Oaktree Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We assessed all the quality statements within the responsive key question. People received continuity of care from a core staff team who knew them well. This helped staff to get to know people and understand how best to meet their needs and provide care in the way they preferred. We saw staff using different means of communicating to offer choices and give people time to respond. Staff told us enjoyed working at the service and several had been there for many years. They worked closely with other professionals to make sure all people’s needs were met. Effective communication helped staff. For example, regular handovers, staff meetings and electronic records. People were given information about the service and their care in different ways depending on their needs. This included written, verbal and demonstrated information. Training and communication care plans helped staff get to know people’s needs. People were able to give feedback about the service in different ways. This included questionnaires, meetings and directly to staff. People and their relatives said they felt included and listened to and would be confident to raise concerns or give feedback where needed. We were assured that complaints were investigated and resolved. The service had been adapted to best meet people’s individual needs. Staff aimed to remove barriers where these could prevent people accessing care or support. The activities which people were encouraged to participate in reflected a wide range of interests and needs. Some people told us they would like different activities, and the management team took immediate action to review this. Staff were aware of people’s wishes about important life changes and empowered people where possible. One person was exploring moving to more independent living. Another person was receiving end of life care. Staff were supporting the people and their families in the ways they wished.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There were initiatives to help ensure people were at the centre of their care. For example, resident of the day and a ‘VIP table’ in the dementia unit at mealtimes. Different people joined the VIP table every day, and staff gave them extra time and care to ensure everyone felt included, valued and special. Overall, people felt they received person-centred care which reflected their preferences. Comments included, “I like bingo”, “I like singing” and “I’m not interested in activities, I like my own company.” However, some people told us they were not asked often enough about what they would like to do.

Staff knew people well and understood how best to meet their needs and provide care in the way they preferred. One staff member said, “It is not task focused here, it is definitely about the person. We know them and we do what they want.” Staff told us people’s care plans were detailed, useful and were regularly updated to reflect changes. Staff gave examples of the person-centred care that people received such as changing someone’s personal care routine when they requested and respecting people’s preferences regarding food.

We saw staff offering choices and giving people time to respond in a personalised way. One person regularly told staff they needed to walk to Bristol. This was over 10 miles away. Rather than try to dissuade them, staff had placed a large image of the Bristol skyline in a corridor. The person could walk safely to this point each day and could then relax because their aim had been achieved. Staff knew from people’s actions or body language what they wanted when they were not able to tell them. One person did not speak English as a first language. Although they were able to communicate, a staff member was learning some of the person’s language, so they could greet and engage with them.

People felt supported and involved in their care where possible. People who were able to tell us about their involvement said they were involved in reviewing their care needs and choices. One person said, “If I want to say something, I’ll say it and they react to it.” People received continuity of care from a core staff team who knew them well.

Staff enjoyed working at the service and several had been there for many years. They worked closely with other professionals, such as pharmacist, GP and paramedics. This helped provide continuity in people’s care. Staff told us care was planned in conjunction with people and their families where possible. One staff member told us, “We know the families. They’re like our own.”

Other professionals were assured that the service made sure people received the right support. They felt staff supported people well and took timely and appropriate action when people’s health changed.

Regular handovers and effective communication helped staff to be aware of people’s current needs and how best to meet them. The electronic system and robust processes enabled staff to make referrals to health and social care professionals promptly. This helped ensure people received co-ordinated care which met their needs.

People told us they had access to the information they needed about the service. Relatives told us they got information from a range of sources, such as informal contact with staff, phone calls and newsletters. Some relatives attended meetings at the service. Menus and information about activities and events were available throughout the home. We saw people being guided and prompted verbally by staff to ensure they understood what was happening at different times. Clear signage helped orientate people around the home.

The registered manager told us individual communication needs were considered before the initial admission assessment. A person-centred communication care plan was developed which identified individual abilities and needs. Staff told us they received training in effective communication. The registered manager told us staff were supported to consider voice tone, body positioning or language, and conversation level. We saw staff putting these skills into practice during our visit. One staff member said, “We can use picture cards, and some people have notice boards. We need to be patient and don’t rush and give people our full attention.” Staff took time to ensure the information they were sharing was accessible for people. For example, some people were able to make meal choices from a written menu, but others needed staff to take time to show them plates of food so they could make an informed decision about their meal.

