About the service:

• Oakes Court is a housing with care scheme that provides personal care to people living in their own flats. At the time of the inspection, 36 people were being supported by the service with personal care.

People’s experience of using this service:

• People were safe when staff provided them with care and were overall, happy with the quality of care they received.

• Risks to people’s safety had been assessed and staff acted to protect them from the risk of harm as much as was reasonably practical, whilst being mindful of people’s rights to maintain their independence.

• Staff understood how to protect people from the risk of abuse. Any concerns raised had been reported to the Local Authority for investigation as is required. However, CQC had not always been notified of some important incidents. This is required so the CQC can monitor the quality of care being provided to people.

• People told us there were usually enough staff working at the service to keep them safe and to provide them with support when they required this. However, some of them said improvements could be made regarding the timings of their care visits. The registered manager agreed to investigate this.

• People received their medicines when they needed them, and staff used good practice to protect people from the risk of the spread of infection.

• When things went wrong, the service learnt from this to improve the quality of care people received.

• Staff obtained consent from people before providing them with care. Where people could not consent, staff acted in their best interests in line with the relevant legislation.

• Staff had received enough training and supervision to enable them to provide people with good quality care. They were happy working at the service and felt valued.

• Staff were kind, caring and compassionate towards people. Staff treated people with dignity and respect.

• There was an open culture within the service. People had a voice and could raise their views about the care and support they received. Their suggestions for improvement were listened to and changes made where possible to improve people’s quality of life.

• The registered manager had developed good relationships with other services within the local community to ensure people received support with their healthcare needs and to enhance their wellbeing.

• People told us they felt the service was managed well. The registered manager continually reviewed the service they provided and was keen to introduce new ways of providing care to help improve people’s health and wellbeing.

Rating at last inspection:

Good (Published November 2016)

Why we inspected:

This was a planned inspection based on the period since the last report was published by CQC.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

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

The inspection took place on 26 October 2016 and was an announced inspection. This meant that we gave the service notice of our arrival so that we could meet with people who used the service.

The service is registered to provide personal care to older people in their own home. On the day of our visit 43 people were using the service. People who used the service have their own individual flat in a purpose built environment.

There was a registered manager for this service. 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 told us that people were safe using the service. Staff were trained in adult safeguarding procedures and knew what to do if they considered someone was at risk of harm, or if they needed to report concerns.

There were systems in place to identify risks and protect people from harm. Risk assessments were in place and carried out by staff that were competent to do so. These recorded what action staff should take if someone was at risk and referrals were made to appropriate health care professionals to minimise risk going forward. Staff were competent with medicines management and could explain the processes that were followed

There were sufficient staff to keep people safe and meet their immediate needs, and the registered manager had followed safe recruitment procedures. The majority of care provided was individualised according to each person’s needs and preferences. However, some people did not always receive care in line with the choices they had agreed.

Policies and procedures were in place to guide staff in relation to the Mental Capacity Act 2005. The registered manager understood that there should be processes in place for ensuring decisions were made in people’s best interests. Staff sought consent from people and recorded this.

Staff were caring, knew people well, and supported people in a dignified and respectful way. Staff maintained people’s privacy. Relatives felt that staff were understanding of people’s needs and had positive working relationships with people. People and their relatives were involved in assessments and reviews of their needs. Staff had knowledge of changing needs and made relevant changes to care records with the people who used the service.

People and staff knew how to raise concerns and these were dealt with appropriately. The views of people, relatives, health and social care professionals were sought as part of the quality assurance process. Quality assurance systems were in place to regularly review the quality of the service that was provided.

We completed this follow up inspection to check that Oakes Court had acted on improvements that we said needed to be made after our inspection of 22 April 2013.

We reviewed five Medication Administration Records (MARs) and found that records clearly identified the time medication was needed. Records were also completed accurately to say whether a person had taken their medication.

During our inspection visit, we spoke with four people who used the service who all told us that staff always asked before they provided any support or care. One person told us, "I always give my consent first and they (the care staff) always explain everything".

We reviewed four people's care files which documented personal details including what they like to be known as, care and support plans and personal risk assessments.

We saw that the provider had suitable arrangements in place for the ordering, storing and disposal of medication. However, we found that documentation to record the time medication was needed and if a person had taken their medication was not appropriately completed.

People we spoke with told us that it was a friendly place to live and staff were wonderful.

People had their comments and complaints listened to and we saw that complaints had been dealt with in accordance with the complaints policy and resolved to the complainant's satisfaction.

People were involved in decisions about their care and had choices about how and when it was provided. The people we spoke with were satisfied with the care they received and told us that it met their needs. One person commented that staff respected their wish to be independent but were very happy to help when it was needed.

Staff had training about safeguarding people from abuse and understood their responsibility to report any potential incidents. People using the service told us that they felt safe and comfortable with the staff at Oakes Court.

Staff received regular training to ensure they had the appropriate knowledge and skills to understand the needs of people using the service. They told us they were well supported by senior staff and could rely on them for help and advice about their role.

People using the service had opportunities to make their views about the service known. They told us that they felt comfortable raising issues for improvement and that these were acted upon wherever possible.

The manager and provider carried out regular checks to make sure that people received a good quality service.