Oak Lodge Residential Home

Oak Lodge Residential Home provides accommodation and personal care for up to 15 older people, including people living with dementia. At the time of our visit 13 people lived at the home.

People’s experience of using this service and what we found

The provider did not always understand their legal duties related to the Mental Capacity Act 2005. Mental capacity assessments were not decision specific. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; however, the policies and systems in the service did not currently support this practice.

The provider’s quality monitoring systems were not effective in recording how people received safe, individualised care.

The provider did not always operate a safe system to ensure staff were recruited in line with their recruitment policy. Employment references had not always been obtained to ensure staff’s suitability to work with vulnerable people. The providers environmental risk assessments did not meet the current Health and Safety Executive guidance.

Care planning was not always focused on people’s whole lives, including goals, skills and abilities. The service enabled people to carry out person-centred activities, but this was not always documented in care records. People knew how to give feedback about their care but there was no systematic approach to gathering feedback from people or their relatives. On the day of inspection there was no-one receiving end of life care, however recording of people’s wishes could be improved.

Staff received training and support to carry out their roles. People had enough to eat and drink and they were involved in planning their meals.

People said that staff were kind, friendly and treated them with respect and dignity. People were involved in making decisions about the service through regular resident’s meetings. People’s relatives did not always feel involved, in part due to the restrictions on visiting caused by COVID-19.

People and staff told us they felt able to speak to the manager and raise any concerns they had. People were positive about the quality of the service they received.

People felt safe and staff had a good understanding of safeguarding and whistleblowing procedures.

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

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 6 September 2019) and there were multiple breaches of legislation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made in some areas and the provider was no longer in breach of some regulations. However, there was not enough improvement in other areas and the provider was in breach of other regulations.

This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Caring, Responsive and Well Led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation safe care and treatment and good governance. of the home at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Oak Lodge Residential Home provides accommodation and personal care for up to 15 older people, including people living with dementia. At the time of our visit 14 people lived at the home and one person was in hospital. Accommodation is provided in an adapted building. Accommodation is provided across two floors, with communal areas on the ground floor.

People’s experience of using this service and what we found

The provider’s quality monitoring systems were not effective in ensuring people received safe individualised care, or in supporting continuous improvement. The provider had not checked some staff’s suitability to work with vulnerable people who lived at Oak Lodge. Low staffing levels negatively affected people’s experiences.

People felt safe. However, individual and environmental risks were not always assessed or well-managed. Lessons had been learnt when things went wrong.

People had enough to eat and drink but there was limited choice available. Some staff training was not up to date. Action was being taken to address this. People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible; the policies and systems in the home did not always support least restrictive practice.

Staff were caring in nature but did not have the time needed to consistently provide person centred care. People’s privacy and dignity was respected by staff. Staff recognised the importance of promoting people’s independence. However, some people’s independence was compromised due to the design of the home. Action was being taken to address this. Staff supported people to maintain relationships with family and friends. Visitors were made to feel welcome. People had developed meaningful relationships with staff and other people who lived at Oak Lodge.

People’s needs were assessed prior to moving into the home. However, assessments did not ensure protected characteristics, in line with the Equality Act, were considered. Care plans required improvement to ensure staff had the information needed to provide safe, personalised care. Complaints were managed in line with the provider’s policy and procedure. Opportunities for people to engage in meaningful activities were very limited.

People and relatives were positive about the quality of service they received. The provider and staff worked in partnership with other professionals to improve outcomes for people. The provider was committed to addressing areas where improvement was needed.

The registered provider was in breach of Regulations 9, 17, 18 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

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

The last rating for this service, under the previous provider was Good (published 19 September 2017). Since this rating was awarded the registered provider and registered manager has changed. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

This provider registered with us on 26/10/2018 and this is the first rating inspection.

Why we inspected: This was a scheduled inspection based on the date the service registered with us.

Enforcement: Please see the action we have told the provider to take at the end of this report.

Follow up: We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.