The inspection took place on the 21 and 22 June 2017 and was unannounced.

The service had a registered manager who was also the owner / provider. 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.

Oakdene Residential Home is registered to provide accommodation and support for up to 19 older people who may also be living with dementia. On the day of our visit 18 people were living at the home.

The home is a large converted property and accommodation is provided over three floors. A stair lift is in place to assist people to move between the first two floors. The third floor provides independent accommodation for one person who is able to access this area without further aid. The home has a well maintained garden and patio area that people are actively encouraged to use.

The provider had systems in place to respond to and manage safeguarding matters and make sure that safeguarding alerts were raised with other agencies.

People who were able to talk with us said that they felt safe in the home and if they had any concerns they were confident these would be quickly addressed by the staff or registered manager.

Assessments were in place to identify risks that may be involved when meeting people’s needs. Staff were aware of people’s individual risks and were able to tell of the strategies’ in place to keep people safe.

There were sufficient numbers of staff deployed to meet people’s needs. Staff were not hurried or rushed and when people requested care or support, this was delivered quickly. The provider operated safe and effective recruitment procedures.

Medicines were stored and administered safely. Clear and accurate medicines records were maintained.

Training records showed that staff had completed training in a range of areas that reflected their job role.

Staff received supervision and appraisals providing them with appropriate support to carry out their roles.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. At the time of our inspection applications had been submitted by the managing authority (care home) to the supervisory body (local authority) and had yet to be authorised. The manager understood when an application should be made and how to submit one.

Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 to ensure any decisions were made in the person’s best interests.

Where possible people were involved in their care planning, and staff supported people with health care appointments and visits from health care professionals. Care plans were amended to show any changes, and care plans were routinely reviewed to check they were up to date.

People were treated with kindness. Staff were patient and encouraged people to do what they could for themselves, whilst allowing people time for the support they needed.

People, relatives and health care professionals told us the management team were approachable and the home was well-managed, with a “calm and pleasant atmosphere”.

Staff interacted with people positively, displaying understanding, kindness and sensitivity.

The home had policies and procedures in place which covered all aspects relevant to operating a care home which included safeguarding and recruitment procedures. The policies and procedures were detailed and provided guidance for staff.

The provider had a complaints policy in place. This ensured prompt action was taken and lessons were learned which led to improvement in the service.

This unannounced inspection took place on 22 December 2014.

Oakdene Residential Home provides accommodation and care for up to 19 people who are over the age of 65 and may live with dementia. The home is a large converted property and accommodation is provided over three floors. A stair lift is in place to assist people to move between the first two floors. The third floor provides more independent accommodation for one person who is able to access this area without further aid. There were 19 people living at the home at the time of our inspection.

The home is run by the registered provider as an individual. They are the person registered with the Care Quality Commission to manage the service. A ‘registered person’ has the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People said they felt safe at the home. They were able to talk openly and honestly with staff and were sure any concerns or issues they had would be dealt with effectively. Staff knew people well and felt confident people would speak with them to raise any concerns. The registered provider and staff had a good awareness of how to safeguard people from abuse. Policies and procedures were in place to enable staff to manage safeguarding issues and the registered provider demonstrated a good working relationship with the local authority.

Risk assessments were in place for people. Some care plans lacked detailed instruction for staff on how to reduce risk for some people. However, daily records showed staff knew people well and supported people to reduce risks. Individual personal evacuation plans were available for people in the event of an emergency evacuation.

There were sufficient staff to meet the needs of people. Through robust recruitment, training and supervision processes, people were cared for by people who had the right skills to meet their needs. People received their medicines in a safe and effective way by staff who had received appropriate training and updates. Medicines were stored safely and an audit of administration was carried out daily.

Staff at the home had been guided by the principles of the Mental Capacity Act 2005 (MCA) when working with people who lacked capacity to make some decisions. Some care plans lacked sufficiently detailed information on guiding staff to what decisions a person may not be able to make and when to involve others in this process. However, daily notes evidenced staff practically applying the principles of the MCA.. The Care Quality Commission monitors the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered provider and staff had an understanding of the MCA and DoLS. They had sought advice from the local authority on DoLS and were in the process of assuring all necessary applications were made for these.

Staff knew people very well and interacted with people in a calm, encouraging and positive manner. They ensured people were offered choice at every opportunity and demonstrated good communication skills.

