We carried out an inspection of Oaklands Nursing and Residential Home on 10 and 11 December 2018. The first day was unannounced.

Oaklands Nursing and Residential Home provides accommodation for 44 people who need either nursing or personal care. At the time of the inspection, there were 41 people accommodated in the home.

The service is situated in a quiet residential area in Harle Syke, Briercliffe on the outskirts of Burnley. There are two floors that can be accessed by a passenger lift or stair lift. All rooms are single occupancy and some of these offer ensuite facilities. There are attractive garden areas and adequate parking for visitors.

At our last inspection of June 2016, the service was rated Good. At this inspection, we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The management team were committed to the continuous improvement of the service and were dedicated to making people feel valued and improving people’s care and self-esteem. Evidence showed they followed best practice and pursued opportunities to influence care in order to attain better outcomes for people living at the home. Quality assurance systems were robust and used to make improvements in the home. People had a wide range of opportunities to provide feedback on the care provided. Feedback from people and their relatives was extremely positive.

People were supported by staff who were extremely kind, enthusiastic and caring. We observed all staff interacting with people and their relatives in a meaningful and caring way which made people feel they mattered to the staff who supported them. Staff enjoyed working at Oaklands Nursing and Residential Home. We observed a strong, family-orientated service where staff were encouraged to demonstrate highly respectful and caring attitudes towards the people they supported.

People were more than happy with the care and support they received. Without exception, they told us they were treated with care and kindness and were treated equally and fairly. People received care which recognised their individual differences and respected their right to be treated with dignity and respect. The service provided outstanding end of life care to ensure people's end of life was as comfortable, dignified and pain free as possible.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff fully understood the importance of acknowledging people’s diversity, treating people equally and ensure that they promoted people’s rights. We saw people’s cultural and spiritual needs were discussed and recorded in their care plans.

People were engaged in varied and meaningful activities which met their individual interests; to support this the home had developed links with organisations in the local community to help enhance people’s quality of life.

Care plans and risk assessments were person centred and provided guidance for staff on how to provide safe and effective care. There were established arrangements in place to ensure all care plans were reviewed and updated as people’s needs changed. Where necessary, staff made referrals to external professionals to ensure people’s health needs were met.

People told us they felt safe. Staff had received training in the protection of vulnerable adults and knew what action they should take if they suspected or witnessed abuse. Lessons were learned from any accidents, incidents or safeguarding matters.

People received their medicines when they needed them from staff who had been trained and had their competency checked. People were cared for in a safe, comfortable

We carried out an inspection of Oaklands Nursing and Residential Home on 14 & 15 June 2016. The first day was unannounced.

Oaklands Nursing and Residential Home provides accommodation for 44 people who need either nursing or personal care. At the time of the inspection there were 40 people accommodated in the home.

The service is situated in a quiet residential area in Harle Syke on the outskirts of Burnley. There are two floors that can be accessed by a passenger lift or stair lift. All rooms are single occupancy and some of these offer ensuite facilities and there are a variety of comfortable communal areas. There are attractive garden areas and adequate parking for visitors.

The service was managed by a registered manager. 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.

People told us they did not have any concerns about the way they or their relatives were cared for. They were happy with the care and support provided and told us they felt safe and well cared for.

Staff were able to describe the action they would take if they witnessed or suspected any abusive or neglectful practice and had received training on the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). This meant they had knowledge of the principles associated with the legislation and people’s rights.

People living in the home considered there were enough staff to support them when they needed any help. People received support in a timely and unhurried way. The registered manager followed a robust recruitment procedure to ensure new staff were suitable to work with vulnerable people. Arrangements were in place to make sure staff were trained and supervised at all times

Medicines were managed safely and people had their medicines when they needed them. Staff administering medicines had been trained to do this safely.

We found people lived in a clean, safe, pleasant and homely environment. All areas were tastefully decorated and furnished to a high standard and appropriate aids and adaptations had been provided to help maintain people’s safety, independence and comfort. People had arranged their bedrooms as they wished and had brought personal possessions with them.

People using the service had an individual care plan that was sufficiently detailed to ensure people were at the centre of their care. People’s care and support was kept under review and they were involved in decisions and discussions about their care. Risks to people’s health and safety had been identified, assessed and managed safely. Relevant health and social care professionals provided advice and support when people’s needs had changed

Care plans were written with sensitivity and basic rights such as dignity, privacy, choice, and rights were considered at all times. We found staff were respectful to people, attentive to their needs and treated people with kindness and respect in their day to day care. We observed good relationships between people. The atmosphere in the home was happy and relaxed. From our observations it was clear staff knew people and their visitors well and were knowledgeable about people’s individual needs, preferences and personalities.

