Oxford House Nursing Home

We found the following examples of good practice.

• There was a spacious and secure indoor area to facilitate visits from relatives. An easy booking system was in place to stagger visitors to minimise contact with staff and people using the service. At the time of our inspection, visitors to the home were restricted, with the exception of people at the end of their life. This decision was based on considerations such as the national lock down, local infection rates and regular updates from the local health protection agency.

• The environment had been adapted to encourage social distancing. Communal areas were arranged to enable enough space between people. We saw people engaged in social activities, laughing and enjoying themselves in a safe environment. The staff changing room was located external to the main home to reduce the risk of cross contamination.

• An extra nurse was allocated on every shift and maximum staff ratios were maintained to increase capacity to support people safely, manage additional Covid-19 related tasks and increased staff welfare breaks.

• The service had developed a specific care plan for suspected or confirmed Covid-19 cases to identify and meet people’s needs. This included clear staff instructions for Covid-19 related procedures to keep people safe.

Oxford House Nursing Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. We regulate both the premises and the care provided, and both were looked at during this inspection.

Oxford House Nursing Home can accommodate 34 people across two floors, each of which has separate adapted facilities. The service provides care to older adults. People live in their own bedrooms and have access to communal facilities such as a bathrooms, lounges and activities areas. At the time of our inspection, there were 28 people living at the service.

The provider is required to have a registered manager as part of their conditions of registration. 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 the time of our inspection, there was a registered manager in post.

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.

Why the service is rated good:

We found people were protected against abuse or neglect. People had personalised risk assessments tailored to their support requirements. We saw sufficient staff were deployed to provide people’s support. People’s medicines were safely managed. The service was clean and infections were prevented and controlled.

The service was compliant with the requirements of the Mental Capacity Act 2005 (MCA) and associated codes of practice. People were assisted 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 practise.

Staff received good induction, training, supervision and support. This ensured their knowledge, skills and experience were appropriate for their caring roles. People’s care preferences, likes and dislikes were assessed, recorded and respected. We found there was appropriate access to other community healthcare professionals. People were supported to maintain a healthy lifestyle. People had adequate nutrition and hydration to ensure their wellbeing. We made a recommendation about adaptation, design and decoration of the premises.

Staff had developed compassionate relationships with people who used the service and relatives. There was complimentary feedback from a variety of sources. People told us they were able to participate in care planning and reviews and we saw evidence of decision-making that promoted people’s independence. People’s privacy and dignity was respected when care was provided to them.

The service provided person-centred care. Care plans were thorough and contained information of how to support people in the best possible way. We saw there was an appropriate complaints system in place. People and their families had a say in the everyday decision-making and operation of the service. The service used nationally-recognised methods of assessing, managing and monitoring people’s end of life care.

The service was well-led. There was a positive workplace culture and staff felt that management listened to what they had to say. We saw the management used tools to measure the safety and quality of care. The service had developed strong relationships with the social and healthcare community in the area. We made a recommendation about the Accessible Information Standard.

Further information is in the detailed findings below.

We spoke with one relative, who was very positive about the quality of the staff team. They told us they had "No problems" with staff, although they felt they worked very hard and could perhaps do with more of them to share the load. They said their relative benefitted from a settled and consistent staff team. This meant people were supported by staff who knew them and who understood their needs.

When we looked at medication practice and recording we found appropriate arrangements were in place and saw medication records were accurate and complete.

People who used the service, their relatives and health and social care professionals were all positive about the standard of care provided. This was explicitly credited by them to the competence, skill and attitude of staff at all levels. Staff told us they received regular training which helped them maintain their skills. They said, for example, they had received training in safeguarding and the Mental Capacity Act 2005. We looked at training records and saw a training matrix which set out all the training staff received. This showed the management team were able to monitor which staff had completed specific training and what training was due. This ensured people were supported by appropriately trained staff. Staff told us they felt very well supported by the manager. Although records showed staff had received formal supervision, this was not always recognised as such by them.

We found the provider took account of complaints and comments to improve the service. We saw the home had a complaints policy and procedure which was readily accessible to people who lived in the home and their relatives. The people we spoke with told us they were aware of this. However, they indicated they would be more likely to raise any concerns or complaints, if they had them, direct with the staff, manager or provider. There was a process in place to obtain the views of people who used the service and their relatives about the standard of care provided. This information was then used to improve the service.