Oaklands House

Updated 8 September 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was undertaken by one inspector with two days on site.

Service and service type

Oaklands House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager in post however they were not registered with the Care Quality Commission at the time of inspection. A registered manager is a person who along with the provider is legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We contacted Healthwatch for feedback on care in relation to this service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

We used all of this information to plan our inspection.

During the inspection

We spoke with five people who used the service about their experience of the care provided. We spoke with eight members of staff including the provider, the manager and care workers.

We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and training.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with staff over the telephone to gather more information about the service.

Updated 8 September 2021

About the service

Oaklands House is in Milnrow, Rochdale and consists of a large period building that has been extended to provide 13 single bedrooms for people who are diagnosed with mental health problems and are over the age of 18 years. There were 13 people living at the home at the time of inspection.

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

The risk to people’s safety was not always well managed. We found there were areas of concern in relation to fire safety and the maintenance of the premises which put people at risk of harm.

There was no clear auditing process in place and policies and procedures were not available at the time of the inspection. There was a lack of auditing across the service which put people at risk of harm as it was not clear what oversight the provider had when things went wrong or people’s needs changed. We received some policies after the inspection, relating to medicines and safeguarding however not all of the information requested from the service was made available.

The recruitment of staff was not always robust and appropriate background checks of staff were not taking place prior to them starting work. People’s medicines were not always appropriately managed and the process for identifying medication errors was not robust.

People told us the management team were approachable and would address concerns. The manager at the home was in the process of applying to the post of registered manager. The person applying to be the registered with the Care Quality Commission as registered manager, will be referred to as ‘the manager’ throughout this report.

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

Rating at last inspection

The last rating for this service was good (published 16 April 2018).

Why we inspected

The inspection was prompted in part due to concerns received about staffing and safeguarding management. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions therefore we did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Oaklands House on our website at www.cqc.org.uk.

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.

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 monitor the service and to hold providers to account where it is necessary for us to do so.

We have identified three breaches of regulation. These relate to the medicines management and recruitment (Regulation 12, Safe care and Treatment), the safe maintenance of the premises (Regulation 15, Premises and equipment) and the systems for oversight were not sufficiently robust to have identified all of the issues we identified (Regulation 17 Good Governance) at this inspection.

You can see what action we have asked the provider to take at the end of this full 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.