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Inspection Summary


Overall summary & rating

Good

Updated 12 August 2016

This unannounced inspection was carried out on 16 and 17 May 2016. At our last inspection on 1 October 2014 the service had met all of the standards we had inspected against .

The Old Prebendal House provides residential and nursing care for 34 older people in the Oxfordshire area. The home is located in a rural area of Oxfordshire. On the day of our inspection 31 people were living at the service.

There was a registered manager 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 2008 and associated Regulations about how the service is run.

People were supported by staff that were not always appropriately trained. The records showed that the provider had not ensured that staff had received up-to-date training in the areas such as moving and handling equipment, fire awareness, safeguarding or infection control. However when we spoke with staff they demonstrated good knowledge about these elements of training. We have made recommendation regarding staff training and training updates.

People told us they felt safe. Staff were confident that if they reported any concerns regarding people’s safety, health or welfare to the registered nurse or to the registered manager, these would be acted upon immediately.

Medicines were stored safely. Records relating to medicines were completed in line with the provider’s medicines policy.

On the day of our inspection there were sufficient numbers of staff deployed to support people safely and effectively. Thorough recruitment practices and appropriate pre-employment checks ensured that staff were of a suitable character to care for people. Staff were supported through regular supervisions and appraisals.

Risks to people had been identified, assessed and were managed safely. Staff understood the signs of potential abuse and what action they needed to take if such suspicion arose. There were sufficient numbers of staff employed to meet people's needs and the service followed safe recruitment practices. People's medicines were managed and administered safely.

Thorough recruitment practices and appropriate pre-employment checks ensured that staff were of a suitable character to care for people. Staff were supported through regular supervisions and appraisals.

Management and staff understood and followed the principles of the Mental Capacity Act 2005 (MCA). The MCA provides the legal framework for acting and making decisions on behalf of individuals who lack the mental capacity to make particular decisions for themselves. The MCA also requires that any decisions made on behalf of a person who lacks capacity are made in the person's best interests. People were able to make decisions concerning everyday aspects of their lives themselves, which helped them maintain their independence.

People were involved in the planning of their care and staff provided support that met people’s needs and maintained their independence. The provider sought support from relevant healthcare professionals to maintain people’s health.

Care plans were reviewed regularly on an annual basis and, reviews of people’s care were carried out and if people’s needs changed, people’s care plans were amended accordingly. Staff were familiar with the contents of people’s care plans and knowledgeable about people’s individual needs, backgrounds and preferences. Individual risk assessments were in place and provided information about how to manage any of the identified risks to people.

The service had a complaints policy in place. People who use the service were made aware of the complaints procedure. They told us they knew how to make a complaint and who to complain to, should such a need arise.

People were given the opportunity to contribute to the enhancement of the service by providing feedback on its management at residents’ meetings.

The service had systems in place to assess the quality of the service. However, the systems had not always been effective and had failed to identify the training issues highlighted in the report. The registered manager addressed the issue immediately and introduced new audits on the second day of our inspection. However to ensure improvements were made we have asked the provider to send us an action plan.

Inspection areas

Safe

Good

Updated 12 August 2016

The service was safe.

There were systems in place to manage medicines in a safe way and people were supported to take their prescribed medicines.

Recruitment procedures were robust to ensure appropriate pre-employment

checks were in place before new staff started to work unsupervised with people.

People told us they felt safe. Staff knew how to identify and raise concerns.

Effective

Requires improvement

Updated 12 August 2016

The service was not always effective.

The provider had not always ensured that staff had the relevant training to be able to promote and maintain people’s safety.

The registered manager and staff were aware of their responsibilities regarding the Mental Capacity Act.

People were supported to eat sufficient and nutritious food and drink. People had timely access to appropriate health and social care support.

Caring

Good

Updated 12 August 2016

The service was caring.

People were valued and treated with compassion, and their dignity was respected.

People we spoke with were positive about the kind and caring nature of staff.

Staff knew people well and responded to their needs appropriately.

Responsive

Good

Updated 12 August 2016

The service was responsive.

People were involved both in planning and reviewing their care and support.

People told us that there were sufficient activities taking place which meant that people were not socially isolated.

Well-led

Good

Updated 12 August 2016

The service was well-led.

Staff were motivated, valued and supported by their colleagues and management.

Staff were aware of their roles and felt supported by the registered manager and the provider. Staff members told us they were able to raise concerns and felt the registered manager provided good leadership.