• Care Home
  • Care home

Archived: Oakhurst Nursing Home

Overall: Inadequate read more about inspection ratings

2 Oak Mount, Manningham, Bradford, West Yorkshire, BD8 7BE (01274) 544279

Provided and run by:
Embrace Lifestyles (B) Limited

All Inspections

19 November 2014

During a routine inspection

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.

15/04/2014

During a routine inspection

Oakhurst nursing home provides accommodation and nursing care for up to 26 adults with mental health problems. On the date of the inspection there were 18 residents in the home. The service did not have a registered manager in post and had not since 1 March 2013. The new home manager had recently submitted an application to become the registered manager.

People told us they were happy living in the home, were safe and that staff were friendly and kind. People said they were free to do what they wanted to do. Some people told us they thought there wasn’t enough to do in the home and would prefer more activities.

Systems and processes were in place to protect people from foreseeable harm, with staff aware of how to deescalate conflict and act on concerns in order to keep people safe. CQC monitored the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes and hospitals. We found there were no DoLS orders in place and staff had received training on DoLS. We did not observe any restrictions of people’s liberty during the inspection.

People were able to make choices in relation to their daily lives, for example choosing what they wanted to do and staff respected these wishes. However, there was no evidence people were involved in the review of their care plans. This meant people were not involved in long term care planning and setting objectives and goals. Care plans were not written in a format that promoted involvement of people that used the service and there was a lack of information provided to people on their care and treatment options. The problems we found breached Regulation 17 (Respecting and Involving people who use services), of 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.

Staff were up-to-date with a range of mandatory training and received regular supervision and support. However, there was no provision for Mental Capacity Act 2005 (MCA) or mental health training on the annual training programme which meant staff may not have the specialist skills and knowledge to meet some people’s needs.

We found improvements had been made to the environment following our previous inspection, however further improvements were required to ensure all outstanding maintenance was completed, to give the home a more homely feel and to ensure people were able to make the most of the facilities and grounds available. The problems we found breached Regulation 15 (Safety and suitability of premises), of 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.

Staff displayed warmth and compassion with people and treating them with dignity and respect. People spoke positively about their relationships with staff.

People’s needs were assessed and care and support was planned and delivered to meet people’s individual needs. Support plans contained personalised information to ensure staff knew how to support people and meet their needs. Staff were familiar with people’s individual needs and their key risks. In one case, the service could have been more pro-active in seeking advice to ensure responsive care and treatment following the completion of a capacity assessment which concluded the person did not have the capacity to make decisions about their personal care.

The manager had only been working at the service for two months, but had developed a plan to improve the service. Staff spoke positively about recent changes and were confident further improvement would be achieved. More could be done to involve people in the running of the service and ensure people’s views, comments and opinions were used to make changes and drive improvement. Some risks to people’s health, safety and welfare were not identified, and there was an underreporting of incidents which meant that some incidents were not analysed and investigated. There were no systems in place to identify safe staffing levels. The problems we found breached Regulation 10(Assessing and monitoring the quality of service provision), of 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.

6 February 2014

During an inspection looking at part of the service

At previous inspections we had found that appropriate arrangements for safely handling medicines were not in place and in November 2013 a warning notice was issued in respect of non-compliance with Regulation 13. At this inspection we found significant improvements had been made and overall we found medicines were now being safely and appropriately managed.

We checked the medicines records and stocks of more than ten people who used the service and spoke with three of them about their medicines. All three people were happy with the way their medicines were given to them and nobody expressed any current concerns.

12 November 2013

During an inspection looking at part of the service

When we inspected the service in June 2013 we found the provider was not meeting seven of the nine regulations we inspected under The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. Following the inspection the provider wrote to us and told us what they would do to achieve compliance. We carried out this inspection to check improvements had been made.

On this inspection we found the provider had made improvements in some areas of service delivery. However, we were concerned the provider had not taken reasonable steps to ensure people were protected against the risks associated with medicines and unsafe or unsuitable premises. We were also concerned the provider not have effective quality assurance monitoring system in place, which identified shortfalls in the service quickly instead them being brought to their attention through the inspection process.

People who used the service told us they continued to be generally happy living at Oakhurst and staff supported them to live their chosen lifestyle. The staff we spoke with confirmed there had been noticeable improvements in the way the service was managed since the last inspection. They said there were now clearer channels of accountability and communication within the home.

13, 17 June 2013

During a routine inspection

When we inspected the service on the 3 January 2013 we had concerns about the safety and suitability of the premises and record keeping. On this inspection we found the provider had failed to take appropriate action to address the concerns raised and also found the provider was not meeting an additional 5 regulations relating to The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

However, people who used the service told us they were generally happy living at Oakhurst and said the staff were approachable and listened to them if they had a problem. One person said "I have lived here a couple of years, I am well looked after and have no concerns about the service or staff. Another person said "I feel safe living at Oakhurst it is much better and safer than living alone in the community."

The home manager was on leave at the time of the inspection and therefore information about the service was provided by the regional director, the providers Health and Safety advisor and the clinical lead nurse.

3 January 2013

During a routine inspection

We spoke with six people who used the service and they told us they had been given help in understanding the care and treatment they could expect. However, they could not recall having been given the information in a leaflet or other form and were not always able to recollect what they had been told.

People told us they were involved in planning their care and signed their care plans. However, they were not sure how much of what they said was included in the plans. When we asked people about choices one person said they had everything they needed and were 'cared for well enough'.

The people we spoke with were generally satisfied there were enough staff to meet their needs. One person said they felt it would be better if there was another member of staff on night duty. People told us they had support workers such as community psychiatric nurses or social workers.

People told us they felt safe and said if they had any worries they could go to a member of staff, a family member or a social worker.

People told us the temperature in the home was good but said they were not able to control the heating independently.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

31 January 2012

During an inspection looking at part of the service

People told us that they liked the new furniture in the home, one person said the environmental improvements made them feel respected. Some people told us the home is cold and one person said that a member of staff makes fun of the people who live at the home.

5 December 2011

During a routine inspection

Several of the people who live at the home told us that they felt intimidated by staff. Three people said that staff don't care about them. One person said staff were "cocky" and another said that there is a "them and us situation"

Two people said that staff are custodian and authoritarian and that people who live at the home felt as if they were being punished. One person said they are bullied (not physically) by staff and another said "They don't care about our feelings"

Several people said that the food at the home is poor, one person said "we have to eat what they say"

All of the people we spoke with were afraid of being "kicked out" of the home as they said they had nowhere else to go.