We last inspected this service in June 2013 and found the provider was meeting all of the requirements of the regulations at that time. This inspection was unannounced and took place over two days on 4 and 5 February 2016.

Oak House Trust Limited, hereafter referred to as ‘Oak House’, is registered with CQC to provide accommodation with personal care for up to 16 people. The service caters for older men who live with a learning disability and / or sensory impairment. At the time of the inspection nine men were using the service. Oak House is required to have a registered manager in post. The registered manager had been registered as manager at the service since 2010. 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.

People benefitted from a family orientated service where they enjoyed stability and long-term friendships and they were able to make a positive contribution to the daily running of their home. People took responsibility for jobs around the home and gardens, including growing vegetables, domestic chores, stock taking and caring for the hens and ducks. People were valued as individuals and were supported to maintain their independence, learn new skills and to sustain relationships with the people who were important to them. They enjoyed positive relationships with staff and regular activities with their local community, including curry nights and skittles. People’s safety and well-being was maintained through effective links with other community health providers and services. People were respected as individuals and their rights to make decisions about their lives were upheld. When people lacked capacity to make decisions, for example in managing their finances, the service needed to complete capacity assessments to evidence this. This work needed to be completed to ensure that Mental Capacity Act (2005) legislation was adhered to.

Staff enjoyed working at Oak House and the majority had worked at the service for many years. They worked well as a team and respected each other’s contribution, knowledge and experience. Staff felt well-supported and valued. They were able to speak openly and discuss issues or difficulties they, or the people they supported, were experiencing, so that solutions could be found. They cared for the people they supported and responded promptly to changes in people’s day to day well-being, to ensure they were safe. Staff acknowledged people’s contribution and hard work and went out of their way in their own time to provide opportunities for them including nights out and transport to their holidays.

The service worked openly and effectively with health service providers and local community services. They were working with the local authorities to complete an agreed action plan. Leadership was provided by the registered manager supported by the charity’s Board of Directors. They worked closely with staff and were always available to provide support and advice and knew of all significant events happening within the service each day. They worked inclusively with people and their families, staff and other organisations to provide the service in line with people’s wishes.

The majority of the men who live at Oak House have lived there for several decades. We saw that they were content and enjoyed friendly banter with others and staff at the home. People were confident in expressing their views and wishes and these were respected by staff. People were involved in decision-making about their care and their independence was maintained through participation in everyday activities. They had access to appropriate medical, dental and specialist care and feedback from families about the service was consistently positive. The people we spoke with told us they were “very happy here” and that there was nothing they would like to change.

The environment was suitable for the needs of people living at Oak House, which was spacious and well maintained. Some training was needed to make sure that staff were up to date on policies and procedures. Effective quality monitoring procedures were in place.

At this scheduled inspection we also followed up on a compliance action issued on 11 October 2012.

Staff routinely sought people's consent before providing care. When a person had limited capacity to manage aspects of their daily life this was recorded and appropriate actions had been taken to protect their rights.

People who use the service were in good health for their years and led active and fulfilling lives. People’s needs were met by staff and appropriate support had been sought from external health professionals when this had been indicated. One person we spoke with said staff were, “kind and patient”. Another person said, “I like it here… staff are good friends”. People told us they felt “safe” and at home at Oak House.

Appropriate arrangements were in place to manage people’s medicines. We found that the home had completed training to address the shortfalls identified at our last inspection. However, during this inspection we identified further areas where updates were required to make sure that compliance was maintained. When this was brought to their attention, the manager acted immediately to address these shortfalls.

Oversight of management of the home was maintained by the trust’s Board of Governors, who had a variety of relevant experience and held positions of trust within the local community. Feedback about the service was routinely sought from people living at Oak House and their relatives. The feedback received was unanimously positive.