About the service: Oaklawn provides a care home service without nursing to a maximum of four older people with learning disabilities. The home is a small family run business, and sits alongside the providers other care home. At the time of our inspection four people lived here.

People’s experience of using this service:

¿ People were positive about the care and support they received. Staff were seen to interact with people in kind and compassionate ways.

¿ Peoples’ health and safety were well managed using risk assessments and ongoing reviews of their care and support needs.

¿ There were enough staff to meet people’s needs and the provider followed safe recruitment practices when employing new staff.

¿ The environment was homely and reflected the interests and preferences of the people that lived there.

¿ Staff received sufficient training and supervision to enable them to provide care and support that met people’s needs.

¿ People had enough to eat and drink and their dietary requirements were understood and supported by the staff.

¿ People told us that they enjoyed the food at the service. Where people were at risk of malnutrition and dehydration appropriate steps were taken to support them.

¿ People were treated in a caring and dignified way. They were involved in decisions about their care. Staff knew people well and provided care that was reflective of their needs.

¿ People had access to activities based around their interests and hobbies.

¿ There were systems in place to review the quality of the care being provided that included audits, meetings and feedback questionnaires.

¿ The registered manager aimed to give people a home from home experience. Due to the small size of the home, and small staff team, this had been achieved. There was a real family atmosphere at the home with people and staff enjoying each other’s company.

Rating at last inspection:

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

Why we inspected:

¿ This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

¿ We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

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

The inspection took place on 19 April 2017 and was announced.

Oaklawn provides a care home service without nursing to up to four older people with physical and learning disabilities; some are also living with the experience of dementia. The service is situated on the outskirts of Epsom, Surrey. At the time of our inspection two people lived here.

This was a focused inspection following the last inspection in August 2016. Despite being awarded an overall rating of 'Good' during the last inspection we found a breach in Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This follow up inspection on 19 April 2017 was a focused inspection to check if the service was effective.

During this inspection we found Oaklawn to be working in line with the principles of the Mental Capacity Act 2005 (MCA). People were involved in the decision making process and when people lacked capacity best interest meetings had taken place.

There was 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.

There was positive feedback about the home and caring nature of staff from relatives of the people who live here. A relative said, “It’s like paradise here for my family member, the staff are amazing at providing care.”

People had enough to eat and drink, and received support from staff where a need had been identified. Staff had a good understanding of specialist diets that people were on to ensure people could eat and drink safely, and still enjoy their meals.

People were supported to maintain good health as they had access to relevant healthcare professionals when they needed them.

Oaklawn provides a care home service without nursing to up to four older people with physical and learning disabilities; some are also living with the experience of dementia. The service is situated on the outskirts of Epsom, Surrey. At the time of our inspection four people lived here.

The premise is presented across one floor, with easy wheelchair access to the private garden with a patio at the rear of the property. People’s bedrooms are single occupancy. Communal space consists of a lounge area and a small dining room/kitchen.

There was 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.

The home was well decorated and adapted to meet people’s needs. Flooring was smooth and uncluttered to aid people’s mobility needs. The home had a homely feel and reflected the interests and lives of the people who lived there.

The inspection took place on 12 August 2016 and was unannounced.

One identified one breach in the regulations. You can see the action we have asked the provider to take at the back of the full report.

People’s rights under the Mental Capacity Act (2005) were not completely met. Where people could not make decisions for themselves best interest decisions were made on their behalf. Assessments of people’s ability to make specific decisions had not been completed before these decisions had been made. Staff were heard to ask people for their permission before they provided care.

The staff did not have a good understanding of the requirements of the Deprivation of Liberty Safeguards (DoLS). The registered manager had not yet submitted applications in accordance with the act, due to the fact that some people were under constant supervision, and could not leave the home if they wanted to. The registered manager said they would put in the applications.

There was positive feedback about the home and caring nature of staff from people who live here. A relative said, “It’s always amazing here when we visit, I can rest easy knowing that all is well for my family member.”

People were safe at Oaklawn. There were sufficient staff deployed to meet the needs and preferences of the people that lived there. Staffing levels changed to reflect the support needs of people, such as when they had to receive one to one support to attend appointments.

Risks of harm to people had been identified and clear plans and guidelines were in place to minimise these risks, without restricting people’s freedom. Staff understood their duty should they suspect abuse was taking place, including the agencies that needed to be notified, such as the local authority safeguarding team or the police.

The provider had carried out appropriate recruitment checks to ensure staff were suitable to support people in the home. Staff received a comprehensive induction and ongoing training, tailored to the needs of the people they supported.

People received their medicines when they needed them. Staff managed the medicines in a safe way and were trained in the safe administration of medicines.

In the event of an emergency people would be protected because there were clear procedures in place to evacuate the building. Staff understood the support that each person would need to get safely out of the building in an emergency. An alternative location for people to stay was also identified in case the home could not be used for a time.

People had enough to eat and drink, and received support from staff where a need had been identified. Staff had a good understanding of specialist diets that people were on to ensure people could eat and drink safely, and still enjoy their meals.

People were supported to maintain good health as they had acc

On the day of our visit there were four people residing in the home, one person was attending day services, which was its maximum capacity. All the people had profound learning disabilities and were in the older age group. We were met by the deputy manager and then joined by the registered owner, who also managed the service along with two other similar homes in the area.

We looked at whether people and their relatives were able to give consent to care and treatment, and found that within the severe limitations of their conditions people were able to give some consent, and that their relatives were also able to do so. We saw evidence that best interest meetings had been undertaken regarding physical health needs..

We looked at the care of people in the home and found that people were generally happy with their care, there was an effective care planning process in place.

We looked at the management of medicines in the home and found an effective process in place to enable the safe provision of medicines.

We looked at the suitability of the workers; we found the provider ensured the staff were trained effectively to carry out their roles. We found that the provider ensured the staff were of good character through obtaining references and the use of the disclosure barring service (DBS)

We looked in to the complaints system. We found this to be an effective procedure to respond to any concerns, the manager advised that they had not received any complaints.

On the day of our visit there were four people residing in the home, which was its maximum capacity. All the people had profound learning disabilities and were in the older age group. We were met by the deputy manager and then joined by the registered owner, who also managed the service along with two other similar homes in the area.

We looked at whether people and their relatives were able to give consent to care and treatment, and found that within the severe limitations of their conditions people were able to give some consent, and that their relatives were also able to do so. However, we noted that there were no written consent forms to document this.

We looked at the care of people in the home and found that people and their relatives were generally happy with their care, and that there was an effective care planning process in operation.

We looked at the safety and suitability of the premises and found that they were accessible for wheelchair users, well maintained and secure. Although the owner told us he conducted regular inspections there was no record of works and maintenance.

We looked at support for staff and found they had received proper training and induction, and were offered regular supervision and appraisal.

The provider was taking steps to assess and monitoring of service quality; however, we were unclear how regularly these processes were being undertaken.

We saw people involved in activities of their choice around the home, and strategies had been put in place to allow them to do this safely.

We saw that staff were attentive to people, and responded to people with a good understanding of their communication styles or body language. We also saw that staff gave adequate time for people to communicate with their individual communication styles and methods. We saw that staff gave appropriate and prompt support at lunchtime.