Background to this inspection
Updated
5 February 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 17 and 18 December 2018 and was unannounced. One inspector carried out this inspection.
We reviewed information we had received from the provider such as statutory notifications. We also contacted Healthwatch to see if they had received any information about the provider or if they had conducted a recent 'enter and view' visit. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We contacted the local authority commissioning and monitoring team and reviewed all the information regarding the service. We also contacted the infection control team and the fire service.
The registered provided had completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
We spoke with the area manager, the registered manager, one of the clinical leads, one nurse, three support staff. We spoke with two relatives during the inspection and spoke with three more relatives over the telephone following the inspection. We contacted three professionals after the inspection for their view on how people were supported.
We reviewed all the information held about the service including maintenance and management checks. We reviewed three staff files and information in relation to staff development.
Updated
5 February 2019
This inspection took place on 17 and 18 December 2018 and was unannounced. Oxfield Court 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. Oxfield Court provides accommodation and support to people with a learning disability.
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 care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion and were embedded within this service which worked to ensure people could live as ordinary a life as any citizen.
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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Staffing levels were based on the needs of people at the home and were under constant review. Staff told us they had the time to support people and numbers of staff were increased when people had outings and appointments to ensure there were always sufficient numbers of staff available to support people. Staff had been trained and were confident to recognise safeguarding issues which meant people were protected from harm.
Risks were assessed and well managed to ensure people's freedoms were not overly restricted and risk assessments were based on positive outcomes for people.
Staff received ongoing support from the management team through a programme of regular supervisions and appraisals and they had been trained to ensure they had the knowledge and skills to care for people. Staff were required to undertake an annual programme of training and specialist training was provided when it was needed to ensure staff had the skills required to support the complex health needs of people living at the home.
People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice
We found decision specific capacity assessments had been carried out for people who lacked mental capacity to consent to aspects of their care delivery. These were compliant with the Mental Capacity Act 2005 (MCA). Staff understood the principles of the MCA and how to ensure people's human rights were respected when making decisions on their behalf.
We found all the staff to be caring in their approach to the people who lived there and treated people with dignity and respect. Staff knew the people they supported very well, and we observed people were very happy in the presence of staff and there was a very positive and friendly atmosphere. Relatives were confident about the love and care provided to their relation and spoke consistently about the caring staff.
The support people received from staff was tailored to their individual needs and staff had worked extremely hard to get to know people and understand what was important to them. People were given opportunities to live fulfilled and meaningful lives regardless of their complex needs.
The service had excelled in supporting people at the end of their lives and worked closely with the local hospice. They had taken an active role in developing a tool to help support people with a learning disability at the end of their life. They had shared their learning with other organisations and presented at various conferences and groups. This truly demonstrated their passion for improving this aspect of care delivery for people with a learning disability.
People were supported to be fully involved in how their support was provided. Information was provided in an easy read format to ensure people with different abilities were provided with information in a format they could understand. Clear, easy read plans were designed to help people manage health conditions that needed monitoring. Health and social care professionals were involved with people's support when needed and their advice was included in the care provided. There was clear evidence of person-centred care and records contained information detailing people's life histories, preferences and choices to enable staff to support them. People were involved in activities based upon their established routines and preferences.
Systems and processes for ensuring the quality of the service included nationally recognised evidence-based standards to ensure they provided a quality service to people living there. The service was well-led by a registered manager who aspired to develop the service continuously and who kept abreast of best practice and developments in this field.