This inspection took place on 18 and 23 April 2018 and was unannounced. The home provides accommodation for up to 28 older people with personal care needs. There were 24 people living at the home when we visited. Accommodation was spread over two floors. There were lounges/dining rooms on the ground floor of the home. There was a garden which was accessible from the ground floor with a patio area.

There was a registered manager at the home. 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.

Oakwood Residential Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided.

At our last inspection, we rated the service 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 provider worked in partnership with other stakeholders and was pro-active in promoting health monitoring and preventative care for people at risk of hospital admission. Staff worked with medical professionals to use tools and assessments this meant that current information about people’s needs could easily be transferred between services.

The registered manager was dedicated to their role and was a prominent presence within the home. Staff were caring and compassionate and understood the importance of treating people with dignity and respect. There were enough suitably skilled and qualified staff to meet people’s needs. The registered manager carried out robust recruitment checks and monitored staff’s performance and behaviour through observation and supervision.

Staff received training which was relevant to their role. Staff had received additional training in end of life care. This helped to ensure that people were treated empathically when receiving care at the end of their life. Staff had also received training in providing effective support around meeting the communication needs of individuals with sensory loss.

Staff understood their responsibilities in keeping people safe from abuse and harm. The registered manager had made appropriate referrals to local safeguarding authorities and had worked in partnership with them to help keep people safe.

People told us they felt safe and comfortable living at Oakwood Residential Home. They told us that there were plenty of activities to keep them occupied and staff were attentive and responsive to their needs. People told us they were involved in making decisions about their care and their independence, preferences and routines had been considered by staff when developing their care plans.

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.

The registered manager was focussed on making improvements to the home. They had worked to make the environment more homely through a series of renovations. The registered manager also used feedback from people, relatives, and other stakeholders in order to make changes to drive improvements. They were constantly assessing the quality and safety of the service through a series of audits and checks and had formulated an ongoing action plan, which identified how and when key improvements would be made.

Risks to people’s health and wellbeing were assessed, monitored and mitigated. Where people’s health and

This inspection took place on 21 January 2016 and was unannounced. The home provides accommodation and personal care for up to 28 people, including people living with dementia or other mental health needs. There were 22 people living at the home when we visited.

The home is based on two floors with an interconnecting stair lift. Some bedrooms have en-suite facilities and there is a separate bathroom and shower room. There is a large lounge, where activities are held and a dining room where most people eat their meals.

There was a registered manager in place. 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 of the Health and Social Care Act 2008 and associated regulations about how the service is run.

At our previous inspection, on 24 and 27 March 2015, we identified that infection control risks were not being managed safely. We issued a requirement notice and the provider sent us an action plan detailing how they would meet the regulation. At this inspection we found action had been taken and improvements had been made.

The laundry room had been extended and a clear process was in place to reduce the risk of cross contamination. The home was clean and staff followed appropriate infection control practices.

People told us they felt safe at the home. Staff knew how to identify, prevent and report abuse, and the provider responded appropriately to allegations of abuse. Clear systems were in place for managing medicines and people received their medicines when they needed them.

Most risks to people were managed safely, although the risks of one person smoking had not been documented. People were supported to take risks that helped them retain their independence and avoid unnecessary restrictions.

The process used to recruit staff helped make sure that only suitable staff were employed. There were enough staff to meet people’s needs at all times. Staff were suitably trained, were supported appropriately in their work and felt valued.

Staff followed legislation designed to protect people’s rights and liberties. They sought verbal consent from people before providing care and acted in their best interests.

People liked the food and were able to make choices about what they ate. They received appropriate support to eat and drink enough. Appropriate action was taken if people started to lose weight and they were able to access healthcare services when needed.

People were cared for with kindness and consideration. Staff knew people well and build positive relationships with them. People’s privacy and dignity were protected at all times and they were involved in planning their care.

Staff encouraged people to remain as independent as possible and empowered them to make choices about all aspects of their lives. Care plans provided detailed information about how people wished to receive care and support. Staff were responsive to changes in people’s needs and this was reflected in people’s care plans. A range of activities was provided based on people’s individual interests.

The registered manager sought and acted on feedback from people and their families. A suitable complaint procedure was in place and complaints were dealt with promptly.

There was a clear management structure in place and management were supportive of staff. Staff enjoyed working at the home and worked well as a team. There was an open and transparent culture. Staff welcomed visitors and had formed good working relationships with external professionals.

Key aspects of the service were audited regularly to help ensure the service ran well. Where improvements were identified, these were implemented promptly. An effective system was in place to analyse incidents and accidents and learn lessons from them.

