Oakfield Nursing Home provides residential and nursing care for up to 37 people. Situated on the A6 between Garstang and Lancaster, the home has easy access to the motorway network. The home has a large car park and accessible gardens with disabled access to the building. At the time of the inspection visit there were 31 people who lived at the home.

At the last inspection the service was rated ‘Good’. At this inspection we found the service remained ‘Good’.

The registered manager had addressed the recommendation from the last inspection by improved care plans so that they included more individual histories and profiles of people. This gave staff more information of individuals and helped develop relationships further.

The management team had systems in place to record safeguarding concerns, accidents and incidents and taken necessary action as required. Staff had received safeguarding training and this was confirmed by talking with staff and training records looked at.

Records looked at and talking with staff and the management team found staff had been recruited safely, appropriately trained and supported. They had the skills, knowledge and experience required to support people with their care and social needs. Staffing levels were observed to be sufficient to meet the needs of people who lived at the home.

Staff spoken with and records seen confirmed training had been provided to enable them to support people who lived with dementia. In addition qualified nurses provided support for people with nursing needs. We found staff were knowledgeable about support needs of people who lived at Oakfield Nursing Home.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. Care records showed they were reviewed and any changes were recorded.

We looked around the building and found it had been maintained, was clean and hygienic and a safe place for people to live. We found equipment had been serviced and maintained as required.

We found medication procedures at the home were safe. Nurses responsible for the administration had the competency and qualifications required. Medicines and controlled drugs were safely kept with appropriate arrangements for storing in place.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

We observed lunch served which was a relaxed social occasion for people. Comments about the food from people who lived at the home included, “The food is excellent.” Also, “The meals are prepared just right.”

We observed the management team and staff demonstrated a caring, compassionate and kind attitude towards people who lived at the home. Relatives and people who lived at Oakfield Nursing Home we spoke with confirmed this. Our observations, evidence from relatives who wrote to the home and comments we received confirmed this. For example one relative wrote, ‘We thank the care and compassion shown to our [relative]. The sum of all your all contributions to [relative] was an outstanding package of high quality care.’

People who lived at the home told us they were encouraged to participate in a range of activities that had been organised. An activity co-coordinator was employed to ensure people could follow their chosen interests and hobbies. One relative said, “They have a good person who does a lot for the residents in terms of entertainment and games and things.”

People who used the service and their relatives knew how to raise a concern or to make a complaint. The complaints procedure was available and people said they were encouraged to raise concerns.

The registered manager used a variety of methods to assess and monitor the quality of care at Oakfield Nursing Home. These included regular audits of the service and staff and ‘resident’ meetings to seek the views of people about the quality

Oakfield nursing home provides residential and nursing care for up to 37 people. Situated on the A6 between Garstang and Lancaster, the home has easy access to the motorway network. The home has a large car park and accessible gardens.

There were systems in place to ensure people's needs were assessed, and their care plan for. Improvements in the way in which the care records are set out would make the information more accessible. The addition of one page profiles relating to each individual living at the home would allow staff to quickly see what people's needs were, the risks related to their care and what their interests were. Activities linked to people's assessed needs, abilities and interests were available, however, some enquiries needed to be made to ensure that everyone living at the home are provided with appropriate opportunities to engage in meaningful daytime activities linked to their assessed needs and interests.

People were able to express their choice in relation to meals and how they spent their time. People knew how to access the complaints process, and know who to talk to if they wanted to raise a concern. People who lived and worked at the home were fully aware of the lines of accountability at the home. Staff spoken with felt well supported by the management team. The systems operated within the home relating to how information was processed and how systems were audited was satisfactory. The systems assisted staff to identify areas of service delivery that required improvement, mitigate risks. People were treated in a kind, caring and respectful way.

There were systems in place to ensure people were involved in their own care planning and support. The training records showed that staff had received awareness training on the subject of end of life care. If people were found to be in need of end of life care, there were systems in place to support this. Staff had access to on-going training and supervision to meet the individual needs of the people they supported. We found that measures were in place to ensure staff received update training and we saw documentary evidence to support this. We saw written evidence that staff supervision was now taking place more regularly and we were satisfied that appropriate measures were in place to address the issues. We have made a recommendation relating to training and supervision to ensure that the registered manager continues to support the staff effectively.

The service had policies in place in relation to the Mental Capacity Act 2005 (MCA) and depriving people’s liberty, and these were put into practice. The menu offered people a choice of meals and their nutritional requirements were met. The building was found to be in a good state of repair, and the environment was found to be fit for purpose. The service had procedures in place for dealing with allegations of abuse. Staff were able to describe to us what constituted abuse and the action they would take to escalate concerns.

