This was an unannounced inspection carried out on the 22 September 2016.

Oakdene Care Providers is a care home providing personal care and accommodation for up to four female adults living with mental health problems. The home offers short to long term residency. The home provides a step-down service from hospital for people who are ready to move on to more independent living as part of their rehabilitation program. The home is a large semi-detached house and is situated within a residential area of Shrewsbury.

There was a registered manager in place. 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.

This home was last inspected in May 2013, when we did not identify any concerns with the care and support provided to people who used the service.

People were safe as staff knew how to recognise different signs of abuse and what to do if they suspected anything was wrong.

The provider ensured staff were safe to work with people who used the service by undertaking checks and obtaining suitable references before they started work at the home.

The home had suitable arrangements in place to ensure people’s medicines were managed safely.

A range of risk assessments had been undertaken to ensure people remained safe and protected against harm. Staff were aware of the individual risks that people faced and the methods they used to manage and reduce the likelihood of harm to people.

There were sufficient numbers of trained staff on duty during our inspection to effectively meet the needs of people.

Staff received regular supervision and annual appraisals and that management were always available to provide advice and guidance.

People’s individual nutritional needs were assessed and planned for by the provider, with clear instruction for staff in maintaining healthy diets.

The interactions between staff and people who used the service were caring and respectful at all times in a homely environment. People were given time to communicate their wishes and were listened to by staff.

Staff actively promoted people's independence both within the home and out in the community.

Staff knew each person's needs in detail and the level of support they required.

People’s care and support was planned in full consultation with families and professionals. Support plans were regularly reviewed to ensure they were meeting the person's specific needs.

The home routinely and actively listened to people to address any concerns or complaints. There was a complaints policy in place and questionnaires were given to people and families to provide comment on the quality of support provided.

The home was well run with a clear focus on supporting people who used the service.

The home undertook a comprehensive range of checks to monitor the quality service delivery and to ensure the environment was safe for people to live in.

Staff were encouraged to share their views, opinions and ideas to improve the quality of services provided.

We met and spoke with all three people who were living at Oakdene. People shared their experiences about using the service and how they were supported in their daily lives. People told us they liked the home, the staff and the activities they did.

Staff demonstrated a clear understanding of the needs of the people they supported. We found that people were involved in the planning of their care and support. People were supported to maintain their privacy, dignity and independence. People told us they were regularly seen by health professionals to review their well-being.

People were confident to recognise and report abuse. Staff had received training on protecting vulnerable adults and were confident to speak out if they observed poor or abusive practice.

People considered there were sufficient staff on duty to meet their assessed needs. We were told staffing was flexible based on people’s needs and activities for daily living.

People were aware of how to make a complaint if they were not happy with the service they received. The told us that staff regularly spoke with them about what to do if they were not happy. The home had information about how to complain however this required reviewing and updating.

We visited the home unannounced on 17 May 2012 to check on the care and welfare of people using this service. We also wanted to review the improvements that we had asked the provider to make following our last inspection undertaken in January 2012.

We met with all three people who were currently using the service. Overall they shared positive experiences of the care and support they received. They told us they liked living at Oakdene and felt well supported. People said the staff knocked on their bedroom door and respected their privacy. They told us the staff involved them in making decisions and supported them to do their daily living tasks to maintain their independence. They said they enjoyed going out on trips, shopping and seeing their families. One person said, “Because I’m better I take part in more things. I’m happy staying here.” Another person said, “It’s alright here.”

People told us they were involved in their meetings and care reviews. One person said the staff were supporting them to move into their own flat. People said they were aware of their care records and felt they got the support they needed. They said staff supported them with arranging and attending health appointments, which we observed during our inspection.

During our visit one person told the staff they were ‘scared’. We saw the staff reassure the person and supported them through their period of anxiety. Staff told us they had recently received training in keeping people safe. They demonstrated an understanding of the different forms of abuse and knew the procedure to follow if they suspected abuse.

People told us that staff supported them to manage their medication and they were happy with the arrangements in place. Staff told us that medication procedures had “definitely improved” following our last inspection when we told the provider to put things right.

People told us they liked the staff. One person said, “The staff are good. If there’s anything wrong or I feel ill I just tell everything to the staff.” Staff told us they had attended lots of training courses since our last inspection. They said the courses had provided them with a greater understanding and better equipped them to do their job.

Overall we found record keeping had improved for example we found no gaps on the medication records and a record of staff training had been developed. Staff acknowledged the need to ensure care plans were updated, particularly for the new staff recently employed. This will ensure staff provide a consistent approach when supporting people with complex needs.

We carried out this review to check on the care and welfare of people using this service. We met with three people who were using the service. They told us they liked being at Oakdene and said they felt safe, supported and well looked after. They told us they had regular contact with their families and health and social care professionals. One person said staff were helping them to move onto another service and was looking forward to the move. They said, “I’m looked after well here and can go out to the shops. I’m offered lots of choices and the staff are helpful and supportive”.

People said they liked the meals provided. They said they chose what they wanted to eat and were supported to shop for their food and help prepare and cook their meals. One person gave us a tour of the home to include the recently decorated lounge. All three people told us they were happy with their bedrooms and said they were comfortable. One person told us about the activities that were made available and said they had enjoyed going bowling.

We spoke with two staff on duty to include the manager. They told us that the service provided a secure and safe environment for people to stay. One person said, “It’s lovely, friendly and relaxed here and people are very much involved in their care and they seem to like it here”. We saw that staff had developed positive working relationships with the people at Oakdene. We were told and saw that people were encouraged to perform daily living tasks to maintain their independence.

We recently received a concern about staff not being trained in moving and handling or the administration of medication. We asked the provider to look into these concerns. We received a response but reviewed staff training and medication as part of this review. We found shortfalls across both areas which may impact on the care and welfare of people using the service if not actioned. We have reported our findings in the main body of the report.