About the service:

Oasis Lodge Residential Care Home provides accommodation, care and support for up to four people with autism and learning disabilities. There were three people using the service at the time of the inspection.

The care service had been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

People’s experience of using this service:

• People received safe care. Staff understood safeguarding procedures.

• Risk assessments were in place to manage risks within people’s lives.

• Staff recruitment procedures ensured that appropriate pre-employment checks were carried out.

• Medicines were stored and administered safely.

• Staffing support matched the level of assessed needs within the service during our inspection.

• Staff were trained to support people effectively.

• Staff were supervised well and felt confident in their roles.

• People were supported to have a varied diet.

• Healthcare needs were met, and people had access to health professionals as required.

• People's consent was gained before any care was provided, and they were supported to have maximum choice and control of their lives.

• Staff treated people with kindness, dignity and respect and spent time getting to know them.

• People were supported in the least restrictive way possible.

• Care plans reflected people’s likes, dislikes and preferences.

• People were able to take part in a range of activities and outings.

• People and their family were involved in their own care planning as much as was possible.

• A complaints system was in place and was used effectively.

• The manager was open and honest, and worked in partnership with outside agencies to improve people’s support when required.

• Audits of the service were detailed and any issues found were addressed promptly.

• The service had a registered manager in place, and staff felt well supported by them.

Rating at last inspection: Good (report published 26/07/2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained rated Good overall.

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.

This inspection took place on the 30 June 2016 and was announced.

Oasis Lodge is a residential home in Potters Bar providing nursing care and support to up to four people. At the time of our inspection there were three people using the service, although one person was not home on the day.

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.

People were kept safe and supported by a staff team who understood their individual needs, preferences and backgrounds. There were risk assessments in place to manage any risks safely, and staff understood the ways in which they could protect people from any avoidable risk of harm. Each person had an individualised care plan in place which detailed the type of support they needs, outcomes for the future and regular reviews to ensure that people’s changing needs were captured. People received their medicines safely, enjoyed a balanced and nutritious diet and had access to external healthcare services as required. People were supported to express their views and contribute to the development of the service through meetings, key worker sessions and surveys. People had developed consistent routines and build their independence and daily living skills over time. They were supported to find opportunities and activities which were meaningful and enjoyable.

Staff demonstrated a kind and caring attitude and received a variety of training to enable them to carry out their roles effectively. They were given opportunities to contribute to the development of the service and encouraged to take on individual responsibilities and duties. There was a programme of induction, supervision and appraisal to further support staffs’ development and allow them to express their views. Team meetings were held monthly to discuss issues that affected the service.

There was a positive and person-centred culture in the service and the registered manager demonstrated strong leadership and commitment to the values of the provider. There was a robust system for managing and handling complaints and compliments in the service. Quality assurance audits were carried out regularly and changes made in response to any identified improvements. People, relatives and staff were asked for their views and feedback through questionnaires and surveys.

During this inspection we set out to answer our five key questions; Is the service caring,

responsive, safe, effective and well led? The inspection was carried out by one inspector over one day.

Below is a summary of our findings.

Is the service safe?

We looked at two care plans and found that these were detailed and centred on the person’s needs including information about their lifestyles, communication, behaviour and their likes and dislikes. We spoke with two members of staff about safeguarding people from abuse. They all understood their responsibilities and how to report any concerns or allegations of abuse. Staff were up to date with their training. The training covered areas such as: diabetes management, food hygiene, how to assist people to move safely and the safeguarding of vulnerable adults. One member of staff said, "If we have any concerns, we report them to our manager."

We looked at two care plans. We saw that these were regularly reviewed and contained relevant and appropriate information about the person who used the service. The information contained personal details, likes and dislikes medication and needs assessments. The manager was able to easily locate and provide any record we asked to see. This meant that records kept were accurate and could be located promptly when required.

Is the service effective?

The care plans included risk assessments for areas such as road safety and diabetes. All staff had received diabetes training and there was clear guidance for staff to follow in the care plan. We found that the kitchen area was visibly clean and that the cupboards, fridge and freezer were stocked with a variety of foods including fresh fruit and vegetables. There were lots of drinks available such as: bottled water, squash, fruit juices, tea and coffee. This meant there was sufficient types of food available to support a well-balanced diet

Is the service caring?

We spoke with staff about respecting and involving people who use the service. One member of staff said, "We always knock on people's doors and wait for permission to enter. When giving personal care we encourage people to do as much for themselves but will assist when required." Another said, "We always talk to people about what they want to do. We may have a plan but do not take that for granted as people can change their minds at the last minute. It’s important to respect people's decisions."

There were activity charts on the wall for each individual who used the service; people’s interests were also documented in the care plans. We saw in people’s daily notes that they were supported to do activities.

Is the service responsive?

The home also had a folder, 'The Purple Folder.' This is used for people’s health appointments or in emergencies. The folder contained all relevant information about the person, for example: contact details, medical history, medication and allergies the person might have. This meant there was a procedure in place to help with the sharing of information in an emergency. The provider had a complaints procedure; we saw records of complaints that had been made had been dealt with in line with service policy.

Is the service well-led?

We found that there were systems in place to assess and monitor the quality of service. We saw annual surveys that had been sent to: GP's, social workers psychiatrists, parents/advocates and people who used the service. We saw minutes from the monthly staff meetings. This meant that people’s views and experiences had been sought.

We visited this service out of hours as we had received information of concern a from member of the public that suggested that there may not be staff members available at night. When we arrived at the service at 22:15, we found that there was a member of staff on duty; however this member of staff was asleep when we arrived. We spoke to the manager at the home who confirmed that the member of staff should have been awake to be able to care for the three people who used the service.

We found that the care records were inaccurate and not always effective in describing the care needs for the people that used the service. We found that the provider was not meeting the nutritional needs of the people that used the service as some of the food available was out of date. We also found that people’s weights were not monitored effectively.

We found that the people who used the service were able to participate in a variety of activities; however the records did not show that people always had a choice of where they went on day trips and on occasions had to pay a substantial sum of money in order to participate.

We found that staff members, in some cases were working shifts which were in excess of the working time regulations. This meant that they may be too tired to be able to provide the appropriate care and support to people who used the service.

We spoke with one person who used the service. They told us that they liked living at Oasis House and that the staff were nice. . We saw that although people did not have regular activities during the week, the home had ensured that people had regular opportunities to participate in the community. For example, the manager was pursuing opportunities for people to take up placements at a local gardening nursery.

We looked at staff records and saw that staff have or are working towards relevant qualifications. We saw that references, criminal records and identification checks are made to ensure that people are supported by staff that are safe.

We found that although people’s needs were assessed and care plans were in place, some information on file was not accurate. This meant there was a risk that care offered to people would not be appropriate. We found that effective systems to monitor the quality and effectiveness of care were not in place.

The home sought the views of people who used the service in a number of ways, such as surveys and residents meetings. We did not see evidence that their views were used to influence the service as no action was identified from these activities.

We found that records relating to people’s care and finances and money were not being kept securely. This meant that people’s confidentiality was not protected and that they were not protected from financial abuse.