Oxton Manor

Updated 24 October 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Oxton Manor 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 service did not have a manager registered with the Care Quality Commission. A registered manager and the provider are both legally responsible for how the service is run and for the quality and safety of the care provided. The service had a manager who was going through the registration process.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection-

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with one person who used the service and three relatives about their experience of the care provided. We spoke with three members of staff including manager. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and additional policies. We spoke with two professionals who visited the service.

Updated 24 October 2019

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 15 people, 11 people were using the service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

People’s experience of using this service and what we found

We found that although the environment had improved since the previous inspection, however parts of the environment did not reflect that Oxton Manor was a home for people as the flooring in a lounge area was a non-slip type flooring more suited to bathrooms and so was not homely.

Processes surrounding recruitment were not robust and staff training and induction were under review at the time of inspection.

The communication between staff and the manager was not always effective regarding the people’s support needs within the home. This was identified and discussed with the manager who assured us that this would be acted on immediately. We also attempted to contact the provider prior to the inspection being carried out however, the provider had not contacted the Commission with the requested information at the time of inspection.

Medications were managed safely however, shop bought medications had not been discussed with a GP. We received evidence following the inspection that this had been addressed.

People living in the home had a comprehensive support plan and risk assessments in place, however we identified those who were staying on a temporary basis did not have appropriate support plans in place.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. There were systems in place to actively seek the engagement and involvement of people and staff in developing the service and driving improvements. The manager was transparent and collaborative and demonstrated a commitment to improve the service. The manager took on board the feedback from our inspection and took immediate action to resolve the shortfalls identified.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People were protected from potential abuse and staff understood their roles in protecting people in their care. Their care was assessed using nationally recognised assessment tools and there were risk assessments in place to guide staff and provide safe care. People's health needs were well managed. They lived in an environment that allowed them the freedom to move around the service safely.

Incident and accidents were analysed for patterns and trends. Risks to people were assessed safely and referrals were made to other professionals in a timely way when people living in the home were in need.

People received care from staff who had a good knowledge of their needs. Their communication needs were met, and the manager worked to the accessible information standards to provide people with information in a way they could understand.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: The last rating for this service was requires improvement (published 23 August 2018). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Oxton Manor on our website at www.cqc.org.uk.

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.