We inspected Oakley House on the 12 February 2019.

About the service: - Oakley House caters for up to two people with acquired brain injury. There were two people living at the service at the time of our inspection. The service was set in a residential house. Each person had their own private room and access to all the amenities in the house. The service was set in a residential area with easy access to the local community and had a large garden.

People’s experience of using this service: One person told us, “I am happy living here.” A relative told us, “I have every faith in the service and I am entirely happy with the care.”

The service was safe.

¿ Care and treatment was planned and supplied to ensure people's safety and welfare.

¿ There were systems in place to minimise the risk of infection and to learn lessons from accidents and incidents.

¿ People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. People’s needs were met by sufficient numbers of staff.

¿ Medication was given to people by staff who had received training to do this safely.

The service was effective.

¿ People were cared for and supported by staff who had received appropriate training.

¿ The registered manager had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.

¿ People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

¿ People were supported to eat and drink enough to ensure they maintained a balanced diet. Referrals to other health professionals were made when required.

¿ The environment was well maintained and suitable for people's needs.

The service was caring.

¿ Staff cared for people in an empathetic and kind manner. Staff had a good understanding of people’s preferences of care.

¿ Staff worked hard to promote people’s independence through encouraging and supporting people to make informed choices.

The service was responsive.

¿ People and their relatives were involved in the planning and review of their care. Care plans were reviewed on a regular basis.

¿ People were supported to follow their interests and participate in social activities.

¿ The registered manager responded to complaints received in a timely manner.

The service was well-led.

¿ The registered manager had systems in place to monitor and provide good care and these were reviewed on a regular basis.

Rating at last inspection: Good (report published 9 April 2016)

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor all intelligence received about the service to ensure the next planned inspection is scheduled accordingly.

Oakley House provides care and support for up to two people who require support following traumatic acquired brain injury. There were two people living in the service when we inspected on 3 March 2016.

The provider was also the 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 received care that was personalised to them and met their needs and wishes. People and relatives were complimentary about the care and support provided. Staff listened to people and acted on what they said. The atmosphere in the service was friendly and welcoming.

Procedures were in place which safeguarded the people who used the service from the potential risk of abuse. Staff understood the various types of abuse and knew who to report any concerns to.

Staff knew how to minimise risks and provide people with safe care. Procedures and processes guided staff on how to ensure the safety of the people who used the service. These included checks on the environment and risk assessments which identified how risks to people were minimised.

Recruitment checks on staff were carried out with sufficient numbers employed who had the knowledge and skills to meet people’s complex needs. Staff respected people’s privacy and dignity and interacted with people in a caring and compassionate manner.

Staff had developed positive relationships with people and respected their diverse needs. They were supportive and respectful and knew each person’s individual care and support needs well. Staff clearly understood each person’s way of communicating their needs and anxieties and responded appropriately.

Appropriate arrangements were in place to ensure people’s medicines were obtained, stored and administered safely. People were encouraged to attend appointments with other health care professionals to maintain their health and well-being.

Care and support was based on the assessed needs of each person. People’s care records contained information about how they communicated and their ability to make decisions. People were encouraged and supported to pursue their hobbies and interests, take part in social activities and to maintain links within the community.

People or their representatives were supported to make decisions about how they led their lives and wanted to be supported. Where they lacked capacity, appropriate actions had been taken to ensure decisions were made in the person’s best interests. The service was up to date regarding the Deprivation of Liberty Safeguards (DoLS).

People’s nutritional needs were being assessed and they were supported to eat and drink sufficiently. People were encouraged to be as independent as possible but where additional support was needed this was provided in a caring, respectful manner.

There was an open and transparent culture in the service. Staff were aware of the values of the service and understood their roles and responsibilities. Audits and quality assurance surveys were used to identify shortfalls and drive improvement in the service.

We saw that there were respectful interactions between members of staff and people living in the home. Staff understood the needs of people who lived at Oakley House and they were able to demonstrate how they supported them. Staff listened to people and provided support in ways that met their needs and took into account their individual preferences. People were consulted about the support they received

Oakley House had systems in place to assist people with their medication safely.

There were procedures in place to supervise and support staff and provide them with the training they needed. This ensured that they had the skills and knowledge to provide safe and effective support to people who used the service.

Oakley House was well run by a competent management team and there were effective processes to monitor the quality of the service. They listened to people and took their views into account to make improvements.