This comprehensive, announced inspection took place on 29 June 2018.

Oak Bank Residential Home 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.

Oak Bank Residential Home accommodates nine people within two self-contained flats that have their own front door or in one of seven double bedrooms most with en-suites. There were seven people using the service at the time of the inspection.

The care service is aware of the values that underpin Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. There were currently no plans to reduce the size of the service or amend the current registration at the service but people using the service were living as ordinary a life as any citizen, because each person’s individual needs were met flexibility and in line with their preferences and abilities.

At the last inspection in May 2017 the service was rated 'Requires Improvement' overall. You can read the report from our last inspection, by selecting the ‘All reports’ link for Oak Bank Residential Home, on our website at www.cqc.org.uk.

When the service was last inspected we found one breach of the Health and Social Care Act 2008. The breach related to good governance. This breach was followed up as part of our inspection. Where we asked the provider to complete an improvement action plan following the last inspection, this was provided.

There was a registered manager in post at the time of this inspection. 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.

At our previous inspection there were ineffective auditing systems in place. This meant that areas for improvement were not always identified. At this inspection we found sufficient improvements had been made. The systems and audits showed where improvement was needed and the registered manager ensured these were acted upon.

At our previous inspection we found that some medicines were left unattended which posed a risk. This inspection found some protocols were not in place for ‘as necessary’ medicines. This was immediately completed, and medicine management is now safe.

At our previous inspection, we found staff did not demonstrate a full understanding of equality and diversity needs and the Deprivation of Liberty Safeguards (DoLS) in place. At this inspection, we found staff understanding was satisfactory.

People’s rights were being upheld in line with the Mental Capacity Act 2005. This is a legal framework to protect people who are unable to make certain decisions themselves. Where people lacked capacity, assessments and best interest decisions were in place.

People’s family members felt the service was safe. Staff understood how to identify abuse and discrimination and knew how to report concerns. Staff that had pre-employment checks in place prior to starting work in the service supported people.

There were sufficient numbers of skilled and knowledgeable staff to meet people individual needs.

Staff ensured people’s health care needs were met through appropriate contacts with health care professionals.

The premises met people’s needs. A professional said, “There is plenty of space. The environment is good for people."

Staff demonstrated a caring and respectful attitude to people. People’s family members were very happy with the service, one saying, “It’s the very best place he has lived.”

People and their family members felt able to complain should there be a need. They said a complaint would be fully

This inspection took place on the 15 and 16 May 2017 and was unannounced. When the service was last inspected in January 2016 we found two breaches of the regulations of the Health and Social Care Act 2008. The breaches related to staffing and good governance. The service also failed to submit statutory notifications, when required. These breaches were followed up as part of our inspection.

Oak Bank residential home provides accommodation for up to nine people who could have a learning disability and who require personal care. At the time of our visit there were eight people living at the home. Oak Bank residential home has two self-contained flats that have their own front door and seven double bedrooms most with en-suites, a staff sleeping room, communal kitchen, lounge, dining room, office, hot tub room, garden and patio area.

There was a registered manager in post at the time of this inspection. 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.

At our previous inspection staff had not received sufficient training or annual appraisals. At this inspection we found sufficient improvements had been made. Staff received training to undertake their roles effectively. They were supported through an annual appraisal programme.

At our previous inspection statutory notifications were not being made when required. At this inspection we found sufficient improvements had been made.

At our previous inspection there were ineffective auditing systems in place. At this inspection we found insufficient improvements had been made. The systems and audits in place at the home had not identified areas of concern found during this inspection. Shortfalls identified during this inspection included safe storage of medicines, records relating to water checks, bathroom hygiene, building maintenance and deprivation of liberty safeguards.

Relatives and staff felt people were safe. Staff knew how to identify abuse and knew how to report concerns should they suspect abuse. People were supported by staff who had pre-employment checks in place prior to starting work in the service.

People were supported by staff with their medicines. Staff had received training to enable them to administer medicines safely. However, we did observe that staff left medicines unattended and unlocked whilst they administered medicines. This meant they could be accessed by anyone within the home.

People were supported by suitable staffing arrangements although it was unclear how staffing levels were arranged each day. The service monitored incidents and accidents and analysed these for any trends to prevent similar incidents from occurring. People were supported by staff to attend medical appointments. Referrals were made if required to specialist health care professionals. Professional’s feedback was positive and they felt there was a good working relationship with the home.