Activities were varied and appropriate to individual needs. People were provided with a nutritionally balanced diet that provided them with sufficient food and drink that catered for their dietary needs.

People were encouraged to be involved in the running of the home and were kept up to date with any changes. People had no complaints and were aware of how to raise their concerns and were confident they would be listened to.

People using the service, relatives and staff considered the management of the servi

We spoke with the registered manager, staff, people living at the home and their relatives. We looked at seven people's care records. Other records we looked at included compliments and complaints, staff training, personnel files and quality assurance documents and audits.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask:

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is a summary of what we found:

Is the service safe?

Care records and our observation of staff provided evidence of good practice in applying the least restrictive options to promote and maintain an individual’s independence. Suitable policies and procedures were in place to monitor the operation of Deprivation of Liberty Safeguards (DoLS) and staff had been trained to understand their responsibilities under the DoLS Codes of Practice.

We saw there were systems in place to make sure staff learned from events such as untoward incidents, complaints and concerns. This reduced the risks to people and helped the service to continually improve. People told us they felt safe and relatives we spoke with said staff understood the needs of the people they cared for.

The service took into account people's care needs when making decisions about the numbers of staff required and staff were continually supervised, trained and appraised to ensure they had the required skills to meet the needs of the people they cared for.

Is the service effective?

We saw that people’s care plans were person-centred and care was delivered in a way they preferred. Care plans were reviewed at least monthly and amended where people’s needs had changed.

The manager followed a programme of audits. We saw action plans were in place where improvements could be made. These were monitored.

Is the service caring?

People's care needs were assessed by the staff. People and their families where appropriate, had been involved in the assessments and review of care plans. We saw records reflected people’s current needs and were up to date.

We observed care workers providing support when it was required or requested.

Is the service responsive?

All complaints and concerns made verbally or in writing were recorded and investigated. Guidance was sought when required and necessary changes to practice were made and disseminated to staff.

Other medical and care professionals were consulted appropriately and were involved in the care of people living in the home. Where a person had to attend an appointment outside the home, or was taken to hospital in an emergency, a care worker accompanied them if they wished and took all relevant documentation with them.

Is the service well-led?

Staff were clear about their roles and responsibilities. The manager held meetings with staff to ensure they knew about changes or updates. We reviewed minutes from staff meetings which showed that staff were involved and consulted about improvements or changes required.

The service had a robust quality assurance system. Audits were undertaken regularly and identified actions were recorded and shared with staff so that they could be addressed. This helped to ensure that people were provided with a good quality service.

During our visit we spoke with five people living in the home and with two visitors. We observed people being offered choices and being supported in a way that respected their privacy and encouraged their independence.

People told us they were happy with the care and support they received. Comments from people living in the home included, “I am well looked after” and “They talk to me about my care”. Visitors commented, "I visit every day and am happy with everything" and "It is very well run; everyone is looked after very well".

People told us they had no complaints about the service but were happy to raise their concerns with the staff or managers. Comments included, “I have no complaints; I like it here that is why I stay” and “I would speak up if I was unhappy; I know they would sort it out”.

Records confirmed a safe and effective recruitment process had been followed which should help to make sure that only suitable staff were employed. People told us they were happy with the staff team and said there were enough staff to meet their needs. Comments included, "Staff are brilliant; there are always enough to make sure everyone is looked after" and "They do their very best. They are very kind".

We found all areas of the home to be clean, bright, safe and comfortable. Improvements to the home were ongoing and there were systems in place to maintain the standards and safety of the environment.

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a CQC inspector joined by an “Expert by

Experience” (people who have experience of using services and who can provide that perspective).

We also used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

People using the service told us they were satisfied with the care and support they received at Oaklands Nursing and Residential Home. We found they were treated with dignity, their independence was promoted and privacy respected.

People told us they liked the meals provided at the Home. We found choices were provided and healthy eating encouraged. Peoples’ food preferences were known and catered for. Consideration was being given to peoples’ individual nutritional needs.

We found there were enough staff to provide care and support. People were content living at Oaklands Nursing and Residentia Home; they knew what do if they had any concerns and were confident hey would be dealt with.

The people that we spoke with during our visit told us that they were treated well by the staff and encouraged to make choices and decisions about how they spent their time. They told us they were consulted, were able to suggest any changes to the daily running of the home and were kept up to date with any changes.

We were told that different activities were available and that people could choose

whether to join in; one person said "I can do what I want to do; I can stay in my room or join in".

People told us they were happy with the care and support that they received and that they were involved in decisions about their care.

The people that we spoke to were happy with the staff team; comments included "I am well looked after", "it is good care; the staff can't do enough for you, nothing is too much trouble", "staff are very kind", "there is enough staff to make sure we are looked after at all times" and "I feel safe" .

A visitor told us that the "staff are very good, they are always around to help".