This inspection took place on 13 December 2017 and was announced. At our last inspection in August 2015, we found the provider was meeting the regulations we inspected and the service was rated “Good”. At this inspection, we found that the service continued to be rated “Good”.

Oakwood House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service provides personal care and accommodation for eight people with mental health needs. At the time of our visit, eight people were using the service.

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.

People felt safe using the service and were protected from abuse because the staff knew how to identify and report concerns. Risks to people were assessed and reviewed regularly.

People were supported to make decisions and choices in relation to their care and support. Staff understood the requirements of the Mental Capacity Act 2005 (MCA) .

The provider undertook all necessary checks before new staff began work for the service. Staffing levels were sufficient to ensure people received appropriate support to meet their needs. Staff understood their role and responsibilities and were supported to maintain their skills through supervision, appraisals and training.

People had access to appropriate health professionals when required and staff monitored and responded when their health needs changed. They were supported to eat and drink sufficient amounts to meet their needs. Systems were in place to make sure people received their medicines safely, as prescribed by their doctor.

People were happy with the support they received from staff who they described as kind and caring. Staff understood the level of support people needed and were familiar with their care and support needs. They respected people's privacy and dignity and promoted their independence.

Care plans were individualised and reflected each person’s needs and preferences. People were involved in planning their care and were supported to access the community.

People and their relatives spoke positively about the way the service was managed. They knew how to make a complaint and their views were listened to and acted upon.

The registered manager was approachable and worked with the staff to ensure people were supported appropriately.

The provider had an on-going quality monitoring process to identify areas of improvement required within the service. Where improvements had been identified there were actions plans in place.

We considered our inspection findings to answer questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found-

Is the service safe?

People who used the service were protected from the risk of abuse because the provider had taken steps to identify the possibility of abuse and prevent abuse from happening. There were systems in place to ensure that management and staff learnt from events that adversely affected the people using the service.

Is the service effective?

People received effective care from staff that were trained and supported by the manager. People were involved in assessments of their health and care needs and in writing their plan of care so they understood the information they included. Staff encouraged and supported people to keep healthy and well through regular monitoring of people’s general health and making sure they attended scheduled medical and healthcare appointments.

Is the service caring?

There were processes in place to ensure that people who used the service were able to contribute to discussions about how they preferred to be cared for and supported. People were supported by attentive and patient staff. We saw them give encouragement to people and these interactions were caring and compassionate. Staff respected peoples’ privacy, dignity and right to be involved in decisions and make choices about their care and treatment. People we spoke with gave us positive feedback on the care and support they received in the home.

Is the service responsive?

There was an effective complaints system available. Comments and complaints people made were responded to appropriately. We found staff continually monitored people’s condition and where necessary sought advice and assistance from other community based health and social care professionals.

Is the service well-led?

People who used the service appeared at ease in their surroundings and spoke freely about their experiences. People who used this service were able to make choices with regard to their daily lives such as what they would like to wear or to eat or whether they would like to join in any activities. Staff helped them in the way that they preferred and they had their wishes, privacy, dignity and independence respected. The provider carried out regular checks to assess and monitor the quality of the service provided. In this way the provider could ensure that the quality of the service was maintained.

People told us they agreed to the support given to them by the service. One person said 'I can go to the staff when I am feeling stressed.' The provider had ensured that people's needs were assessed and they had up to date care plans in place. People had a programme of activities each week which they said they enjoyed. They had access to snacks and drinks throughout the day and a choice of meals. The provider had procedures to reduce the risk of financial abuse and had made sure staff knew how to safeguard people using the service.

Oakwood House was located in suitable premises. One person said 'I like having my own room and bathroom and the garden is nice.' The provider had taken steps to reduce any risks to people by checking all parts of the building for any maintenance issues. They had organised safety checks by specialists of the gas, electricity and heating systems. There were regular fire drills. The complaints procedure was effective and the provider had asked people to comment on the quality of the service.

People told us that they were treated with respect by the staff. They said that the care they received was "good". One person said, "yes they do help me." "I got better here."

People also told us that they felt safe with the staff. They said they would raise any concerns with the staff or their relative or friend. The staff were aware of the signs and symptoms of abuse. However, we were concerned about the absence of up to date national and local guidance about safeguarding people from abuse. This could have a detrimental effect on people using the service as they would be unable to respond in a timely manner to identify and prevent abuse from happening. People who use the service were positive about the staff who supported them. They told us that the staff were "friendly". Although people said they liked the food in the home, one person said "you can't have cereal that you like everyday. You can't have everything you like because there are other residents to think of." We found that on the day of the inspection the food stocks in the home were low. We have made a compliance action so that people are supported to have adequate nutrition and hydration.

People we spoke with were satisfied with the care and support that they received. One person said, “Its okay here, staff talk to me and help me. You can talk to the manager. I think I have settled here”. Another said, “Its okay here. Staff are good, kind and charitable people. They help me. I do my own washing and ironing. It’s a good place, I can do what I want. I can go out when I want, I can get up when I want. I can come and go”.

A relative told us, “I am honestly really happy with the home and pleased with what they’ve done. He’s come on in leaps and bounds. He’s got a routine now and they are helping him to be more independent. He’s starting to get back a better quality of life. I have found the staff that I have spoken to really nice and they have put a lot of effort into working with him”.

We also spoke with two care managers. They were both very positive about the care and support that their clients had received. One said, “It is a fairly new service and it takes time to build a rapport with people. I have found that staff are polite and welcoming and that they are giving the right care. I get feedback from my client and he said its okay. Generally there’s been an improvement in my client and I would use the service again”. The other said, “They work very well with my client. My client has very complex needs and they support these well. They are proactive in getting my client to do things. They set boundaries and give explanations. The team that I work with have been surprised by the progress that the client has made”.

This inspection took place on 19 August 2015 and was unannounced. At our last inspection in May 2014 we found the provider was meeting the regulations we inspected.

Oakwood House provides personal care and accommodation for eight people with mental health needs.

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.

People were safeguarded from the risk of abuse as the service had systems to identify the possibility of abuse and stop it occurring, and staff had appropriate information to report any concerns.

The risks associated with people’s support were assessed, and measures put in place to ensure staff supported people safely.

People received their medicines as prescribed. Medicines were ordered, stored and disposed of safely.

Staff demonstrated a good understanding of the requirements of the Mental Capacity Act 2005, and were aware of the steps to take should someone who use the service need to be deprived of their liberty for their own safety.

People received individualised care that met their needs. People were encouraged to make decisions about their care and support and the service ensured that information was provided to people in ways they could understand.

Staff were qualified, skilled and knowledgeable for their roles, and received appropriate support through supervision meetings and appraisal of their work.

People were provided with sufficient food and drink and their individual nutrition needs were well supported.

The service encouraged and supported people to undertake a wide range of activities, both individually and in groups. Staff supported people to attend health and medical appointments, and ensured that people received the medical care they needed when they were unwell.

Staffing levels were managed and planned to ensure consistency and staff who were familiar to people at the service. The service had effective recruitment procedures.

People were encouraged to do as much for themselves as possible. Staff were knowledgeable about the people they cared for. Staff were caring and knowledgeable about the people supported by the service. People’s privacy and dignity were respected.

There were effective management systems to monitor and improve the quality of service provided. The service sought feedback from people who used the service and their relatives, and we saw that this was acted upon.