The Care Quality Commission

Archived: The Oaks Nursing Home

114 Western Road, Mickleover, Derby, Derbyshire, DE3 9GR (01332) 510447

Provided and run by:
Quality Care (EM) Limited

All Inspections

30 April 2012

During an inspection looking at part of the service

Most of the people who live at The Oaks Nursing Home would find it difficult to help us understand their views about the quality of the care being provided to them. We used a special tool designed to help us understand how people who have Dementia experience the care being provided to support them. We observed five people who live at the service in one of the lounges over two hours starting at 11.55am. We looked at how staff interacted with people and how care was being provided to support people with their needs. We looked for clear and observable signs which would show us how people felt about the care they were receiving.

We found mixed evidence about how people were treated by staff. We saw that some staff were kind and attentive, and promoted people's independence. We were concerned about the attitude and conduct of a member of qualified staff who did not assist people in a way which upheld their dignity and met their needs.

We were concerned about the arrangements to keep people safe from harm and protect their rights. We saw that a person the local authority had identified as presenting a risk of harm to themselves and others was agitated with others living at the service. We witnessed incidents between her and others living at the service which staff missed as they were busy assisting others.This meant that the person and other people living at the service were at risk of harm. We were concerned about how a nurse managed behaviour which may challenge and about the restrictions on one person's freedom which was unlawful.

We inspected all communal areas and the bedrooms of twelve people using the service. We found the areas we visited to be clean and well maintained with no unpleasant odours.

We found continued evidence to show that staff had not been recruited safely and in a way which ensured that they were safe to work with vulnerable people.

We had concerns about the conduct of a member of staff which we shared with the provider to ensure the safety of people living at the service. They shared the concerns but there was no evidence to show they had taken any action to discuss this with the member of staff or to assess their performance. This showed us that the systems in place to support staff and ensure they were competent were not sufficiently frequent, rigorous and robust.

25 January 2012

During an inspection looking at part of the service

We carried out this review to check compliance with a warning notice previously served, and were concerned that there might be continuing breaches of the regulations. Where areas of non-compliance were identified during inspection they are being followed up and we will report on that action when it is complete.

Most of the people who live at The Oaks Nursing Home would find it difficult to help us understand their views about the quality of the care being provided to them. We used a special tool designed to help us understand how people who have Dementia experience the care being provided to support them. We carried out our observations in two lounges and in the dining area over the lunchtime period. We looked at how staff interacted with people and how care was being provided to support people with their needs. We looked for clear and observable signs which would show us how people felt about the care they were receiving.

We found that in spite of some slight improvements, people were still not being treated with the respect and dignity they deserved. With one or two exceptions, we did not see many staff really attempt to communicate effectively either verbally or by using touch to reassure people. During our inspection we saw that people using the service appeared passive or withdrawn. We did not observe people smiling, talking or laughing, apart from when we instigated it, which shows that it was possible to engage with people living at the service.

We were very worried about how people were moved and handled and we witnessed one person sustain a serious injury following an unsafe manoeuvre. We were concerned about how staff managed restrictions to people's freedoms which had been assessed under the Deprivation of Liberty Safeguards. This law is part of the Mental Capacity Act 2005. It aims to protect people who do not have the capacity to make their own decisions about their lives and care from unlawful restraint.

We found the staff were still not safely recruited or effectively supervised, this meant that the care being provided was not of good quality and safe. We found that the providers and manager failed to have effective systems in place to identify, assess and manage the risks to people's health safety and wellbeing. We were concerned that improvements could not be sustained.

21 March 2012

During an inspection looking at part of the service

We carried out this review to check whether there had been any improvements in the quality and safety of care being provided following action we had taken to protect the safety and wellbeing of people living at the service. We found that there had been some improvements in some areas as detailed below but we continued to be concerned that there were ongoing breaches of the regulations in specific areas. Where areas of non-compliance were identified during inspection they are being followed up and we will report on that action when it is complete.

Most of the people who live at The Oaks Nursing Home would find it difficult to help us

understand their views about the quality of the care being provided to them. We used a special tool designed to help us understand how people who have Dementia experienced the care being provided to support them. We carried out our observations in the lounge and in the dining area over the lunchtime period. We looked at how staff interacted with people and how care was being provided to support people with their needs. We looked for clear and observable signs which would show us how people felt about the care they were receiving.

We saw care staff were better at communicating and interacting with people and we saw that people were being treated with more respect for their privacy and dignity. As a consequence we saw that the people living at the service looked more contented. We observed that the staff seemed better at supporting people when their behaviour was challenging.

However, we were very concerned about the quality of the work undertaken by the nursing staff at the service. We had serious concerns about their practice in respect of preventing and managing pressure areas. We also found that the changes the providers had made were not sufficient to ensure compliance with the warning notice previously issued.

29 September 2011

During an inspection in response to concerns

We are unable to communicate effectively with all of the people who live at The Oaks nursing home because of the nature of their needs. We used a specialist tool to observe them discreetly during the lunchtime period to check they were treated with dignity and respect and had their needs met by the staff in the way their care plan advised.

We found that although the staff showed an understanding of how to treat people with dignity and respect, they did not do this in practice. In several cases, they did not follow the written plans of care.

We found the staff had a very limited understanding of safeguarding and of local procedures. This meant that incidents involving people being assaulted by others had not been reported to the local authority placing people at risk of further incidents.

We found the recruitment procedures were not safe and that the staff were not being properly and regularly supervised to make sure they delivered good quality care. This showed that the service was not being properly monitored by the providers and the manager and there were significant risks to people living at the service as a result.