This unannounced inspection took place on 22 November 2017. At our last inspection of 09 November 2015, the service was rated ‘Good’. At this inspection we found the service remained ‘Good’.

Oatlands Care Ltd is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home is registered to accommodate up to 43 people across three separate units over three floors, each of which have separate adapted facilities including dining rooms and sitting areas. There were 25 people living at the home when we visited.

The service had a registered manager who had worked at the service for several years. 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.

At this inspection we found that people’s medicines were still managed in line with safe medicine administration and management guidelines. Medicines were administered as prescribed. Records were correctly completed and medicines were stored in a safe way.

People were protected from avoidable harm. Management plans provided guidance to staff to mitigate risks to people. Staff were trained on safeguarding adults from abuse. They understood signs of abuse and how to report it in order to protect people. There were sufficient staff deployed to meet people’s needs and recruitment checks were conducted before new staff were employed.

The provider maintained health and safety systems, and carried out regular checks to ensure the environment continued to be safe. Staff were trained in infection control and knew the procedures to reduce risks of infection and cross contamination. The service was clean. Records of incidents and accidents were maintained, and the registered manager reviewed them to ensure lessons were learned and to reduce the risk of repeat occurrence.

People’s needs were assessed, planned and delivered in a way that met their individual needs and requirements. People and their relatives were involved in reviewing their care plans. Staff updated people’s care plans in line with their changing needs and preferences.

People’s nutritional needs and dietary requirements were met. Staff received training, support and supervision to provide effective care to the people, and to carry out their duties effectively. People had to access to healthcare services they needed to maintain good health. The provider had arrangements and systems in place to enable people receive consistent care when they moved between services and departments.

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. People gave consent to the care and support they received. The service complied with the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Relatives and healthcare professionals were involved in making decisions for people in their best interests where this was appropriate.

Staff were kind and compassionate to people. They provided people with reassurance and comfort when needed, and treated them respectfully, maintaining their independence and dignity. Staff also communicated with people in a way they understood.

Staff were trained in end-of-life care. People’s end-of-life wishes were documented in their care plans, to ensure these implemented appropriately. People were also encouraged to participate in activities they enjoyed. The service supported people’s needs with regards to their disabilities, culture and religion. Staff had

This inspection took place on 9 November 2015 and was unannounced. At our last inspection in July 2013 the provider met the regulations we inspected.

Oatlands Care Ltd is registered to provide residential care for up to 43 older people, many of whom are living with dementia. It is one of three registered locations at the same address owned by the provider.

The service is part of the Oatleigh building and is situated on the ground floor and the first floor also known as ‘Aldgate’ and ‘Barbican’. Some services and facilities such as activities, kitchen and laundry arrangements are shared between the locations as a community. Oatlands has its own staff and operates independently, under the overall supervision and management control of the provider. There were 41 people using the service at the time of our inspection.

The home had a registered manager who was also one of the registered providers. 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 and their relatives were positive about the care and support provided at Oatlands. Staff knew people well and care plans were person centred. We observed friendly and positive relationships between staff and people at the service during our inspection.

People said they felt safe and that staff treated them well. There were procedures in place to recognise and respond to abuse and staff had been trained in how to follow these. The provider’s recruitment procedures also helped to ensure that people were protected from unsafe care.

People’s needs were assessed and appropriate risk assessments developed. There were enough staff on duty to make sure people’s needs were met in a safe and timely way. Staffing was managed flexibly so that people received their care when they needed and wanted it.

People received effective care and support because the staff were trained to meet their needs. Staff understood their roles and responsibilities and were supported to maintain and develop their knowledge and skills through regular management supervision.

Medicines were stored, administered, recorded and disposed of safely. Staff were trained in the safe administration of medicines and kept records that were accurate.

All areas of the home were kept clean and hygienic. Staff knew the procedures to follow to stop the risk of infection and keep people safe. Each person had a single room which was appropriately furnished and homely.

Care provision at Oatlands considered the needs of people living with dementia as the provider had implemented a Namaste care programme in March 2015. Namaste care is designed to improve the quality of life for people living with advanced dementia and included hand and foot massage and sensory stimulation. Namaste was available to people living in all three locations in the Oatleigh building including Oatlands. Other activities took place seven days a week in the ground floor Angel Lounge.

We found that some communal areas within Oatlands could be decorated and equipped more suitably for people with specialist dementia needs. The provider acknowledged this and agreed to look at ways to improve the environment to provide more engagement and stimulation for those people who chose not participate in the main activities.

The provider acted in accordance with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. This provides a legal framework to help ensure people’s rights are protected. Staff understood people’s rights to make choices about their care and support and their responsibilities where people lacked capacity to consent or make decisions.

Arrangements were in place for people and relatives to share their views or raise complaints. The provider listened and acted upon their feedback. The provider obtained the views of people using the service and their relatives or representatives and there were systems to regularly monitor the quality of the service provided at Oatlands.

People and relatives we spoke with were happy with the care provided. One person told us "staff check on me regularly" and that they felt "well looked after". One relative told us they found the care to be "excellent" and that they had been involved and consulted during the care planning process. Another relative told us they had "no complaints whatsoever" and described the staff as "lovely". We also spoke to a GP who was making a visit to people in the home on the day of our inspection and they confirmed that the provider kept the practice well informed of people's changing conditions and that they considered the care people received at the home to be good.

We found that people receiving care were asked for their consent and that the provider acted in accordance with their wishes. Care was planned based on an assessment of people's needs and delivered in a way which ensured their safety and welfare. Records relating to people's care were accurate and fit for purpose. The provider had also made checks on new staff prior to their starting work in the home to ensure they were suitable for the role and staff were able to demonstrate an understanding of the safeguarding of vulnerable adults.

People and relatives we spoke with said that the staff spoke to them in a pleasant manner and addressed them as appropriate. One person we spoke with said the staff “never rush and are always friendly”. They said that staff were available when they needed them, and they could easily speak with them about their needs. One relative we spoke with said the staff treated people “with great consideration”. People and the relatives we spoke with were happy with the care provided at the home. One relative told us, “the place is always clean and smells good”.

We found that the people who used the service were involved in their care planning and received a personalised care and support which was based on an assessment of their needs. Staff received support and training in different aspects of care and demonstrated an understanding of safeguarding of vulnerable adults. Care records were accurate and stored securely.