About the service:

Shire Oak House provides personal care and accommodation for up to 26 older people who are living with dementia or other mental health needs. At the time of our inspection there were 21 people using the service.

People’s experience of using this service:

Staff knew how to keep people safe and protect them from harm. A person told us, “I’ve lived here a long while, I like it, I feel safe here. There are people around you, they are caring and kind.” The home was well-staffed and people had their needs promptly met. People had their medicines on time. Incidents and accidents were investigated and actions were taken to prevent recurrence. The premises were clean, fresh and tidy.

People were assessed before they came to the home to ensure their needs could be met and people and relatives were involved in this process. Staff were well-trained and knowledgeable about people's care and support needs. A person said, “The staff know me well and can help me get up and go to bed and walk about.” Staff referred people to community healthcare professionals when necessary. People said they liked the meals served and the menus had been improved in line with their preferences.

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. When people were unable to make decisions about their care and support, the principles of the Mental Capacity Act (2005) were followed.

The staff were kind and compassionate. A relative told us, “They take time to get to know their residents and listen carefully to them. They respect their individuality. They are warm and caring. They are patient with them all. There is a good rapport.” The staff team was established so people had the opportunity to build relationships of trust with staff. A care worker said, “We listen to people and work out what they need. Sometimes a person just wants to sit and hold your hand because that speaks more than words to them.” People were supported to make decisions about their care and support and staff respected people’s dignity, privacy and independence.

Staff understood people’s individual needs and wishes and supported them in the way they wanted. They assisted people with their preferred daily routines. People had access to a range of activities and entertainment that they enjoyed. The activities co-ordinator put a lot of thought into how best to work with people and encourage them to be mentally stimulated. They told us, “I want all our residents to be involved if possible. I try to find each individual’s own happy activity.” If people had any concerns about the home, managers and staff listened to them and made improvements were necessary.

People, relatives, staff, and a visiting professional made many positive comments about Shire Oak House. The home had an open and friendly culture. A care worker told us, “I tell everyone to come here. I’m so proud to wear my uniform. The nurses and the doctors praise us for looking after people so well. It’s a friendly caring place with a good manager and deputy.” People were asked for their views on the home at meetings and one-to-ones and through surveys. The managers audited all areas of the service to ensure the home was providing high-quality care and made improvements where necessary.

Rating at last inspection:

Good (report published 19 February 2016)

Why we inspected:

This was a planned inspection based on the rating at the last inspection. The service remains Good.

Follow up:

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

This inspection took place on 3 September 2015 and was unannounced. At our last Inspection on 30 August 2013 the provider was meeting all the regulations required by law. Shire Oak House is a residential home which provides accommodation for up to 26 people. At the time of our inspection there were 25 people living in the home.

The home had a registered manager. 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 and their relatives told us that they felt safe at the home. Staff we spoke with were aware of their responsibilities in protecting people from the risk of abuse. Assessments were in place when people were at risk of harm. People were given their medicines when they needed it. Medicines were not always stored correctly but this was rectified during our inspection.

Principles of the Mental Capacity Act and Deprivation of Liberty Safeguards had not always been followed. People told us there were sufficient staff to look after them and staff knew them well and understood how to meet their needs.

People were supported to have sufficient food and drink to enable them to maintain a healthy diet. Staff were aware of people’s individual needs and understood the importance of offering people with special dietary needs appropriate choices to meet their needs. People had access to outside healthcare services when they needed treatment from other healthcare professionals.

People and their relatives told us that the staff were kind and considerate when caring for them. Their privacy and dignity was respected by staff when delivering personal care.

People felt comfortable in speaking up if they felt they had any concerns or complaints. Staff supported people to access activities in groups or individuals when they chose to.

We saw that there was an open culture within the home and staff were happy to raise any concerns with the registered manger. Systems were in place to monitor the quality of the service provided. Improvements had been made as a result of some of the systems in place.

This was a scheduled inspection but we also looked at the actions the home had taken to improve the way it managed complaints. During this inspection we spoke with people that lived at the home, relatives, care staff and the manager. We spent time observing how care was provided as most people could not tell us about their experiences of living at the home.

We observed and people told us they were very happy at the home. Relatives commented: "I am definitely happy. The carers are first class" and "My relative is safe and well cared for".

People were involved in decisions about their care. Care staff knew about people's needs and how they wanted their care to be provided. We saw that people were treated well: they were spoken to in a respectful way and their dignity, privacy and independence was promoted.

People received care that met their individual needs. They were supported to have their personal and health care needs met. When people were ill their GP was involved and when specialist health care was needed this was arranged.

People were supported to take part in activities of their choice. Where people had spiritual needs these were addressed.

Care staff knew how to keep people safe and to respond if they had concerns about people's welfare and safety.

The home had systems in place to review and monitor the quality of care. People were asked for their views and these were acted upon. The home had improved the way it managed complaints.

We spoke with two people who lived at the home and four relatives. People we spoke with were positive about the care that they or their relative received One relative told us, "It's such a relief to have someone here to look after my mum, the staff are all very good".

We saw that people received the care and assistance they needed to ensure that they were protected against the risk of poor nutrition or dehydration.

People told us that staff were kind and caring and gave them the assistance they needed.

Safeguards were in place to try to eliminate the risk of medication errors from occurring. The home had appropriate medication policies and regular audits had taken place.

Improvements were needed to ensure that verbal concerns or complaints were responded to appropriately to reduce the risk of unsafe or inappropriate care.

We spoke to six people who live at the home and three relatives. People told us that they were happy with the care they received and that they felt safe living at Shire Oak House. A relative said:

"Mum is well cared for and has settled in really well it's such a relief ".

We found that the home is a comfortable and pleasant place to live. People all have their own bedroom, which they do not share. People are able to personalise their bedrooms as they choose to reflect their taste and interest.

People told us how they spend their day. They said that they got up and go to bed when they choose and are able to have their meals in either the main lounge/ dining room or their bedrooms if they prefer or were unwell. They told that they enjoy the activities that take place and spend time in the garden or quietly in their own room either watching television or reading. They told us that their friends and relatives are able to visit them.

People told us "staff are kind and very caring". They told us that staff assisted them when they needed it.