We carried out an announced inspection of the service on 7 December 2017.

The Oaklands is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. Some people also attended this service for a short, respite period. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The Oaklands accommodates up 20 people living with mental health needs and/or learning disabilities and an autistic spectrum disorder in three separate bungalows. On the day of our inspection 19 people were living at the service and one person was staying for a short, respite period.

The care service has 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.

A registered manager was present during the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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’s medicines were managed appropriately and safely. People were protected against the risks of experiencing avoidable harm and staff understood how to protect people. Regular assessments of the risks to people’s safety were carried out, where risks were identified these were managed safely and effectively. People were supported by an appropriate number of skilled and experienced staff and safe recruitment procedures were in place. Safe infection control practices were in place and equipment was well maintained. Accidents and incidents were regularly reviewed, assessed and investigated by the registered manager.

People’s physical, mental health and social needs were assessed and provided in line with current legislation and best practice guidelines. Staff were well trained, received continued professional development and had the quality of their performance regularly reviewed. People were empowered to make choices about their food and people’s nutritional intake was monitored where needed. The registered manager had built effective relationships with external health and social care organisations and people’s health was regularly monitored. 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 support this practice.

People had excellent, meaningful relationships with the staff. People were treated with respect and dignity and staff were very kind, caring and compassionate towards them. Providing dignified care was a fundamental aim of the provider and staff understood how to support people appropriately. Independence was widely encouraged and innovative methods were used to communicate with people as well as to support people with remaining independent. People felt able to contribute to decisions about the support needs and always felt staff acted on their wishes. People’s rights were always respected. Staff rotas were flexible and regularly amended to ensure people were able to be supported by the staff they wanted. People were provided with the information they needed if they wished to speak with an independent advocate, to support them with decisions about their care. People’s friends and relatives were able to visit whenever they wanted to and people were supported to develop and maintain relationships with family and friends.

People received person centred support focused on what mattered most to them. People were fully involved with the on-going development of their support needs. People

We carried out an unannounced inspection of the service on 10 December 2015. The Oaklands is registered to accommodate up to twenty people and specialises in providing care and support for people who live with a learning disability. The service also offers a short break service. At the time of the inspection there were twenty people using the service.

On the day of our inspection 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.

During our previous inspection we identified concerns that people were not protected from the risks associated with financial abuse. This was because robust processes to monitor the way people’s money was spent and then recorded were not in place. During this inspection we found improvements had been made and people were now protected from the risks of financial abuse.

The risk to people’s safety was reduced because staff had attended safeguarding adults training, could identify the different types of abuse, and knew the procedure for reporting concerns. Risk assessments had been completed in areas where people’s safety could be at risk. Staff were recruited in a safe way and there were enough staff to meet people’s needs and to keep them safe.

Accidents and incidents were investigated; however the registered manager did not record their recommendations or check to see whether they had been implemented. Assessments of the risks associated with the environment which people lived were carried out; however people did not have personal emergency evacuation plans (PEEPs) in place. People’s medicines were stored and handled safely, however protocols to protect them from the risks associated with the administration of ‘as needed’ medicines were not in place. Records of people’s allergies and how they liked to take their medicines were not recorded.

We have made a recommendation about the management of some medicines.

People were supported by staff who received an induction, were well trained and received regular assessments of their work.

The registered manager ensured the principles of the Mental Capacity Act (2005) had been applied when decisions had been made for people. People told us they were free to do as they wanted and to go where they wanted. However we identified people that may require Deprivation of Liberty Safeguards to be applied for and the registered manager had not done so.

People spoke highly of the food and were supported to follow a healthy and balanced diet. People’s day to day health needs were met by the staff and external professionals. Referrals to relevant health services were made where needed.

Staff supported people in a kind and caring way. Staff understood people’s needs and listened to and acted upon their views. Staff responded quickly to people who had become distressed.

People felt able to contribute to decisions about their care and support needs. People were provided with information about how they could access independent advocates to support them with decisions about their care. Staff understood how to maintain people’s dignity. People’s friends and relatives were able to visit whenever they wanted to.

People’s care records were person centred and focused on what they wanted. Care records were regularly reviewed and people and their relatives where appropriate attended meetings to review them. Staff knew people’s personal preferences and what interested them. People were encouraged to take part in activities that were important to them and were provided with the information they needed if they wished to make a complaint.

People spoke highly of the registered manager. The registered manager understood their responsibilities and had a clear focus on improving people’s lives. Staff understood their roles and felt able to contribute to the development of the service by giving their views which were welcomed and valued by the registered manager. People who used the service were encouraged to provide their feedback on how to improve the quality of the service they received.

There were a number of quality assurance processes in place that regularly assessed the quality and effectiveness of the support provided. However, these had not identified the concerns raised within this report.

During our visit we spoke with two staff members, the quality compliance manager and the registered manager. We spoke briefly to one person who used the service. It was not possible to speak directly with other people who used the service due them being involved in activities or having particular communication needs. We spoke with the relatives of three people who used the service.

The person we spoke with who used the service told us they were happy living at The Oaklands. This person showed us their room and said they were happy with the care and support they received.

All of the relatives we spoke with told us they were very happy with the care and support their family members received. All spoke very highly about the staff, the registered manager and standards of care. One relative told us, “I feel very fortunate to have been able to access such a wonderful service for [family member’s name].” Another told us, “I had previously looked at other care facilities in the area, but The Oaklands comes top.”

Staff we spoke with told us they enjoyed working at The Oaklands, they felt well supported and that the provider was good in terms of providing training and development opportunities and ensuring that staff training was kept up-to-date. One staff member we spoke with told us, “I love it here, we have a great team and all get on really well.”

Prior to our inspection we reviewed all the information we had received from the provider. As part of the inspection with spoke with three people who used the service and two relatives. We also used observation to help us understand the experiences of people who used the service, because some of the people had communication needs which meant they were not able to tell us their experiences.

The registered manager was unavailable during our inspection. We spoke with the quality compliance manager, the training and compliance officer, the business manager, the deputy manager and three support workers. We looked at service information, care plan files for three people and carried out a tour of all the bungalows.

We found that where people did not have capacity to consent to their care the provider had acted in accordance with legal requirements and people received care and support which met their needs.

People who lived at The Oaklands told us they felt safe. However we found concerns with the recording of their personal finances which meant they were at risk of financial abuse.

We found that appropriate arrangements were in place to manage people’s medication and ensure they received medication they needed. We found staff received relevant training and were supported to review their role and development. A person who used the service told us, “The staff are great, it’s a big family here, we all get on.”

We saw there were systems in place to assess and monitor the quality of service provided and views of people who used the service and their relatives had been sought.