Oak House

Updated 29 March 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: This inspection was undertaken by one adult social care inspector.

Service and service type: Oak House is a domiciliary care agency.

A domiciliary care agency provides support to people in their own homes.

The service had two managers registered with the Care Quality Commission. This means 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 announced on the morning of the inspection. This was because we needed to be sure that a manager or member of staff was available in the office of the domiciliary care service to assist with the inspection.

What we did: Before the inspection we reviewed information we had received about the service since the service was registered. 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 contacted the local authority to gain their feedback on the service. We used all this information to plan our inspection.

We talked with two people who used the service and two relatives. We spoke with the registered managers, the quality and development lead, a team leader and two support staff.

We reviewed a range of records. This included three people's care records and a sample of medication records. We viewed three staff recruitment files and other records relating to staff training and support and the management of the service.

Updated 29 March 2019

About the service: Oak House is a domiciliary care agency providing personal care to people in their own homes. The service was supporting 56 people with personal care in their own homes at the time of our inspection.

People’s experience of using this service:

The systems and processes in place to monitor the quality and safety of the service were not always effective in identifying and driving up improvements in the service. This meant that the service was not always well led.

Medication administration was not always safe and the competency of staff to administer medication had not been checked regularly to ensure they were safe to undertake this task.

Staff had information on the different ways people could communicate their needs and indicate their consent. We also found evidence of good practice with regards to the application of the Mental Capacity Act 2005 for one of the people whose file we looked at. We found however that it had not been consistently applied to the other person whose care we looked.

For example, assessments made of people’s financial capabilities and risks had not always been properly completed or signed to show that consent for the financial arrangements in place had been obtained.

Statutory notifications relating to safeguarding incidents had not always been reported to CQC in accordance with the provider’s regulatory responsibilities.

People’s needs and risks were assessed and for most of the time staff had had clear guidance on how to provide people with safe and appropriate, person centred care. Improvements were required to the information and guidance staff had with regards to people’s identified nutritional risks.

Staffing levels were sufficient to meet people’s needs. The people and relatives we spoke with told us that at times the staff members supporting them were not always the same staff. This meant that at times people were not supported by staff who knew them best. They told us in recent months, this had improved.

Staff had access to a range of training to support them to be effective in their job role. Some of the training that the provider required staff to complete had not been fully completed. It was difficult to tell if this applied to new staff only, as the evidence provided to inspectors did not provide this level of detail.

People’s support was person centred. They told us that staff were kind, caring and respectful of their needs and wishes. People’s independence was promoted and people were supported to live active lives based on their social and recreational preferences.

People received enough to eat and drink and people told us their nutritional preferences were respected.

Regular meetings took place with people using the service and staff to ensure that their views and opinions with regards to the service were sought.

People’s needs were met by a range of health and social care professionals and staff supported people to attend external appointments in support of their mental and physical well-being.

People we spoke with were happy with the service and had no complaints.

Staff told us they felt supported by the provider and that managers were approachable if they needed support.

The culture of the service was open and transparent. The manager and staff were responsive to our feedback and committed to improving the service.

Rating at last inspection and why we inspected: This was the provider’s first scheduled inspection at Oak House.

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.