This inspection took place on 10 January 2018 and was unannounced.

Oak Trees is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided. The inspection team looked at both during this visit.

Oak Trees is registered to provide personal care and accommodation for up to 68 people. At the time of the inspection there were 44 people living at the home. The provider divided the home into three units. One unit provided care and support to older people and the other two units provided care and support to people who were living with dementia. All bedrooms were for single occupancy and the provider employed staff 24 hours a day.

At the last inspection, the service was rated Good.

At this inspection, we found the service remained Good.

The provider had employed a registered manager who was responsible for the home. 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 and associated Regulations about how the service is run.

Staff supported people who lived at Oak Tree’s. One person told us, “Staff do everything for me,” another person said, “I’m safe here, I can’t live on my own and I’m glad to have found this place”.

The provider had systems in place that safeguarded people from abuse. These included assessing risks to people and monitoring their safety. There were sufficient numbers of suitable staff to support people to stay safe and meet their needs.

The provider had robust medicine management systems in place to ensure the proper and safe use of medicines. Staff managed the prevention and control of infection and made improvements when things went wrong.

Staff had the skills, knowledge, and experience to deliver effective care and support in line with current legislation. Staff supported people to eat and drink enough to maintain a balanced diet.

The provider worked across organisations to deliver effective care. People received ongoing healthcare support. Staff sought consent to care and treatment in line with current legislation and guidance.

Staff treated people with kindness, respect, and compassion. People were actively involved in making decisions about their care. Staff respected privacy, dignity and the independence of people living at the home.

The provider used feedback to improve the quality of care. There was a clear vision to deliver person-centred care, which achieved good outcomes for people.

Further information is in the detailed findings below.

When we visited 62 people were living at the home. The home was divided into three units two of which provided care to people who had a dementia. We spoke with people on each of the three units and were able to observe how staff interacted with the people who lived at the home.

People told us that they were consulted about the care they received. One person said “I feel that the staff understand me very well. They know all those important things that mean so much to me.” Another person said “they never do anything without asking you. They always check that you are happy with things.”

Each person had a plan of care which was personalised to their needs and preferences. The people we spoke with were positive about the care and support they received. Comments included “the staff are very good here. We have a laugh. I am very happy here” and “it really couldn’t be any better here. They are marvellous. All the staff are wonderful.”

The home’s health and safety procedures minimised risks to the people who lived at the home. We saw that people had been provided with equipment in line with their assessed needs.

The home’s staff recruitment procedures meant that people were supported by staff that were suitable and appropriately trained.

There were systems in place which monitored and improved the quality of the service provided. The views of people who lived at the home were regularly sought and responded to.

The home was divided into three units two of which provided care to people who had a dementia. During our visit we spent time on each unit.

People who lived at the home told us that they were able to make choices about all aspects of their daily lives. During our visit we observed that people moved freely around the home and they were able to access their bedrooms when ever they wished. Comments included “you can go to bed when you like and you can always have a lie in whenever you want. They even bring me a cup of tea in bed”, “I can do as I please and that is what I do”.

Some people who had a dementia were unable to make their needs or preferences known verbally. We observed staff offering people choices about what they wanted to do and where they wanted to spend their day. Staff recognised and responded to any change in an individual’s behaviour which meant that people did not become distressed.

People who were able, told us that they had been consulted about their preferences for food, drink, activities and daily routines. Comments included “all the staff know me very well and they always make sure that I am happy with everything”, “the thing I like is that they let you do as much as you are able to do but they are always there if you need them”.

People appeared very comfortable in the presence of staff and it was evident that staff knew people well. Staff interactions were noted to be kind and respectful. The atmosphere in the home was relaxed and inclusive and people were offered assistance with personal care in a dignified and discreet manner. We saw that staff knocked on people’s bedroom doors before entering. People said “the staff are so kind and I never feel embarrassed when they help me to have a bath” and “I am always treated with such respect by all the staff here”.

People who lived at the home were very positive about the care they received. Comments included “The care and the staff are just first class”, “there is nothing they could improve on and every member of staff is so very kind” and “I get the care I need when I need it”.

People told us that they could see a doctor whenever they needed to. “I have seen the doctor today because I wasn’t feeling well”, “The doctor pops in every week and the staff will always arrange for a visit if you are under the weather”.

People commented on the kindness of staff working at the home. Comments included “I love it here. All the girls are so lovely and I like every one of them” and “they work so hard but they are always smiling and always have time for a chat”.

Throughout our visit we observed that staff responded promptly to any requests for assistance and there was a good staff presence on each of the units. There was a relaxed atmosphere in the home and people looked comfortable in the presence of staff.

People commented on the kindness of the staff team. They also told us how they were supported to make decisions about their lives and of life at the home; "My key worker is wonderful, she talks to me about my care and about want I would like", "We have meetings and we are kept very well informed", "The staff are so kind and respectful".

People who were able to express a view told us that they were involved in their care planning and review process. “I have a key worker who talks to me about the care I received and asks whether I am happy”, “You never feel pressurised to do anything, the staff are so kind”, “I know that the staff keep my relative informed about things and I am happy about that”, “The staff know exactly what I like, they are marvellous really”.

People told us that they were "very happy" with the care they received. They told us "I am so happy here, you really couldn't find a better place", "All the staff are so wonderful and so very kind", "I feel very well cared for and have no complaints at all", "I don't know how the staff do it, they know exactly what I like", "It was hard giving up my home but I am so happy here and I feel so safe and well cared for".

Through our observations and on discussion with staff, It was apparent that people benefit from a staff team who are aware of peoples needs and preferences.

