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

This inspection took place on 1 and 12 April 2018 and was unannounced. Oak Tree Mews accommodates up to 20 people in one adapted building. At the time of our inspection visit there were 15 people using the service.

Oak Tree Mews had a registered manager in post. 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.

We previously inspected the service in May 2017 and it was rated Requires Improvement. At this inspection we rated the service Good. We found improvements to people’s care plans and the provision of activities had been made. However we found some assessments of people’s needs had not been accurately completed and therefore did not provide staff with the appropriate information to support people. The provider had plans in place to make this improvement.

The service was well led. Quality assurance checks were in place and identified actions to improve the service. Staff and relatives spoke positively about the management team.

People were protected from harm and abuse through the knowledge of staff and management. People were protected from risks in the care home environment. People’s medicines were safely managed. We found the environment of the care home was clean and had been well maintained.

People received support from caring staff who respected their privacy, dignity and the importance of independence. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. There were arrangements in place for people and their representatives to raise concerns about the service.

Further information is in the detailed findings below.

This inspection took place on 5 May 2017 and was unannounced. Oak Tree Mews provides accommodation for 18 older people who require personal care without nursing. 14 people were living in the home at the time of our inspection. Oak Tree Mews is a small care home set over two floors. The home has a lounge and dining room and people have access to a private garden. This service was last inspected in March 2015 when it met all the legal requirements associated with the Health and Social Care Act 2008.

A registered manager was in post at the time of our inspection. 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 and their relatives were positive about the care they received. We observed the relationships between staff and people receiving support demonstrated dignity and respect at all times. Staff knew, understood and responded to each person’s needs in a caring and compassionate way. Staff had the knowledge and confidence to identify safeguarding concerns and told us they would act on these concerns to keep people safe.

People told us there was enough staff to meet their needs. Staff rotas confirmed this. Staff carried out additional duties when required. Bank and agency staff were called in if there were any unplanned staff absences. Recruitment checks had been carried out to ensure staff were suitable to work with people. Staff told us they were supported well and had the training and skills they needed to meet people's needs.

Staff had responded quickly when incidents had occurred or people’s needs had changed. However, people’s care records were not consistently completed to reflect their support needs, changes in their well-being, consent to their care or the management of their risks. A range of activities were available for people to access, however some people told us their social and recreational needs were not always met.

The registered manager and the provider’s representatives responded to people concerns and monitored the quality of the care provided, although shortfalls in people’s care planning had not been consistently identified during their auditing process.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and Care Quality Commission (Registration) Regulation 2009. You can see what actions we told the provider to take at the back of the full version of this report.

This inspection took place on 20 March 2015 and was unannounced. Oak Tree Mews provides accommodation for 18 people who require personal care without nursing. 18 people were living in the home at the time of our inspection. Most of the people living in the home were mobile and had the capacity to make decisions for themselves. This service was last inspected in July 2013 when it met all the legal requirements associated with the Health and Social Care Act 2008.

Oak Tree Mews is set over two floors. The home has a lounge with an attached dining room and seating area. The home is situated close to the town centre and has an enclosed garden with raised garden beds.

A registered manager was in place as required by their conditions of registration. 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. We were told the registered manager in post on the day of our inspection had resigned; however the provider had put systems in in place to support the deputy manager until a new manager was recruited.

Opportunities for some people to take part in individual meaningful activities were limited, although people enjoyed external entertainers and some group activities as well as their own social interests. The registered manager was reviewing the activities programme to ensure everybody’s social and leisure needs were being met. Staff were kind and compassionate towards people. People were encouraged and supported to have a well-balanced and nutritional diet. People who needed special diets were catered for.

People were involved in planning for their care. Their individual needs were assessed, planned and reviewed. People and their relatives were positive about the care and support they received from staff. They were supported to maintain their health and well-being and access additional care and treatment from other health care services when needed. People’s medicines were managed and stored safely so that they received them in a timely manner. There were sufficient numbers of staff to ensure people’s needs were being met.

Risks for individual people had been assessed. Staff were given guidance on how to best support people when they were at risk of harm. Staff had been trained to support and protect the people they cared for. People were protected against abuse because staff knew how to report any concerns of abuse to the relevant safeguarding authorities. Policies to protect people were in place to give staff guidance.

The registered manager and provider had a good understanding of their role and how to manage the quality of the care provided to people. Quality monitoring systems were in place to check and address any shortfalls in the service. People and their relatives felt that any concerns raised were dealt with immediately.

We did not speak to people who used the service. This was a follow up inspection to check on two compliance actions following a previous inspection. We found that arrangements for sharing important information when a person was transferred to hospital were in place and being followed. We also found an improvement in the number of staff that had received training in infection control as well as improvments to the organisation of the laundry.

We spoke to three people who used the service. They made positive comments about the service such as “I don’t think I could be in a better care home”. We found that although there were arrangements in place to share information about people’s needs when care was transferred to others, these had not been used when a person went into hospital.

We also found that there was a lack of arrangements in place to protect people from the risk of infection, this included not following up to date guidance and a lack of staff training. At a previous inspection we found issues with the storage of chemicals. We checked and found that action had been taken and chemicals were stored safely. Equipment provided for people using the service was properly maintained.

We looked at staff recruitment and found that required checks had been made before staff started work in the service. Although we did not ask people specific questions about staff recruitment, we did hear positive comments about the staff such as, " they all do the best they can“ and "very good indeed, all of them, very helpful".

In this report the name of a registered manager appears who was not in post and not managing the regulatory activity at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time. We have advised the provider of what they need to do to remove the individual's name from our register.

We spoke to four people who used the service. They told us how staff respected their privacy and how they received care and support from the staff. One person told us, “any help we need we only have to ask” and stated they were “quite happy here”.

Although people using the service made positive comments about the environment of the home we found some issues with the storage of chemicals that may have put them, staff and visitors at risk.

People told us that there was enough staff for their needs although commented about the current lack of a manager.

People told us they would approach the staff with any complaints. However we found they were unclear where a written complaint would be sent to.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activity at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

We have advised the provider of what they need to do to remove the individual's name from our register.