Oxford Road

Updated 6 November 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

The inspection was conducted by two inspectors.

Service and service type

The service is a 'care home'. People in care homes receive accommodation and nursing or personal care. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The home had a manager registered with CQC. This means that they, and the provider, are legally responsible for how the home is run and for the quality and safety of the care provided.

Notice of inspection

The inspection was conducted over two days. The first day of the inspection was unannounced.

What we did

We reviewed information we had received about the home since it was registered. We assessed the information we require providers to send us at least once annually to give some key information about the home, what it does well and improvements they plan to make. We used all this information to plan our inspection.

People living at the home were unable to engage in conversations with us because of their health conditions. However, prior to the inspection we spoke with two relatives of people who lived in the home. We spoke with the registered manager, the college principal and five care staff.

We reviewed a range of records. This included two people's care records, two staff files and other records relating to the management of the home.

Updated 6 November 2019

About the service

Oxford Road is part of Arden College that provides specialist further education for young people aged 16-25 years of age with learning disabilities. There were support staff present in the home 24 hours per day. Accommodation can be term time only and outside of term time if required. At the time of our inspection there were two people living at the home, and one person receiving respite care two days a week.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 16 people but had been adapted to provide individual accommodation for five young adults aged over 18 who attend the college. There was additional classroom space on the ground floor of the property. The size of the service having a negative impact on people was partially 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. However, the presence of an industrial bin and minibuses in the car park identified the building was not in use as a domestic dwelling.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.

People’s experience of using this service

Staff were not always deployed safely in accordance with people’s needs. Staff from other services did not always receive a thorough induction before undertaking their duties. Some staff had not completed essential training.

Risk was not always managed in accordance with best-practice guidance. Changes were not always made to reduce risk following incidents. The service did not have the resources to respond to complex behaviours in a timely manner. We made a recommendation regarding this.

Medicines were managed safely in accordance with best-practice guidance. Staff had been trained in adult safeguarding and understood their role in relation to keeping people safe. The service sought support from other social and healthcare professionals to improve practice.

Staff did not always understand their roles and how to safely manage some risks. People living at the home were involved in discussions about their care wherever possible. Staff used alternative forms of communication to help people understand important information.

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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

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.

Rating at last inspection and update

The last rating for this service was Good (published 14 May 2019).

Why we inspected

We received concerns in relation to the safe deployment of staff and the management of medicines. As a result, we undertook a focused inspection to review the Key Questions of Safe and Well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other Key Questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those Key Questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the Safe and Well-Led sections of this report.

You can see what action we have asked the provider to take at the end of this full report.

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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