Archived: Oakhurst Nursing Home

Updated 3 July 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008[BR1] to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection was carried out on 19 November 2014 and was unannounced. The inspection was carried out by three inspectors. One inspector was also a specialist advisor for people living with mental health problems and complex needs. There were 16 people living at Oakhurst Nursing Home on the day of inspection including one person on respite care.

We used a number of different methods to help us understand the experiences of people who used the service. We spent time observing care and support being delivered. We looked at four people’s care records, medicines administration records (MAR) and other records which related to the management of the service such as training records, policies and procedures.

We spoke with six people who used the service, two support workers, the registered manager, a registered nurse, the estates manager, the maintenance man, the administrator and two catering staff. We looked around the building including bedroom accommodation, communal bathrooms and toilets and the lounges and dining room.

Before the inspection we reviewed the information we held about the home. This included information from the provider, notifications and speaking with the local authority safeguarding team and commissioning service. Before our inspections we usually ask the provider to send us a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We did not ask the provider to complete a PIR on this occasion.

As part of the inspection process we also spoke with two healthcare professionals who visited the service on a regular basis.

Updated 3 July 2015

Oakhurst Nursing Home provides accommodation and nursing care for up to 30 adults with complex mental health problems. The service is located in the Manningham area of Bradford close to the local shops and other amenities.

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.

We inspected Oakhurst Nursing Home on the 19 November 2014 and the visit was unannounced. Our last inspection took place in April 2014 and at that time we found the home was not meeting three of the regulations we looked at. These related to the safety and suitability of the premises, respecting and involving people who use services and assessing and monitoring the quality of the service. We asked the provider to make improvements and following the inspection they sent us an action plan outlining the work to be completed including timescales.

During this inspection we found people were becoming more involved in their care and treatment and held regular meetings with the registered manager. The people we spoke with told us they enjoyed living at the home and the support workers encouraged them to make choices and decisions about their lifestyle.

However, we found systems and processes to keep people safe were inadequate. For example, we found staffing levels were not always being maintained at a safe level. This meant people were at risk of not receiving the care, support and treatment they required.

We also found the support workers we spoke with were unable to clearly demonstrate they had skills and experience to safeguard the health and welfare of people who used the service.

We found that in relation to the premises there was still a significant amount of work to be completed before the service provided people with a safe and comfortable place to live. Building work was in progress at the time of the inspection to achieve this. However, there was no consideration through risk assessment to identify and minimise the hazards associated with the work, equipment, lack of access, noise and emotional concerns it might cause people who used the service.

We saw that arrangements were in place that made sure people's health needs were met. For example, people had access to the full range of NHS services. This included GP’s, hospital consultants, community mental health nurses, opticians, chiropodists and dentists. We saw medicines records were clear and accurate. We checked all people’s medicines against the corresponding records and these showed that the medicines had been given correctly.

However, we found the quality assurance systems were inadequate as many of the shortfalls highlighted in the body of this report relating to people’s health, well-being and safety had not been identified by the providers as areas that required improvement.

We also found the service was not meeting the requirements of the Deprivation of Liberty Safeguards. This legislation is used to protect people who might not be able to make informed decisions on their own. This was because the manager had failed to comply with the conditions on one person’s Deprivation of Liberty safeguards authorisation which were imposed on the 16th May 2014..

We found three breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 came into force on 1 April 2015. They replaced the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.