We inspected the service on 19 May 2015. The visit was unannounced. Our last inspection took place on 10 June 2013 and at that time we found the service was meeting the regulations.
Oakwood Hall is a 12 bedded residential home which provides support and rehabilitation for people aged 18 and over who have enduring mental health problems and who have needs that are difficult for other services to provide for. Most of the people who use the Oakwood Hall service have had unsatisfactory experiences of being supported by others in the past and may have been labelled as difficult or untreatable.
The home had a registered manager. 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.
People told us they felt safe in the home and we saw there were systems and processes in place to protect people from the risk of harm. People were protected against the risk of unlawful or excessive control or restraint because the provider had made suitable arrangements for staff to respond appropriately to people who communicated through their behaviour/actions.
Altercation between two of the service users, although recorded on daily diary sheets, was not reported or referred to the CQC as a ‘Safeguarding Concern’. This was in breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
The care records we looked at did not contain a life history documents. These would be for the purpose of gathering information about the person and their life before they moved into the home. A life history document enables staff to understand and have insight into a person’s background and experiences. This was in breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
Staff had received training in the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards and they were able to demonstrate a good understanding of when best interest decisions needed to be made to safeguard people.
We found people were cared for, or supported by, sufficient numbers of suitably qualified, skilled and experienced staff. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work.
Suitable arrangements were in place and people were provided with a choice of healthy food and drink ensuring their nutritional needs were met.
People’s physical health was monitored as required. This included the monitoring of people’s health conditions and symptoms so appropriate referrals to health professionals could be made.
We observed interactions between staff and people living in the home and staff were kind and respectful to people when they were supporting them. Staff were aware of the values of the service and knew how to respect people’s privacy and dignity.
The manager investigated and responded to people’s complaints, according to the provider’s complaints procedure. People we spoke with did not raise any complaints or concerns about living at the home.
There were effective systems in place to monitor and improve the quality of the service provided. Staff were supported to challenge when they felt there could be improvements and there was an open and honest culture in the home.
We looked at the arrangements in place for the storage, administration, ordering and disposal of medicines and found these to be safe. Medicines were administered to people by trained staff.
Staff received regular supervision and annual appraisals. This gave staff the opportunity to discuss their training needs and requirements.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.