We carried out a review of the data available to us about The Lady Nuffield Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Lady Nuffield Home, you can give feedback on this service.
We found the following examples of good practice.
Additional activities had been introduced to promote people's well-being during the pandemic.
The home was spotlessly clean and a rigorous cleaning schedule was in place and followed by a dedicated domestic team.
Staff had been well trained and followed robust PPE [personal protective equipment] protocols.
Due to the layout and size of the building, social distancing was in place and followed. Staff had taken steps that supported people with social distancing wherever possible.
The management were aware of zoning guidelines but did not need to implement it as no people were Covid-19 confirmed or suspected in this location.
The provider ensured there was a sufficient stock of personal protective equipment (PPE) and the vetted supplier ensured it complied with the quality standards. Staff had infection control training and understood the correct donning and doffing procedure.
People were supported by a stable and committed team of staff whom they knew well. This helped people to recognize the individual staff with the need to wear face masks. Staff were well supported and praised the management team, comments included; "Management support has been really excellent."
The provider considered risks and impact of the inspection on the individual staff members, this included around their health conditions as well as their caring responsibilities.
Additional cleaning schedules had been introduced to reflect additional tasks such as cleaning of frequently touched surfaces. Regular audits took place which led to improvements and safety. For example, revised cleaning schedules and extra hand sanitiser stations.
Regular testing for Covid-19 was conducted for both people living at the service and the staff. There was a comprehensive contingency plan of what to do in case of an outbreak.
The provider ensured people's relatives were able to stay in touch with people. For example, by using technology and through safe, face to face visits in an adapted shielded room.
Further information is in the detailed findings below.
The Lady Nuffield is a care home located close to Oxford town centre. The home is registered to provide accommodation for up to 30 persons who require personal care. On the day of our inspection 27 people were living at the service.
At the last inspection, the service was rated Good.
At this inspection we found the service remained Good overall.
Why the service is rated Good:
People remained safe living in the home. There were sufficient staff to meet people's needs and staff had time to spend with people. Risk assessments were carried out and promoted positive risk taking which enable people to live their lives as they chose. People received their medicines safely.
People continued to receive effective care from staff who had the skills and knowledge to support them and meet their needs. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to access health professionals when needed and staff worked closely with people's GPs to ensure their health and well-being was monitored.
The service continued to provide support in a caring way. Staff supported people with kindness and compassion. Staff respected people as individuals and treated them with dignity. People were involved in decisions about their care needs and the support they required to meet those needs.
People had access to information about their care and staff supported people in their preferred method of communication. Staff also provided people with emotional support.
The service continued to be responsive to people's needs and ensured people were supported in a personalised way. People's changing needs were responded to promptly. People had access to a variety of activities that met their individual needs.
The service was led by a registered manager who promoted a service that put people at the forefront of all the service did. There was a positive culture that valued people, relatives and staff and promoted a caring ethos.
The registered manager monitored the quality of the service and looked for continuous improvement. There was a clear vision to deliver high-quality care and support and promote a positive culture that was person-centred, open, inclusive and empowering which achieved good outcomes for people.
This inspection took place on 12 November 2015. It was an unannounced inspection.
The Lady Nuffield is a care home located close to Oxford town centre. The home is registered to provide accommodation for up to 30 persons who require personal care. At the time of our inspection 28 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 safe. Staff understood how to recognise and report concerns and the service worked with the local authority if there were any concerns. People told us they felt safe and were happy with the support they received. People received their medicines safely as prescribed. Staff assessed risks associated with people's care and took action to reduce risk.
There were sufficient staff to support people. Staff were not rushed in their duties and had time to support and engage with people. The service had robust recruitment procedures which ensured staff were suitable for their role.
Staff understood the needs of people and provided care with kindness and compassion. People spoke positively about the service and the caring nature of the staff. Staff took time to talk with people and provide activities such as and arts and crafts, games and religious services.
The registered manager and staff were aware of their responsibilities under the Mental Capacity Act 2005 (MCA) which governs decision-making on behalf of adults who may not be able to make particular decisions themselves.
People told us if they raised a concern they were confident they would be listened to and action would be taken to address it. The service had systems to assess the quality of the service providedat the service. Learning was identified for staff and action taken to make improvements which improved people’s safety and quality of life. Systems were in place that ensured people were protected against the risks of unsafe or inappropriate care.