Nutritious and well-presented homemade food was provided for people, with visitors and relatives actively encouraged to join people for lunch. Dietary requirements were recognised, recorded and met in a clean and efficient kitchen.

People had access to external health and social care professionals for support and treatment as was required. The home fostered good working relationships with other professionals including community nurses and GP’s.

People said they felt valued, happy and content in their home. They said they enjoyed living there and found staff very caring and compassionate. Their privacy and dignity was respected and they felt able to express their views and have them respected and acted upon.

People had their needs assessed on admission to the home. The information gathered informed care plans and risk assessments which were discussed and agreed with people and their families. Care plans did not always reflect all the actions staff needed to take to assist people with their needs, however daily records identified the actions staff took to support people. People said they were supported to meet all their needs and often did not wish to participate in a review of their care plans as staff knew them very well and would always respond to their needs. Relatives and health and social care professionals spoke highly of the very responsive nature of the home in ensuring people’s needs were met.

People had access to activities they requested and enjoyed. An activities coordinator knew people’s preferences for social interactions and worked with staff to ensure these needs were met.

The home had an open and honest culture where people were encouraged to voice their opinions and have these addressed. People and their relatives spoke highly of the registered provider and their staff. They said they were easy to talk to, open to suggestions for improvements or new ways of supporting people, and always responded to them positively and with encouragement.

The registered provider had a system of quality assurance in place to ensure the safety and welfare of people. This included audits in; infection control, care plans, health and safety, medicines management and equipment. They were quick to respond to any concerns or issues raised with them. Incidents and accidents were monitored and actions taken to reduce the risk of these recurring. The home had received no complaints in the time since our last inspection and had received many compliments and letters of appreciation from people and their relatives.

We carried out an inspection on 22 and 23rd July 2013. On the days we inspected there were 18 people living at the home. During our inspection we spoke with the registered manager, five staff members, and four people who live at this home.

We saw that the home was clean and well maintained. People were able to personalise their rooms with their own possessions and people could access their rooms whenever they chose. Some rooms were locked by the person living there to allow them further privacy with the master key available to staff should it be required.

There was a clear plan for people as to activities they could participate in for the week though this was flexible and offered choice to people. We observed one person watching television in their room, whilst another did a jigsaw in a communal area.

We saw that the home had in place clear care plans for supporting people who lived in this home. We saw people being actively encouraged to maintain their independence in all activities. We saw that people had their care discussed and agreed with them or their representative.

People told us they were happy living at this home and that the staff, “Couldn’t be more helpful.”

People who lived at Oakdene told us they were really happy to be living in such a wonderful home. People told us it was like having their own family around them. One person said the staff and managers were wonderful and that nothing was too much trouble. Another person told us they had been lonely before coming to live at Oakdene but they had made new friends and got involved in the range of activities provided at Oakdene.

We observed people getting involved in the different activities that were available. One person told us they were looking forward to making easter cakes, another told us they liked the exercise class and another person said they liked the quiz because it kept their mind active.

We looked at peoples’ rooms and we saw that they had personal items in them and were 'homely'. We also observed a variety of pictures and crafted items that people had made around the home.

We reviewed the care plans for people who lived at Oakdene and noted that people had effective care plans and the information that was provided to assist staff in caring for people was person centred. We noted that people had been involved in deciding what level of support they needed.

We observed lunch being served and noted that people had a choice of food offered to them. People told us they enjoyed the range of food and it was 'home cooked'.

As part of our review we visited Oakdene and spoke with four people who use the service and two relatives who were visiting. We also observed the way staff were interacting with people.

Everyone we spoke with said that staff treated them well and maintained their dignity. People are consulted about the care they receive and how they want it to be provided. We observed staff responding to requests for assistance promptly and interacting with people in a friendly and respectful manner.

People said they were happy with the care provided and we saw staff talking with people before providing care and seeking their consent. People said they liked the food and had a choice of meals.

People are able to see their doctor or other health professional when they need to. They said they felt safe in the home and confident that any concerns would be resolved. People told us the home was always kept clean and fresh and that the building is well maintained, warm and comfortable.

Everyone we spoke with said that staff helped them to take their medicine when they needed it and they had access to the equipment they needed.

We were told there were enough staff in the home at all times and staff respond promptly when they are needed.