We spoke with three people living at the service and five members of staff. People told us they were happy at the service. One person told us “the service isn’t at all bad; they’re very good to me” and another told us they had “no complaints”. All were positive about the support they received from staff. One person gestured two thumbs up when asked what they thought of the staff.

The service took steps to ensure people were involved in decisions about their care and support. People’s diversity, values and rights were respected. A member of staff told us that their approach was to “care for people with compassion and respect, and they feel cherished”.

We reviewed care plans, and found issues with completeness and lack of personal information. Plans did not ensure or evidence that everybody’s care and welfare needs were fully met. However, the provider was taking steps to address this and support was observed to be respectful and responsive to people's basic needs.

There were effective procedures and systems in place for the management of medication.

The service had problems maintaining its staffing level. The provider was taking action to address the situation, but at the time of inspection it had yet to be resolved. When the service was understaffed people had to wait longer for support to get up in the morning, and it took longer for staff to respond to call bells.

People were listened to and their comments and complaints were responded to appropriately.

Residents told us that they enjoyed the food, the staff were very good and responsive.

Visitors told us the home was very flexible, looked after their relatives well and that their relatives were happy at the home.

This inspection took place on 24 and 27 March 2015 and was unannounced. The home provides accommodation and personal care for up to 28 people, including people living with dementia or other mental health needs. There were 17 people living at the home when we visited.

At our last inspection, on 24 and 26 June 2014 we identified breaches of 10 regulations relating to: care and welfare; assessing and monitoring the quality of service; safeguarding; infection control; management of medicines; safety and suitability of premises; respecting and involving people; consent to care and treatment; records; and staffing. We set compliance actions and the provider sent us an action plan telling us they would meet the requirements of the regulations by 31 August 2014. In September 2013, we had taken enforcement action and imposed a condition to prevent the service from accepting any new admissions. This condition was still in place at the time of this inspection.

At this inspection, on 24 and 27 March 2015, we found action had been taken. Significant improvements had been made in all areas and the provider was meeting the requirements of all but one of the regulations.

The home is required to have 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. There was no registered manager in place at the time of our inspection. A new manager had been appointed, who was in the process of applying to be registered.

People were satisfied with the cleanliness of the home. However, we found the infection control risks associated with the laundry were not managed effectively and the hand washing sink was not accessible. This put people and staff at risk of infection. Other areas of the home were clean and hygienic.

Improvements to the environment, which the provider told us they would make, had not all been completed. Work to install additional handrails and change the flooring in the lounge and dining room were outstanding. However, some bedrooms and a bathroom had been refurbished and raised flower beds had been built in the garden.

People felt safe and staff knew how to identify, prevent and report abuse. Risks of people falling or developing pressure injuries were managed effectively. Medicines were managed safely, although one medicine that needed to be given before food was often given with or after food, so may not have been effective.

There were enough staff to meet people’s needs and the process used to recruit staff ensured staff were of good character and had the skills and experience to support people appropriately. Staff were well-motivated and received appropriate support and supervision. They were skilled and knowledgeable about the needs of people living with dementia and were suitably trained.

People spoke positively about the quality of the food and received appropriate support to eat and drink. They received fresh, nutritious meals and menus were tailored to people’s individual needs.

Staff sought consent from people before providing care and followed relevant legislation to protect people’s rights and ensure decisions were made in their best interests.

People’s privacy was protected and they were cared for with kindness and compassion. Staff spoke fondly of the people they cared for. People and visitors commented on how quiet and calm the home was and the “family feel” and “happy atmosphere” that had been created.

People (and their families where appropriate) were involved in assessing and planning the care and support they received. They received personalised care from staff who were responsive to their needs. Staff had created a relaxed atmosphere and reduced the levels of anxiety and distress people had previously displayed.

Care plans were comprehensive and were regularly updated when people’s needs changed. People were referred promptly to doctors or specialists when changes in their health were identified. They had access to a range of activities which were adapted to reflect their interests.

People, their families and health care professional recognised and appreciated the improvements that had been made and told us the home was well-led. Staff also praised the management of the home. Their morale had increased and they worked well as a team, which reflected on people and the quality of care they received.

There was an open and transparent culture where visitors were welcomed and good working relationships had been built with external professionals. Care was based on a clear set of values which staff understood and followed in their everyday work.

The quality assurance system used to assess and monitor key aspects of the service, such as care planning, medicines and staff training was effective. When improvements were identified, action plans were developed and monitored to ensure they were completed promptly. Analysis of accidents or incidents was undertaken so lessons could be learnt in order to minimise the likelihood of them reoccurring.

We identified a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 which corresponds with Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the full version of the report.