow up concerns we recently received about the service and to check they continued to meet regulations and fundamental standards. We inspected the service against two of the five key questions we ask about services: Is the service safe? and Is the service well-led?

Before our inspection we reviewed the information we held about the service. This included previous CQC inspection reports and notifications the provider is required by law to send us about events that happen within the service. We also reviewed the provider information return (PIR). The PIR is a document we ask current provider to submit before our inspection about how they are meeting the requirements of the five key questions and what improvements they intend to make.

During our inspection we spoke in person to three people who currently lived at Oakley House, the interim manager (former deputy manager) who was now in day-to-day charge of the service and a support worker. We also made telephone contact with two people’s relatives and a member of the Board of Directors of the provider who has applied to register with CQC. Records we looked at included three peoples care plans and associated risk assessments, staff rotas and other documents that related to the overall governance of the service.

Updated 31 August 2017

At the last Care Quality Commission (CQC) comprehensive inspection of Oakley House, which we carried out on 13 March 2017, we rated the service ‘Good’ overall and for the five key questions ‘Is the care home safe’, ‘effective’, ‘caring’, ‘responsive’ and ‘well-led’. This was because we found the service was meeting the regulations and fundamental standards we checked.

We undertook this focused inspection on 10 August 2017 in response to information of concern we received about the service including, an allegation of abuse that the provider had referred to the relevant local authority, which was currently being investigated, a sudden change in the homes management and outstanding fire safety issues identified in the provider’s previous CQC inspection report. The aim of the inspection was to check that the people who still lived at Oakley House remained safe and the service continued to be well-managed.

This report only covers our findings in relation to this inspection. You can read the report from our previous comprehensive and focused inspections, by selecting the 'all reports' link for ‘Oakley House’ on our website at www.cqc.org.uk.

We have reduced the services last ‘Good’ rating to 'Requires Improvement’ overall because we found the provider to be in breach of the regulations and fundamental standards we looked at during this inspection. Specifically, the provider had failed to assess and review risks relating to people’s health and welfare and nor did they establish and operate good governance systems to monitor the quality and safety of the care and support people living at the home received.

Oakley House is a care home which provides personal care, support and accommodation for a maximum of 11 adults. The service specialises in supporting people with mental health needs. At the time of our inspection there were four people aged 40 and over living at the home. Four people who had previously lived at Oakley House had moved out in that last two months and another person was currently in hospital.

The service used to be managed by an individual who was the registered provider. A registered provider is a person who has registered with the Care Quality Commission (CQC). Registered providers 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. The registered provider left the service in July 2017 at which point the deputy manager was appointed interim manager. At the time of this inspection our records showed that the current provider had applied to cancel their registration. A different limited company has applied to become the registered provider of Oakley House. We are waiting to hear the outcome of their registered provider application to the CQC before we process the current provider’s application to cancel their registration. This is because we cannot allow a home to operate and provide care without a person or corporate body having legal responsibility for the service. In this report we refer to the current provider as the individual who although, is no longer in day to day control is still legally responsible. Where we mention the proposed provider we are referring to the company who has applied and is still going through our assessments process. Where we just refer to providers we mean both the current and the proposed providers.

During this focused inspection, we found that the current provider had taken on board the comments made in their previous CQC inspection report about fire safety and had improved these arrangements. People and their relatives told us Oakley House was a safe place to live. There remained robust procedures in place to safeguard people from harm and abuse and staff were still familiar with how to recognise and report abuse. There also remained enough staff deployed in the home to keep people safe.

However, the current and proposed provider’s had not ensured risks people might face due to their health care needs or lifestyle choices had been identified and routinely reviewed. Although the interim manager and staff demonstrated a good understanding of how to manage assessed risks, the current provider had not considered all the risks people might face and nor had existing risk assessments been reviewed. This put people living at the home at unnecessary risk of harm or injury because risk assessments either did not exist or the information they contained for staff to follow in order to keep people safe was inaccurate.

In addition, the current and proposed providers did not always operate effective governance system to assess, monitor and improve the quality and safety of the service. Although there were some good systems in place to monitor and review the quality of service delivery, we found limited documentary evidence checks and audits were routinely undertaken and the outcomes formally documented. We also identified a number of issues during our inspection which had not been picked up by the providers around monitoring finances handled on behalf of people living in the home by staff, and the assessing and reviewing of risks people might face. This meant the providers had always sufficiently monitored and improved all aspects of the service so that people experienced good quality, safe care.

These failings represent two breaches of the Health and Social Care (Regulated Activities) Regulations 2014 in relation to safe care and treatment, and good governance. You can see what action we told the providers to take with regards to these breaches at the back of the full version of the report.