This inspection took place on 23 and 26 February 2018 and was unannounced. This meant the staff and provider did not know we would be visiting.

This was the first inspection of the service since it was registered with a new provider.

The Oaks is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The Oaks accommodates a maximum of 45 older people, including people who live with dementia or a dementia related condition, in one adapted building. At the time of inspection 33 people were using the service.

A manager was in post who had applied to become registered with CQC. Since the inspection they have become registered with the Commission. 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 two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This related to regulation 18 and 17 with regards to staffing levels and governance. You can see what action we told the provider to take at the back of the full version of this report.

Changes had been made to the environment. Some areas had been refurbished. However, not all areas of the home were clean and well maintained for the comfort of people who used the service. The home was not designed to promote the orientation and independence of people who lived with dementia, although plans were in place to address this. We have made a recommendation that the environment should be designed according to best practice guidelines for people who live with dementia.

Improvements were needed to improve staff understanding of the Mental Capacity Act 2005 and best interest decision making, when people were unable to make decisions themselves. People were not always supported to have maximum choice and control of their lives and they were not always supported in the least restrictive way possible, the policies and systems in the service supported this practice.

We have made a recommendation that staff receive training about person-centred care in order to ensure people receive individualised care and support.

We considered that staff deployment and staffing levels needed to be kept under review to ensure people’s needs were met in a safe, effective and timely way. Care was at times task centred rather than person-centred. There were limited opportunities for activities for some people to keep them engaged and stimulated.

Risk assessments were in place and they accurately identified current risks to people as well as ways for staff to minimise or appropriately manage those risks. Care was provided with kindness and people’s privacy and dignity were respected.

Systems were in place for people to receive their medicines in a safe way. People had access to health care professionals to make sure they received appropriate care and treatment. People received a varied and balanced diet to meet their nutritional needs. However, we considered improvements were required to consultation and the involvement of people who lived with dementia.

Staff knew people’s care and support requirements. However, record keeping required improvement to ensure it reflected the care provided by staff. A complaints procedure was available. People had access to an advocate if required.

Staff and relatives said the management team were approachable. Communication was effective to ensure staff and relatives were kept up to date about any changes in people’s care and support needs and the running of the service.

The home had a quality assurance progra