The inspection took place on the 4 and 11 August 2016 the first day was unannounced. At the time of our inspection 11 people were living at the home. The home was previously inspected in November 2013 and was compliant with the areas inspected. Oaklands Grange provides support to people with mental health support needs. The home was in a detached well maintained building with well-kept gardens on a residential street in Wallasey, Wirral.

The home had a recently appointed manager in place who was not yet registered with the CQC. The manager had been in the role for three months since taking over from a previous long standing manager who had retired.

Most people had lived at the home for a long time and knew each other well. We saw that there was a pleasant friendly and relaxed atmosphere. It was not clinical but had a homely style, both in the décor and feel of the building and in the interactions between people living at the home and staff members.

People told us they were treated with dignity and respect and said that this contributed to a “family atmosphere”. People supported and the staff spoke of there being good relationships between people living at the home, the staff and the manager. We saw that building up relationships with people was very important to the manager.

People without exception gave praise to the staff and the support they received. They told us they felt safe, relaxed, listened to and comfortable living at the home. We saw that people had active lives in their community and came and went throughout the day as they chose.

People told us they were supported with their health needs. We saw documents that confirmed this was happening. The service operated within the principles of the Mental Capacity Act (2005).

People’s support plans didn’t always reflect their main support needs or the day to day support they received. Sometimes there was no guidance for staff, no background information, or clear rationale for the way support was offered to the person or the person’s consent to being supported in the way they were documented. There was detailed information about a person personal and medical history, their interests and hobbies and person centred documents recording what was important to a person.

The home had a safe environment with the relevant health and safety checks being completed. Staff received training in safeguarding vulnerable adults, medication administration and were assessed in administering medication. New staff had been recruited safely, with a criminal records check (DBS) being completed and they received a thorough induction into the role. There were risk assessments on people’s files which gave guidance for staff on how to mitigate risks and keep people safe.

Staff received support so they were equipped to carry out their role effectively. This support included appropriate training and training refreshers, supervision meetings with a manager, staff meetings and annual appraisals. Staff we spoke with told us they felt supported in their role and they felt comfortable going to seek advice from a manager as necessary.

People told us that the food provided was of good quality and they enjoyed it. There were alternatives available and people needs and preferences were catered for. People helped to plan upcoming menus The manager and staff had built up good relationships with people, which had a positive impact on their support. The manager contributed to a relaxed and friendly atmosphere at the home, he had an approachable manner and spent his time speaking to people who lived at the home.

The manager had ensured that the relevant health and safety checks had been completed at the home. He had a file of audits that he completed which ensured checks of people’s care and care plans, meetings, staff supervisions and appraisals and training were completed and up to date.

We spoke to four people who used this service, one care assistant and one cleaner. We saw and were told people’s respect and dignity was maintained. When asked, staff were able to tell us how they would assist people with care in a dignified manner.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We reviewed three care plans. These were well presented, individualised and well organised. They all contained social history and risk assessments, for, example mental health and falls.

We saw evidence of staff monitoring weights on a regular basis and were told they informed the GP of any weight loss. We saw staff collated daily food and fluid charts on those who were losing weight.

When staff were asked they were all aware of what to do in emergency situations, where to find policies and procedures and knew who to contact.

We saw and were told by the service users that the environment was very “homely” and clean.

People who lived at Oaklands Grange all told us that they were very happy there. One person said “We can come and go as we please, but we tell the staff if we are going to be out late or miss a meal.” Another person said “It is all good here, good food and lovely people.”

People living at the home said they had good relationships with the staff. One person told us “The staff are all the same, you just have to ask and they will do anything to help you.”

We saw letters of appreciation that had been received at the home and one of these praised the ‘high standard of staff and leadership’.

A member of staff told us “We love our jobs, it’s not like going to work, although we do work hard.”

We saw a letter that had been sent to the home by a healthcare professional who supported one of the people who lived there. They had written:

‘Since being a resident at Oaklands care home her admissions to hospital have dramatically reduced. The general care she receives and the monitoring of her medication have been major contributing factors.’

Another professional visitor had commented:

‘Staff are always courteous and interested in my opinions or concerns and always deal with any issues in the correct way according to care plans.’