Oak Lodge Residential Home

Updated 23 July 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 conducted by two inspectors.

Service and service type

Oak Lodge Residential Care Home 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 registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider would be in the home to support the inspection.

What we did before the inspection

We reviewed information we had received about the service. This included details about incidents the provider must notify us about, such as alleged abuse. We sought feedback from the local authority who worked with the service. We used all this information to plan our inspection.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with three people who used the service and two relatives about their experience of care provided. We spoke with four members of staff including the provider (who was also the registered manager), senior care worker 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 staff supervision. A variety of records relating to the management of the service, including policies and procedures were viewed.

Updated 23 July 2021

About the service

Oak Lodge Residential Home provides accommodation and personal care for up to 15 older people, including people living with dementia. At the time of our visit 13 people lived at the home.

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

The provider did not always understand their legal duties related to the Mental Capacity Act 2005. Mental capacity assessments were not decision specific. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; however, the policies and systems in the service did not currently support this practice.

The provider’s quality monitoring systems were not effective in recording how people received safe, individualised care.

The provider did not always operate a safe system to ensure staff were recruited in line with their recruitment policy. Employment references had not always been obtained to ensure staff’s suitability to work with vulnerable people. The providers environmental risk assessments did not meet the current Health and Safety Executive guidance.

Care planning was not always focused on people’s whole lives, including goals, skills and abilities. The service enabled people to carry out person-centred activities, but this was not always documented in care records. People knew how to give feedback about their care but there was no systematic approach to gathering feedback from people or their relatives. On the day of inspection there was no-one receiving end of life care, however recording of people’s wishes could be improved.

Staff received training and support to carry out their roles. People had enough to eat and drink and they were involved in planning their meals.

People said that staff were kind, friendly and treated them with respect and dignity. People were involved in making decisions about the service through regular resident’s meetings. People’s relatives did not always feel involved, in part due to the restrictions on visiting caused by COVID-19.

People and staff told us they felt able to speak to the manager and raise any concerns they had. People were positive about the quality of the service they received.

People felt safe and staff had a good understanding of safeguarding and whistleblowing procedures.

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

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 6 September 2019) and there were multiple breaches of legislation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made in some areas and the provider was no longer in breach of some regulations. However, there was not enough improvement in other areas and the provider was in breach of other regulations.

This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

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.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Caring, Responsive and Well Led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation safe care and treatment and good governance. of the home at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.