Oakleigh is a residential care home which is registered to provide accommodation for nine people with a learning disability who require personal care. On the day of our visit there were seven people living at the home. The main house can accommodate six people. There are three self-contained apartments (Oakleigh Mews) adjacent to then main building where people live on their own, whilst receiving staff support. The complexity of people’s care needs meant we were only able to engage in short conversations with people. We therefore used our observations of care and our conversations with staff and people’s relatives to help us understand their experiences. Oakleigh and Oakleigh Mews have extensive grounds. Facilities available to people include a games room, gymnasium and spacious garden for people to enjoy, grow vegetables and tend to animals. There was a registered manager in post. 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.
Prior to the inspection we were aware concerns had been raised by a family member with the local safeguarding team and the provider, which were being investigated. We took this information in to account during our inspection.
People experienced care and support that suited their individual needs and which helped them to live safe, fulfilled and meaningful lives, in the way they wanted to. There was a relaxed, calm and happy atmosphere at the home with lots of smiles, good humour, fun and affection. People were relaxed and comfortable with staff that were attuned to their needs. Staff spoke with pride about the people they cared for and celebrated their achievements. Relatives told us that people’s confidence and ability to be as independent as possible had grown since being at Oakleigh. One family member told us that before their relative came to live at Oakleigh they were not able to look after themselves and did not have the confidence to go out. They described how the staff had used small steps and encouragement which resulted in their relative cooking, cleaning and shopping for themselves. They told us how delighted they were with their progress.
Staff had a ‘can do’ approach and they really made the most of opportunities to support people in taking risks so that they could participate in things which were important to them. There was a wide variety of activities available for both individuals and groups. These were designed to provide a variety of familiar and new experiences for people to lead fulfilled lives in accordance with their individual interests and abilities. People enjoyed spending time in their local community where they frequently visited cafes, shops and pubs. Relatives said they appreciated that people were stimulated, enjoyed a range of activities, went out regularly and had holidays. Relatives and friends were able to visit the home at any time and people were supported to visit and stay with relatives whenever possible.
People told us they felt safe with staff. Relatives had no concerns about the safety of people. There were policies and procedures regarding the safeguarding of adults and staff knew what action to take if they thought anyone was at risk of potential harm. There were systems and processes in place to protect people from the risk of harm. These included thorough staff recruitment, staff training and systems for protecting people against risks.
Risks to individuals were well managed and people were able to stay safe without having their freedoms restricted. Managers and staff promoted peoples independence and encouraged positive risk taking. If an incident or accident did occur, they were well reported and investigated. Staff understood the importance of learning from incidents, so they could make sure they did not re-occur.
There were enough suitably trained staff to meet people's individual care needs. We saw staff spent time with people and provided assistance to people who needed it. Staff were available to support people to go on trips or visits within the local community and pursue their own interests and activities.
People received their medicines safely and received on going health care support. The service utilised specialists such as learning disability nurses, behaviour analysts, practitioner psychologists and psychiatrist in learning disabilities within the organisation to ensure that people who needed extra support were provided it quickly. Staff members were assigned as key workers to people working closely with them to achieve goals in relation to their daily living skills.
Staff had received training in the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS), and they demonstrated a good understanding of the act and its application. Where people did not have the capacity to make decisions about their care, meetings were held with people, their relatives, and health and social care professionals to help ensure that any decisions were made in the best interests of people using the service.
People were supported to maintain a healthy diet. People were able to choose what they wanted to eat and were involved in the shopping and preparation of their meals where possible. In the main house, people took it in turn to plan and prepare the evening meal for all residents. Menus were discussed at residents meetings where people were able to say what foods they liked or din not like. People could access the kitchen at any time and were able to help themselves to meals, drinks and snacks.
People we spoke with knew how to make a complaint and we noted the home openly discussed issues so that any lessons could be learned. People felt they were able to express their views at any time and that they were listened to and acted on.
There were systems in place to effectively monitor the quality of the service and drive a culture of continuous improvement. The provider gathered information about the quality of their service from a variety of sources including people who used the service, their family and friends and external agencies. This was used to enable the provider to identify where improvement were needed and to implement and sustain continuous improvement in the service.
Summary of findings