People’s opinions were sought and acted upon to improve the service. Regular surveys were sent to people and their relatives and the results analysed. Where people and their relatives had made practical suggestions they were adopted to improve the service.
All staff spoke positively about the support they received from the registered manager. Staff told usthey were approachable and there was a good level of communication within the home. People knew the registered manager and spoke to them openly and with confidence.
Accidents and incidents were investigated and learning shared amongst the staff to prevent reoccurrence. The registered manager’s vision of ‘making a difference to people’ was shared by the staff. The service had a culture of openness and honesty where people came first.
This inspection took place on 5 November 2014.
This location is registered to provide personal care and accommodation for up to 30 people. At the time of our inspection 29 people used the service.
The home had a registered manager. 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.
As part of our visit we completed an observation in the dining room at lunchtime. We saw staff were available if people wanted support, extra food or drinks. We found that some improvements were needed to ensure a positive dining experience for everyone.
Most people we spoke with were satisfied with the choice of food available to them. One person told us they would prefer more choices to be made available to them.
The provider had ensured that people were safe at the home. There were enough staff to meet the needs of people who used the service. People we spoke with told us that staff responded quickly when they needed support.
Staff were skilled and experienced and received on-going supervision and appraisals to monitor their performance and development needs. People we spoke with told us they had no concerns about how staff provided care and support to them.
People told us and we observed that staff were kind, caring and respectful to them when providing support and in their daily interactions with them.
People were able to participate in crafts and events taking place in the home and in the community. People were supported and encouraged to maintain relationships with people who were important to them.
The provider regularly sought feedback from people who used the service to improve service delivery. People completed questionnaires and took part in coffee mornings, where their views were recorded and acted on by the provider. There were audit processes in place intended to drive service improvements. The registered manager demonstrated a commitment to values, a vision and a working culture which placed people who used the service at the centre of service development and care delivery.
The registered manager and staff had received training on the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). This legislation sets out how to proceed when people do not have capacity and what guidelines must be followed to ensure people’s freedoms are not restricted. At the time of our inspection no DoLS applications were needed for people at the home.
Records showed that we, the Care Quality Commission (CQC), had been notified, as required by law, of all the incidents in the home that could affect the health, safety and welfare of people.
We found people were supported by sufficient skilled and experienced staff. One relative we spoke with told us 'the care workers here are all very good, they tend to stay here and not constantly move on '. Another relative we spoke with told us 'that staff here are very good and all appear to be well trained'.
We found improvement in training and supporting care workers. Care workers were trained and supported to deliver good care. One relative we spoke with told us 'the care staff here are all very good, they tend to stay here and not constantly move on '.One care worker told us 'we have supervision on a regular and planned basis now and it really helps".
We found improvement in record keeping. We found that care records were accurately maintained. A visiting professional informed us 'the staff here are very good, I am able to raise any issues with them, their records are good and I record any action in the multi-disciplinary notes section of the person's care plan '.
We spoke with one relative who told us 'everything here is lovely' another visitor told us 'it is very pleasant here, a nice atmosphere and very friendly'
During our visit we looked at care plans for eight people. Care plans included admission detail, a photo of each person, individual needs assessments, risk factors and health information. There were inconsistencies in the information held on care plans. One staff member informed us 'care plans are clear but it is good to ask to get extra information '.
Staff were aware of safeguarding and had undertaken training.
Staff had undertaken varied training but had not had formal appraisals or supervision consistently.
There was an effective complaints system available. Comments and complaints people made were responded to appropriately and in a timely manner.
People told us they could provide feedback about their care to the manager or in surveys which had been sent out recently. They said there were staff around when they needed them and that staff were friendly, patient and respectful. One person commented that staff sometimes get sidetracked when going to get something for them, because they were busy, which meant that they were kept waiting. Another person told us 'most staff are excellent.'
A relative told us they were very pleased with the care given at the home. They told us care was consistent, staff were flexible and there had been good management of increase in care needs. The person also told us there was very good leadership from the home's manager. They described the home as 'home from home'.
Staff told us there were good training opportunities at the home including undertaking National Vocational Qualification (NVQ) awards. We met the home's external NVQ assessor during the visit who said that most of the staff at The Lady Nuffield Home had achieved NVQ at level 2 or above. The assessor commented positively about staff attitudes and abilities.