We inspected Oaklands House on 16 April 2018. This was an unannounced inspection.

At our last inspection in October 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

Oaklands House is in Milnrow, Rochdale and consists of a large period building that has been extended to provide 13 single bedrooms for people who are diagnosed with mental health problems and are over the age of 18 years. The home provides 24 hour care and has a wide range of equipment and facilities to assist people with their care needs. At the time of our inspection the home was full with 13 people living in the property. There was enough room to allow for privacy and communal living. People had their own rooms, which were decorated to reflect their personal taste, and there were a number of communal areas which were well furnished and laid out with consideration of the needs of those who used the service. All areas were clean with close attention paid to minimising the risk of infection.

The home was secure, and there were no undue restrictions on people who were supported to maintain their independence. People told us that they felt safe and when we spoke with staff they demonstrated a good understanding of how to prevent abuse. The service had safeguarding procedures which were in line with legislation and local authority policies so when incidents of potential abuse occurred these were reported and appropriate action taken to protect people from harm.

Care records showed that risks to people's health and well-being had been identified, and where risk had been identified, corresponding detailed care plans were put into place, and reviewed on a regular basis. Risks were assessed in relation to each individual, taking into consideration their choices, abilities and lifestyle.

We saw that when recruiting new staff, appropriate processes were in place to ensure that they had the right quality and character to work with vulnerable people. Once in post all staff received regular supervision and appraisal and were provided with training opportunities to develop their skills. There were sufficient staff on duty, and we saw that there was a low turnover of staff. Care workers knew the people they supported and had time to spend talking and interacting positively with them.

Medicines were well managed and records showed that regular audits ensured that people received their medicines safely and effectively.

There was evidence to show good cooperation with health and social services professionals, and staff at Oaklands House showed knowledge of people who used the service. Needs were met in a person centred way. Staff were well trained and training needs were monitored, with refresher training on a regular basis. Staff told us they found their supervision sessions to be useful and helped them with their daily tasks.

People who used the service influenced the food provision, and when we spoke with them they told us they liked the food on offer. Dietary requirements were met, and individual tastes and preferences were catered for.

People who used the service were offered choices, and capacity and consent issues were considered. Where people lacked capacity, best interest decisions were taken and documented to show that decisions made were in their best interests. Where people were subject to a deprivation of liberty the service sought the appropriate authorisation to provide care and support.

The service recognised and responded well to people’s needs and wishes and people were treated with respect and dignity by kind and patient staff. People who used the service said they felt valued and included, and that their privacy was respected. All were comfortable in their surroundings. They were involved in planning their care and reviews and their wishes and needs were

This was an unannounced inspection which took place on 28 October 2014. Oaklands House is registered for up to 13 people who have been diagnosed with mental health needs. There were 12 people living at the home on the day of our inspection. Accommodation is provided in single en-suite rooms.

The home 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.

People living at Oaklands House told us they felt safe. Staffing levels varied according to people’s care needs and planned activities in the community. Safeguarding procedures were robust and members of staff understood their role in safeguarding the people they supported. Staff also understood the restrictions imposed on people under the terms of the Mental Health Act 1983. We found that recruitment procedures were thorough so that people were protected from the employment of unsuitable staff.

We saw that medicines were managed correctly in order to ensure that people received their medicines as prescribed. Members of staff responsible for the administration of medicines had received training and their practice was regularly assessed to ensure correct procedures were followed.

Staff told us they were supported by management and received regular training to ensure they had the skills and knowledge to provide effective care for people who used the service. Staff had also received training about the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards so they knew when an application should be made and how to submit one.

People who used the service said the meals were good and they could help themselves to snacks and drinks throughout the day. People told us that members of staff were kind and treated them with dignity and respect.

People’s personal preferences, interests and diverse needs had been recorded in their individual care plans. These plans were reviewed regularly and amended to reflect people’s changing needs. The registered manager and staff worked closely with other health and social care professionals such as the Community Mental Health Team to ensure people’s needs were met.

People who used the service were supported to access leisure activities in the local community and to visit local amenities such as the shops and pubs. People were also encouraged to take part in leisure activities organised at Oaklands House.

People were given the opportunity to express their views about the care and facilities provided at Oaklands House at their regular meetings and by completing satisfaction surveys. The recently completed surveys we saw indicated that people were mostly satisfied with the care and support provided at the home. Copies of the complaint’s procedure were readily available to people who used the service. Although no one had made a complaint during the last year a number of people told us they did not feel confident to do so.

There were systems in place for assessing and monitoring the quality of the service provided. We saw that audits completed regularly by the registered manager covered all aspects of the service provided.

The members of staff we spoke with told us they enjoyed working at the home and said the registered manager was approachable and supportive.

We received an action plan in October 2013 that stated all staff would receive updated training in medication and stock checks and audits would be introduced to identify any medication that needed to be renewed. We looked at the stock checking systems and saw weekly and monthly audits were now in place and people were receiving their medications in time.

The action plan stated that quality assurance systems were to be updated and additional audits had been set up in checking of the mattresses, care records and infection control. We looked at the audits and found they had been set up and were being updated on a regular basis.

We spoke with two people who use the service. They told us they had been involved in the care plans and had been asked for consent where appropriate. The people using the service told us they felt they were being looked after properly. One person told us the staff helped him maintain his independence so he could go and look for his own flat.

Both people told us they had freedom to choose their activities and one person told us he enjoyed painting but felt that sometimes support from the home was lacking.

Both people felt their medications were administered safely and staff prompted them on time.

Both people were complimentary about the staff and felt that staff treated them with respect and dignity and helped them maintain their independence.

There was no registered manager in place at the time of inspection which impacted on the quality monitoring provisions. We found that there was no overall audit programme in place.

We spoke with two people who were living at the home. They told us the staff were good and treated them well. Both people confirmed staff asked them for verbal consent. One person said “I am involved with the care plans and staff discuss these with me.”

Another person told us “The staff are always available for confidential discussions about private issues.”

Both people were positive about the environment and living with the other people. Both people felt safe living at the home and did not have any concerns related to the wellbeing of any of the people at the home.

There were positive comments about the staff and the service that was being provided. One person said “Everybody is friendly and there are always staff to help out.”

Neither person had any complaints. One person told us “If I ever need to raise anything, I speak with the staff who would deal with it immediately.”

In this report the name of a Registered Manager appears who was not present and not managing the regulatory activities 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.