People were supported by staff who received training to undertake their role. However, staff did not demonstrate a full understanding of equality and diversity needs and the Deprivation of Liberty Safeguards (DoLS) in place. Staff attended additional training relating to people’s individual needs, such as end of life care. Staff had supervision and appraisals and all staff felt well supported and happy in their roles.

People’s rights were being upheld in line with the Mental Capacity Act 2005. This is a legal framework to protect people who are unable to make certain decisions themselves. Where people lacked capacity, assessments and best interest decisions were in place.

Relatives felt positive about the caring attitudes of the care staff. Relatives felt staff treated people with kindness, respect and

We observed six people receiving care and support and saw that they were treated with dignity and respect. We were unable to talk with people as they only communicated non verbally, however we observed non verbal communication and interactions with staff which demonstrated that people were happy receiving care and support.

We looked at three case files and saw that there were comprehensive assessments and thorough care plans in place.

Where people lacked capacity we saw that the provider had acted within the legal requirements for making decisions on behalf of people living at Oak Bank House.

We saw the arrangements for the administration of medication and saw that they were well kept and that staff were trained to administer medication.

We looked at three staff files and spoke with two staff who had recently joined the service. We saw that there safe and effective recruitment procedures in place.

We saw the quality assurance system kept by Oak Bank House and saw that people's views were taken into account in the running of the service.

During the visit we spoke with five members of staff and observed eight of the people who lived at the home. The level of communication skills for some individuals meant that they were not able to tell us about their experiences of living in the home.

The manager was present for the visit and they provided us with an overview of the services and care provided to the nine people who used the service. We were shown around the building by a member of staff. All of the nine people who lived at the home were male.

Two people who lived in the home were able to explain to us that staff provided the care and support they needed. One person told us “I’m doing alright”. Another person said they were involved in all of the decisions about the care and support provided to them.

People chose what activities they wished to take part in both inside and out of the home. They were supported to access a range of activities. Staff told us they encouraged people by offering choice and new experiences.

Two people lived in self contained flats within the home. They were responsible for their flats, for preparing and cooking their meals, shopping and laundry.

People told us they felt safe living in the home. No concerns were raised with us during our inspection. All of the staff we spoke with said the home was a “safe place” for people to live.

We carried out this unannounced inspection on the 11 and 15 January 2016. At our last inspection in November 2013 no concerns were identified.

Oak Bank residential home provides accommodation for up to nine people who could have a learning disability and who require personal care. At the time of our visit there were nine people living at the home. Oak Bank residential home has two self-contained flats that have their own front door and seven double bedrooms most with en-suites, a staff sleeping room, communal kitchen, lounge, dining room, office, hot tub room, garden and patio area.

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. The registered manager was present during the inspection.

The building was not always clean and properly maintained to ensure care and treatment was delivered safely to those living there, although people and relatives felt safe. People did not have a personal evacuation plan in place should there be an emergency. Incidents and accidents were not always reviewed so that there was a clear action recorded that demonstrated learning opportunities were being taken to prevent similar situations occurring. There was a safe system in place for the recruitment of new staff.

The service was not ensuring where safeguarding concerns were raised referrals were being made. People were not always supported by staff who had received training to provide them with the skills and knowledge to meet people’s individual needs. There was regular meetings and supervision for staff but they had not received an annual appraisal so that they could have any development needs identified.

Staff sought people’s consent to care and treatment in line with legislation and appropriate paperwork was in place but staff were not familiar with what depriving someone of their liberty included or that anyone at the home was under restricted practices. A Deprivation of Liberty Safeguard is where people have restrictions placed upon them to keep them safe.

People and relatives were happy about the care they received. Staff demonstrated a kind and caring approach and people were given daily choices so they were involved in decisions about their care and support. People received support from staff who knew them well. People were treated with dignity and respect by staff and were supported to maintain relationships important to them. There was enough staff to ensure people had access to the community and able to have one to one support.

People were involved in their care planning although relatives did not always feel involved. There was a complaints policy in place along with an easy read version and all people we spoke with were happy to make a complaint should the need arise.

Areas of the service were not being monitored to ensure concerns were being identified and action plans implemented to address shortfalls found during this inspection. The provider had failed to notify us of events happening in the service. This is a requirement of their registration. There was no system in place to gain views from people, relatives, staff and professionals as there was no annual survey collated.

You can see what action we told the provider to take at the back of the full version of the report.