People benefit from a stable and very well trained staff team who are aware of individual's assessed needs and preferences.

People told us; "the food is just wonderful", "there are so many choices", "You can have snacks when ever you want". "I have never eaten so much"

When asked people confirmed that staff were aware of their dietary preferences.

People have access to appropriate health care professionals. People said "we can always see a doctor when we need to”; “I haven’t been feeling so well so they have arranged for the doctor to visit”

Each person spoken with during our visit confirmed they felt "very safe" at the home. People are protected by the home's procedures for safeguarding people from the risk of abuse.

People using the service can be confident that their medicines are appropriately managed and administered by staff who have been appropriately trained.

People live in a homely environment which is well maintained and comfortably furnished.

We observed people moving freely around the home and utilising all communal areas.

People are able to access their bedrooms throughout the day as they choose.

We observed staff knocking on bedroom doors before entering.

People living in the specialist unit benefit from an environment which has been specifically designed and furnished to assist people who have dementia.

People told us; “I am really happy with my bedroom and I was able to bring my things from home with me”, “It is very comfortable here and very homely”, “I have settled in well and it feels like home now”.

People can be confident that the home provides the specialised equipment they need to assist with their mobility and orientation needs.

People using the service are protected from the risk of harm or abuse by the home's staff recruitment procedures.

Whilst not involved in staff recruitment, people using the service were very positive about all the staff at the home. They said "All the staff here are so kind and helpful", "There is always some one about and they are all so kind", “All the staff here make you feel so special and nothing is too much trouble”.

People using the service told us that "the staff are always there when you need them".

Throughout the visit we were able to observe staff interacting and communicating with people using the service. Interactions were noted to be respectful and unhurried. Staff communicated with people in a kind and professional manner. People using the service were seen to respond in a positive way to staff interactions.

The atmosphere in the home was calm and relaxed and we noted a good staff presence throughout the day.

People live in a home which encourages and makes changes based on the views of people using the service. People can feel confident that the quality of the service provided is regularly monitored.

People told us that they would feel confident in raising concerns if they had any. They said "I don't have any concerns but if I did I would tell my key worker", "I would feel comfortable talking to the management or any member of staff if I had any worries", "All the staff here are so easy to talk to so I wouldn't hesitate if I had any problems", "I don't have any complaints but I know that they would deal with it if I did".

People can feel confident that their records are up to date and appropriately stored.

This inspection took place on 29 June and 2 July 2015 and was an unannounced inspection.

At the last inspection carried out on 17 June 2013 we did not identify any concerns.

Oak Trees is a purpose built home which can accommodate up to 68 people. The home is divided into three units. One unit provides care and support to older people and the other two units provide care and support to people who are living with dementia. All bedrooms are for single occupancy and the home is staffed 24 hours a day.

There is a registered manager who is responsible for the home. 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 and associated Regulations about how the service is run.

The registered manager had an excellent knowledge about the needs and preferences of the people who lived at the home. They had a clear vision for the home and they made sure this was understood and followed by the staff team. They were committed to ensuring people received the best possible care. They told us they wanted people who lived at the home to “have an amazing quality of life.” They said “This is their home. We want people to feel happy and safe. We don’t focus on people’s disability; we want to enable people to live their life to the full.”

Staff morale was very good and there was a happy and relaxed atmosphere throughout the home. Staff interacted with people in a very kind and caring manner and people looked relaxed and content with the staff who supported them. One person said “All the staff are so very kind. Nothing is too much trouble.” Another told us “Pat [the registered manager] is like my mother; she is always checking on me and making sure everything is alright. All the staff are lovely. Do you know; they check on me all through the night to make sure I am alright.” A visitor said “The staff are wonderful. From the top down, nothing is too much trouble. There is always a happy atmosphere and staff will always stop and say hello.” They also told us “My [relative] really wanted to come here. My [relative] is very happy and refers to all the staff as their friend.”

People were cared for by staff who knew them well and staff knew what was important to people. One person said “I love it here. All the staff are wonderful. They know what I like and that means a lot.” Another person said “The staff help me just the way I like it. They had a chat with me when I moved here and asked me all about what I wanted and what I liked.” A visitor said “All the staff know what’s important to my [relative]. That means so much to me and my [relative]. Another visitor told us “I would give every one of them ten out of ten. From the management down; they are superb. I know all the staff get the training they need. They are very skilled. You can just tell”

People told us they felt safe at the home and with the staff who supported them. One person told us “I started to fall a lot when I was living at home. I was living on my own and it worried me. Since moving here I feel completely safe and haven’t fallen once.” A visitor told us “I am so happy knowing my [relative] is safe and well cared for. It’s such a relief to me.” There were policies and procedures in place to minimise risks to people and to help keep them safe. These were understood and followed by the staff team.

People received effective care and support which was adjusted to meet their changing needs. People had access to appropriate healthcare professionals to make sure they received effective treatment when required. There were systems in place to make sure people received their medicines when they needed them.

People had their nutritional needs assessed and food was provided in accordance with people’s needs and preferences. People were complimentary about the food served. One person told us “You get plenty to eat here I can tell you. I’m sure I’ve put on weight.” Another person said “It’s like a five star hotel here. You don’t get a chance to be hungry or thirsty.”

Staff had a good understanding of people’s legal rights and of the correct procedures to follow where a person lacked the capacity to consent to their care and treatment.

There were systems to monitor the quality of the service and seek people’s views. People were able to give feedback in person, through comments and questionnaires and at resident’s meetings.