Oxford House Nursing Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to governance at the service.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities. Staff supervisions and appraisals were completed as required, in line with the provider’s policy at the time of our inspection. Staff felt supported and told us the registered manager operated an open door policy and they felt comfortable to discuss any concerns and suggestions with them. Staff told us they worked together as a team to provide high quality care for people.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty. Many staff had worked at the service for a number of years, including the registered manager who had started working at the service as a nurse. The service’s management team had supported staff over the years to develop their knowledge and qualifications in order to provide the best care to people. Staff and people told us how supportive both the registered manager and nominated individual were and how they felt listened to if they expressed any concerns, "I think that I am treated well at work. I am very happy. They are both happy to support me.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. People told us when they raised a concern, staff listened to them. People told us the registered manager was approachable and regularly visible throughout the day.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them. The registered manager worked regularly alongside staff delivering care so they could understand any issues staff encountered. This encouraged an inclusive and equal workforce and mutual respect amongst staff. The working environment was inclusive, and staff’s wellbeing was considered. This ensured the service had a positive culture which supported better outcomes for people.

The provider had audits in place to review information including incidents and accidents, any complaints the service received, safeguarding concerns and care plans. However, not all audits included identifying themes and trends. The service had recently implemented further audits in order to continue to improve the service however they had not yet been embedded into the service. There was also missing information in some staff’s recruitment files that had not been identified by the management team. Not all risk assessments were in place for people where a risk had been identified for example, where people had been prescribed flammable creams.

Quality assurance systems and audits reviewed identified areas of improvement within the service. Audits completed had not identified all the concerns we found during the inspection, but where areas of improvement had been identified, the improvements were being made. When people were given medication covertly, the staff did not always record the rationale for it consistently. The provider must ensure covert administration of medicines were not overused.The management team failed to identify and prevent poor conduct from some staff. They did not ensure compassionate care in relation to the way some staff spoke to people. Supervisions were not focussed on staff well being or the needs of the staff member.

Although care plan audits had been completed, they did not identify any themes or trends. The audits also did not include actions required, who the actions are to be completed by or by when. This was discussed with the registered manager who stated new audits will be completed on the services new auditing system and will include the missing information.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

The provider worked with a number of health and social professionals, this included the local commissioners and health professionals such as, the local GP surgeries, care home support team and the local authority. By working collaboratively, it supported people to achieve positive outcomes in relation to their care and overall wellbeing.
 

The registered manager told us they had a process in place to ensure that learning happened when things went wrong, and from examples of good practice. The registered manager had a tracker in place to monitor incidents and accidents and safeguarding concerns which was reviewed on a monthly basis. The trackers included information such as the incident, actions taken immediately after, any external professionals notified and the type of investigation completed. There was a daily handover to raise any concerns as well as any new information staff being flagged on the service’s new IT system to ensure staff received the information as quicky as possible.

The registered manager and nominated individual had established good partnership working with outside organisations. Where necessary, external health and social care professionals had been consulted or kept up to date with developments. The service had good links with the local community and the provider worked in partnership with other agencies to improve people's wellbeing.