The Oakes provides accommodation and support for up to seven people with learning disabilities, autistic spectrum disorders or mental health needs. On the day of our inspection the service did not have any vacancies. The service does not provide nursing care.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

The service was safe. The registered provider’s recruitment procedures ensured that only suitable staff were employed. There were enough staff to help keep people safe, meet their needs and protect them from harm and abuse. Risks to people’s health and wellbeing were appropriately assessed, managed and reviewed. There were safe systems in place for receiving, administering and disposing of medicines.

The service was effective. People were supported by staff that had the skills and experience needed to provide effective care. The registered manager understood their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. 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 were supported to eat and drink enough and maintain a balanced diet and to access health and social care services when required.

The service was caring. Staff knew people very well and were kind and sensitive to their needs. Staff were observed providing excellent personalised care and it was evident they clearly understood people’s individual needs. Staff ensured people’s privacy and dignity was respected and maintained at all times. Where people required additional support staff supported them using appropriate methods of communication for their individual needs.

The service was responsive. People were involved in the planning and review of their care and support needs. Care plans were person centred and were regularly reviewed. People were encouraged and supported by staff to pursue their interests and hobbies and activities were tailored around people’s likes, choices and abilities.

The service was well-led. Staff, relatives and healthcare professionals spoke positively about the registered manager who was committed to providing an excellent person centred service; ensuring people had a good quality of life. There were systems in place to regularly assess and monitor the quality of the service provided and people living and working in the service had the opportunity to say how they felt about the home and the service it provided. The registered manager was able to demonstrate how they measured and analysed the care and support provided to people, and how this ensured that the service was operating safely and was continually improving to meet people’s needs.

The inspection of The Oakes took place on the 21 October 2014 and was unannounced; this meant that the provider and staff did not know that we would be visiting.

The service is provided in a large detached house which has been adapted for the needs of people using it. This service also has a self-contained flat which is used as an enablement residence to support and encourage people’s independence. The Oakes is registered to provide accommodation and care for up to seven adults who have a learning disability. Some of whom may also have a formal diagnosis of autism.

This service requires a registered manager to be 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.

The CQC monitors the operation of the Mental Capacity Act 2005 (MCA) Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We saw that there were policies, procedures and information available in relation to the MCA and DoLS to ensure that people who could not make decisions for themselves were protected. The service was applying these safeguards appropriately. This was through assessing people’s capacity and making appropriate referrals to the supervisory body, (the Local Authority,) if people’s liberty was being restricted.

People were happy with the service they were receiving and there were many positive comments about the service, the management and the staff team.

We found that people’s health care needs were assessed, and care planned and delivered in a consistent way which met their needs. From the four people’s plans of care we looked at we found that the information and guidance provided to staff was clear. It would enable them to provide appropriate and individual care. Any risks associated with people’s care needs were assessed and plans were in place to minimise the risk as far as possible to keep people safe.

Staff knew how to support people in ways that they wished to be supported and there were sufficient numbers of staff were being provided to meet people’s needs.

Staff had the knowledge and skills that they needed to support people. They received training and on-going support to enable them to understand people’s diverse needs and work in ways that were safe and protected people.

We saw that staff respected people’s privacy and dignity and worked in ways that demonstrated this. Staff asked for permission before providing any personal care or any activity.

Records we looked at and people we spoke with showed us that the social and daily activities provided suited people and met their individual needs. People were supported to make their own decisions about if they undertook activities or not. People’s preferences had been recorded and we saw that staff respected these.

Records viewed showed that people were able to complain or raise any concerns if they needed to. We saw that where people had raised issues that these were taken seriously and dealt with appropriately. People could therefore feel confident that any concerns they had would be listened to.

The provider used a variety of ways to assess the quality and safety of the service that it provided. People using the service and their families were consulted with. The organisation undertook a range of monitoring and areas such as health and safety and medication were regularly audited.

The management team at the service were well established and provided good and consistent leadership. This helped them to provide a good quality service that was proactive, learned from experiences and ensured people were enabled to live positive and fulfilling lives.

We saw from records that people who used the service are involved in the planning of their care wherever possible. Care records showed us that people expressed their views and were involved in making decisions about their care and treatment.

We spoke with people who used the service. They told us that they were happy with the care and support that is provided at The Oakes. One person told us. "I like everyone, I go out everyday." During our visit two people who used the service were being supported by staff to get ready for a short break to Barcelona, this had been organised with the support of staff and was the choice of the persons involved.

We found that the service had a safe and effective process for the safe handling of medicines and these were in line with the relevant guidance and legislation.

We found that there were enough qualified, skilled and experienced staff to meet people’s needs during our visit.

We saw that an effective complaints system was in place, this supported people who used the service to raise a complaint or make comments and protected from discrimination.

Records showed that people had an individualised support plan detailing their specific care needs and any potential risks.

We found that staff interactions with people who live at the service were positive and staff were seen to have a good rapport with individuals. Staff on duty at the time of our visit were observed to have a good understanding and awareness of people's support needs. Staff confirmed to us that they liked working at the service and that team work was good.

We found that people were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. The provider had suitable arrangements in place to ensure that newly appointed staff received a comprehensive induction, received appropriate training and development and benefitted from regular supervision.

The service was noted to have an effective quality assurance system in place for assessing and monitoring the quality of service provided at The Oakes.

Where people were unable to provide a verbal response or tell us verbally their experiences, as a result of their limited verbal communication, we noted their non verbal cues and gathered information about people’s experiences through our observations.

One relative told us that their family member was actively involved in their care plan and that they had seen it and agreed to the information recorded. They also told us that the care and support provided for their family member was “excellent” and that they could not have wished for more. The relative told us they were always kept informed of any healthcare appointments and the outcomes.

During our visit we were able to hold a conversation with two people who use the service and to view others experience through our observations. People with whom we spoke told us they were happy and liked where they were living. People also told us that the care and support they received was good and that they liked the staff working within the service. Both people told us that they participated in sufficient leisure activities throughout the week, both during the day and at evenings and weekends. Their last case reviews in 2010 recorded “I like living at The Oakes because it’s nice and the food is good”, “I like all the staff at The Oakes” and “I like it at The Oakes because I do activities”. People with whom we spoke with told us that they liked the sensory room and enjoyed spending time in there.