The inspection took place on 14, 15, 17 and 20 August 2018 and was unannounced on the first day, which meant staff did not know we would be visiting. The service is situated on the outskirts of Hexham town centre. Each bedroom has en-suite facilities and there is a range of communal rooms accommodating dining, relaxing and activities. A very large external garden area is available with a separate activity hub situated within it. The service is registered to provide accommodation with nursing for up to fifteen adults with a learning disability, mental health condition or those who may experience autism. At the time of the inspection, fifteen people were living at the service.

Oaklands is a 'care home'. People in care homes receive accommodation and nursing or personal care as single packages under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

In 2016 the provider had applied to the Care Quality Commission (CQC) to register a further five beds at the service, making the total 20. This had not been agreed by the CQC as it was not in line with values that underpin the Registering the Right Support guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. Although the service had not been originally set up and designed under the Registering the Right Support guidance, they were continuing to develop their practice to meet this and used other best practice to support them.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good in the caring and effective domains, but the overall rating had deteriorated to Requires Improvement as there were some areas for further development.

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. We were informed during the inspection that the registered manager was working their notice and due to leave in October 2018.

People received their medicines safely, although we have made a recommendation regarding the administration of medicines as we found some people routinely brought to the medicines room to be given their medicines to take with no record of this being agreed. This was not person centred. The registered manager was in the process of addressing this.

There were sufficient staff working at the service, although a number were agency staff and not permanent, which relatives had recognised and commented on as not being ideal. The registered manager was working hard to address this, but recruitment uptake had been slow due to the rural location of the service.

Risk assessments were carried out and promoted positive risk taking which enabled people to live their lives as they chose. We noted that records were not kept of checks made to ensure that staff were shown how to use the mini buses at the service and we have made a recommendation about this. We also asked the registered manager to consider risks in relation to a lift at the service and its isolated location which accessed unstaffed parts of the building.

People told us they felt safe living at the service and relatives confirmed their feelings were the same.

Bedrooms had been individualised in most cases, although we found not all. One bedroom was very sparse in items and in decoration due to the person's needs. However, when questioned, full consideration had not been given as to how this could still be individualised. This was being reviewed by the management team.

People were not always supported to have full choice and control of their li

The inspection took place on the 29 September 2015 and was unannounced.

Oaklands provides care for up to 20 people who have learning disabilities. There were 14 people living at the home at the time of the inspection.

We have not inspected the service since the new provider Oakview Estates took over in September 2013.

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 and associated Regulations about how the service is run.

People told us they felt safe. There were safeguarding policies and procedures in place. We saw that the building was well maintained and clean. Medicines were managed safely.

People, staff and relatives told us there were enough staff to meet people’s needs. This was confirmed by our own observations. There was a training programme in place. Staff were trained in safe working practices and to meet the specific needs of people who lived at Oaklands.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS). DoLS are part of the Mental Capacity Act 2005 (MCA). These safeguards aim to make sure that people are looked after in a way that does not inappropriately restrict their freedom. The manager told us that the local authority had approved all 14 DoLS applications that they had submitted.

People told us that they were happy with the meals provided at the home. We saw that the kitchen was well stocked with fresh fruit and vegetables and the chef was knowledgeable about people’s dietary needs.

People and the relatives told us that staff were caring. We saw positive interactions between staff and people. People were supported to maintain their hobbies and interests. There was a complaints procedure in place. There were a number of feedback mechanisms to obtain the views from people, relatives and staff. These included meetings and surveys.

The provider had a national award system in place to recognise outstanding achievement for its staff. We saw that the manager had received ‘Service manager’ of the year award. Staff informed us that they enjoyed working at Oaklands and morale was good.

A number of audits and checks were carried out to monitor all aspects of the service.