This inspection took place on 09 June 2017 and was announced. The provider was given 24 hours’ notice of the inspection to ensure minimal disruption to the daily routines of the people using the service.

Oakdene House provides care and support for up to six men with learning disabilities, autistic spectrum disorder, mental health needs or sensory impairment. There were four people using the service at the time of our inspection. 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.

At the last comprehensive inspection in March 2016 we found a breach of regulation 12 because people's medicines were not safely managed which resulted in our serving a warning notice on the provider and registered manager. We found further breaches of regulations 17 and 18 because staff were not always up to date with training in areas considered mandatory by the provider and staff had not always received regular supervision in line with the provider’s policy. We also found that quality assurance systems used within the service were not very effective because they did not always identify areas of risk to people’s health and safety so these could be addressed.

We carried out an announced focused inspection on 27 July 2016 and found the provider had met the requirements of the warning notice and people received their medicines as prescribed. Records of the administration of people's medicines were accurate and up to date. We therefore amended the rating for the key question 'Is the service safe?' to ‘Good’; however the overall rating for the service remained as 'Requires Improvement'.

At this inspection people continued to receive their medicines appropriately and staff knew how to manage medicines safely. We saw that medicines were stored appropriately.

Also at this inspection we found the provider was meeting the breaches of Regulations 17 and 18 we had identified at our March 2016 inspection because they had implemented new systems to audit and monitor the quality of the service people received. There were also new systems in place to ensure staff received appropriate training and supervision thereby meeting their needs for improved and effective support with their professional development and their work.

Relatives told us they felt people were well cared for and living safely at the service. This view was confirmed by the health and social care professional we spoke with. Staff knew how to help protect people if they suspected they were at risk of abuse or harm. Risks to people’s health, safety and wellbeing were assessed. Staff knew how to minimise risks and manage identified hazards in order to help keep people safe from harm or injury.

There were sufficient numbers of staff to meet people’s needs. Relatives of people and staff we spoke with confirmed this view.

Staff had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). DoLS provides a process to make sure people are only deprived of their liberty in a safe and correct way. There were policies in place in relation to this and appropriate applications were made by the provider to the local authorities for those people who needed them. Staff supported people to make choices and decisions about their care wherever they had the capacity to do so.

People had varied and nutritious diets and a choice of meals. They were supported to stay healthy by staff who were aware of their healthcare needs and through regular monitoring by healthcare professionals.

Relatives and professionals told us staff were consistently kind and caring and established positive relationships with people a

We carried out an unannounced comprehensive inspection of this service on 16 March 2016 and took enforcement action. We served a warning notice in respect of a breach found of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) 2014. This breach related to concerns regarding the safe management of people’s medicines. People did not always received their medicines at the prescribed times and records relating to the administration of people’s medicines had not always been accurately maintained.

We carried out this announced focused inspection on 27 July 2016 to check that the provider had met the requirements of the warning notice. The provider was given notice of the inspection shortly before our arrival on the day, to ensure minimal disruption to the daily routines of the people using the service.

At this inspection we looked at one aspect of the key question 'Is the service safe?' This report only covers our findings in relation to the focused inspection. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for 'Oakdene House’ on our website at www.cqc.org.uk.

Oakdene House provides care and support for up to six people with learning disabilities, autistic spectrum disorder, mental health needs or sensory impairment. There were three people using the service at the time of our inspection. There was a new registered manager in post who had registered in the time since our previous 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 this inspection we found that the provider had met the requirements of the warning notice. People received their medicines as prescribed and records of the administration of people’s medicines were accurate and up to date in all but one case. We have therefore amended the rating for the key question ‘Is the service safe?' to 'Good'. The overall rating for the service remains 'Requires Improvement'. This is because we have yet to follow up on issues identified at our last inspection under the key questions 'Is the service effective?', and 'Is the service well-led?'

This inspection took place on 16 March 2016 and was unannounced.

Oakdene House provides care and support for up to six people with learning disabilities, autistic spectrum disorder, mental health needs or sensory impairment. There were three people using the service at the time of our inspection. 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.

At this inspection we found a breach of regulations because people's medicines were not safely managed. CQC is considering the appropriate regulatory response to resolve the problems we found in respect of this regulation. We will report on action we have taken in respect of this breach when it is complete.

We found further breaches of regulations because staff were not always up to date with training in areas considered mandatory by the provider, and had not always received regular supervision in line with the provider's policy. We also found that quality assurance systems used within the service did not always identify areas of risk to people's health and safety. You can see the action we have asked the provider to take in respect of these breaches at the back of the full version of the report.

Risks to people had been assessed and plans implemented to manage risks safely. There were sufficient staff deployed within the service to meet people's needs and the provider undertook appropriate recruitment checks on staff before they started work. People were protected from the risk of abuse because staff were aware of the action to take if they suspected abuse had occurred.

People were supported to maintain a healthy diet and had access to a range of healthcare professionals when required. The service worked within the requirements of the Mental Capacity Act 2005 (MCA) and people were only deprived of their liberty where lawful authorisation had been sought under the Deprivation of Liberty Safeguards (DoLS).

People were treated with kindness and consideration and their privacy was respected and maintained by staff. They were supported to make day to day decisions about their care and treatment and encouraged to maintain their independence where possible. The provider had a complaints procedure in place and people and relatives told us they knew who they would speak to if they had any concerns.

People's relatives spoke positively about the leadership of the service. Staff told us that the management team was available to them when needed and offered them support and encouragement in their roles. Improvements had been made to the service in response to feedback.

People had care plans in place which were person centred and reflective of their views and preferences.