Employees were asked to undertake checks prior to employment to ensure that they were not a risk to vulnerable people; the records relating to these checks were complete. Risks associated with medicines management, infection control and cleanliness, and environment factors were assessed. Satisfactory control measures were in place.

Staff spent time ensuring people understood what was being asked of them and gave people time to make considered responses. One person said, “Things are always discussed with me first, I never do anything unexpectedly.”

Everyone we spoke with who lived in the home said they were happy with the home, staff and management. One person said, “I’m happy with absolutely everything, all the staff are brilliant and really good to me.”

People living in the home we spoke with said they were supported by staff they believed were competent in their role. One person said, “The staff are great, don’t think you could improve on things much to be honest.”

People we spoke with living in the home said they felt they could influence how their care was provided. One person said, “I can change my mind about anything and its ok. Staff will accommodate my wishes if they can; by and large everything is ok.”

At the last CQC inspection a minor concern had been noted against outcome 16 (quality assurance and monitoring). The provider had developed a comprehensive action plan which we checked on the day of the inspection. Actions had been completed to bring this outcome into compliance.

We spoke to four people who all said they were treated very well. One said, “The staff are marvellous and really friendly.”

Everyone we spoke with who lived in the home said they were happy with the staff and the support they received. One said, “You don’t have to use your buzzer to get staff as you know they will come. People come in and out all day offering tea and biscuits and making sure I’m ok.”

People who lived in the home that we spoke with all said they were kept safe. One person said, “They are all very careful when they move me.” Another said, “The staff always tell me what they are going to do before they do it, so nothing is a surprise.”

We spoke to people about the home and whether they liked the building. People thought it was nicely decorated and easy for them to get around. One said, “I use two sticks to get from my room to the dining room and don’t have any problems.”

Everybody we spoke with felt that there were enough staff doing the right things to meet everyone’s needs. One person said, “I usually get up and dressed on my own, but if I’m having an off day there will be somebody to help.”

People we spoke with about their care plan were unsure if they had seen it. Most referred to the ‘Stop,’ ‘Think,’ ‘Go’ file held in their rooms. When asked about formal reviews, no one said they had been involved with one. However they all said that their needs were being met.

During the course of the visit we spoke individually with the registered manager, three people living at the home, another resident and their visitor, a qualified member of staff and a care assistant. Short informal chats also took place with some other residents and members of staff throughout the course of the day. The conversation with some residents was however limited because of mental incapacity. We also spent a period of time observing staff and residents in a communal area of the home over the lunchtime period.

One person spoken with who has lived at the home for some considerable period of time said, “Staff discussed the care plan with me a few weeks ago and asked me if I was happy with it. This happens quite often”. Another person said, “Lots of people care for us well and talk to us about the way we are”. A relative spoken with said, “They do everything right here” and confirmed that staff were very good at contacting him when this was required.

People living at the home were very positive about the care and support provided by the staff team. One person told us, “Staff know what they are doing alright”. Another person said “Staff are very good they help us do whatever we want, you just have to ask and they will get it for you. We are very well looked after”. A relative spoken with spoke very highly of the care and support provided at Oakfield Nursing Home and the qualities of the staff team. A member of staff told us, “We give a very good standard of care, I would bring my mother here, there is no rushing, we are just told to give the best care possible to the resident”. A second member of staff said, “Good standard of care. If an issue is raised it is addressed straight away. Everybody is very receptive”.

When asked, one person we spoke with said, “I feel safe and comfortable living here”. A relative told us that he felt his wife was, “Safe and protected” living at Oakfield Nursing Home. A member of staff confirmed that everybody working at the home had received adult abuse training that was regularly updated.

Two recently appointed members of staff confirmed that a thorough recruitment process had taken place prior to them being offered employment at the home. Without exception everybody spoke very highly of the staff team with one person telling us, “They are just like our friends”. Another person said, “Staff know what they are doing, it’s a nice place”. A relative told us that staff are very good at, “Looking after the personal things. ***** is loved and looked after”.

Staff spoke positively about the training provided.

People living at the home told us that from time to time they were asked their thoughts and views regarding the service provided to them. People were also very confident that any views expressed would be taken into account, discussed and actioned if at all possible. One person told us, “The staff are very good, they help us do whatever we want”. A relative spoken with confirmed that they were always encouraged to voice their opinions and suggestions for improvement.