Written information, including posters and brochures contained both text and pictures. Information could be provided in large text or other languages if needed. Care records included information about how each person communicated, any aids they used and the support they needed to understand information. One person’s care plan stated, “[Name] needs time to process information and verbalise her responses.” This helped staff ensure they met the person’s needs in an accessible way.

People gave feedback about the service in different ways. For example, there were different versions of a survey that people completed. As well as a detailed questionnaire, other versions were ‘dementia friendly’ or ‘dementia simplified’. One relative told us, “If there was a concern regarding nursing, I would speak to someone at the nursing station, otherwise [Name] at the admin office or [registered manager] is available. Things have been resolved quickly.” We saw many examples of compliments which had been received by the service. Families had shared their gratitude for the care their relatives received. One card read, “I would like to thank the staff for the wonderful care and dignity shown to my husband whilst at Oaktree. I feel assured that his last days were made as comfortable as possible.”

The provider stated they aimed to, “Make it easier for people to share feedback and ideas or raise complaints or concerns about care, treatment and support.” Staff and leaders told us they listened to people and supported them to share their views of the service. One staff member said, ”We always take time. We listen to people.”

Processes were in place to involve people in their care and give feedback. We saw records of complaints, compliments, resident meetings, resident committee meetings, survey feedback and care plan reviews. Where concerns were raised, there were action plans to address these or make improvements. The survey results we saw showed people were satisfied with the service overall and the quality of care. A complaints procedure was on display and provided internal and external contact details for people to raise concerns or make suggestions. Where complaints had been received, these had been investigated and responses provided to the complainants.

People had access to care and support which met their needs. The provider had reviewed and changed the service to better meet people’s diverse needs. For example, since our last inspection, the structure of the service had changed and people who were living with dementia were now supported together in one unit. This meant the staff, their training, equipment and the environment catered specifically to people’s complex needs and enabled staff to support them more effectively.

Staff received training in equality and diversity. This helped to ensure they were aware of potential discrimination or inequalities that people could face, and they aimed to remove barriers where possible. The management team told us they had previously faced challenges in getting urgent medical attention and admission to hospital for people. They had taken action to manage this and reduce the barriers, and the issue had improved.

A healthcare professional told us staff promptly contacted them if there were concerns about changes to people’s health or condition. This helped them take timely action when necessary.

Assessments of people’s needs considered the support people needed to overcome potential barriers. For example, one person had a large chair but wanted to have meals in the dining room. Staff had raised and repositioned a table so their chair could fit underneath, and they could join others at mealtimes. The GP carried out weekly visits to ensure people could receive equal access to treatment when they needed it.

People told us they were treated equally and fairly. A resident’s committee had been set up since our last inspection which met monthly. This empowered people or their representatives to regularly give their views and feedback. The activities which people were encouraged to participate in reflected a wide range of interests and needs. This included cultural celebrations and events, for example a summer fete, visiting entertainers and D-Day commemorations. Some people did not want to or were unable to attend group activities, and staff took individual activities to their rooms.

Staff described how they supported people’s diverse needs. For example, by tailoring the activities which were available or changing how personal care was provided. The management team told us how they acted on information about people’s experiences and made changes where necessary.

People’s care records contained personalised information about their unique needs and preferences. This helped staff to provide support which was tailored to the individual. People and relatives were regularly asked to provide formal feedback about their experience. Surveys were carried out and feedback was reviewed and analysed to support change where necessary. The feedback we saw from recent surveys was positive. There was an awareness of equality and human rights legal requirements in the organisation. Policies and procedures were in place to support equity in people’s experience and outcomes.

One person was being supported to explore moving to a more independent living setting. They had an active and meaningful role in the service which was valued by people and staff. Staff were supporting the person to make informed choices in their own time to achieve their goal.

Staff told us their knowledge of people and their families helped them support individuals to plan for important life changes. For example, staff understood the wishes of a person who was receiving end of life care and their family. This helped ensure their wishes were respected as their condition changed.

People’s wishes regarding important life changes were made clear in care records. Some people and their families had made decisions about resuscitation or future treatments. Having this information clearly documented helped staff to support people to remain in control and respect the decisions they had made about their life.