We carried out a review of the data available to us about Oxbridge House 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 Oxbridge House, you can give feedback on this service.
About the service
Oxbridge House is a care home and provides accommodation and support for up to 13 people living with a learning disability and/or autistic spectrum disorder. There were 9 people living at the service when we visited.
People’s experience of using this service and what we found
Right Support
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 on the whole supported this practice. People were supported safely with medicines. Staff followed infection prevention and control good practice guidance.
We have made a recommendation about the management of medicine policy and reviews.
Right Care
Staff promoted equality and diversity in their support for people. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. The service had enough appropriately skilled staff to meet people’s needs and keep them safe. Where people had support, this was flexible, generally available when they needed it and to the level they needed. Staff understood and responded to people’s individual needs. Staff understood people’s individual communication needs.
Right culture
Staff placed people’s wishes, needs and rights at the heart of everything they did. They sought advice and feedback from everyone involved in people's care. The environment was bright and highly personalised. Staff were aware of and working to best practice guidance for supporting people with a learning disability and/or autistic people.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 9 June 2021). At the time we found the service was in breach of two regulations regarding medicines, risk assessment and the effectiveness of the service’s quality assurance systems. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an unannounced inspection in May 2021 and breaches of regulation were found. We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe and well-led which contain those requirements.
We assessed whether the service is applying the principles of Right support right care right culture. We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Oxbridge House on our website at www.cqc.org.uk.
Oxbridge House 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. Oxbridge House accommodates up to 13 people in one adapted building providing support for people with learning disabilities who may also experience mental health needs. At the time of our inspection visit there were nine people using the service.
People’s experience of using this service and what we found
Records did not demonstrate people received their medicines as prescribed. The medicine policy needed to be updated to make it relevant to the service.
Risks to people’s health and welfare were not all in place. Records to evidence fire drills needed to be more robust. Care records were cumbersome and contained information not relevant to the person. Audits that had took place did not highlight the concerns found on the inspection day.
Accidents and incidents, although few, were monitored monthly for themes and lessons learnt.
Staff were recruited safely and felt supported by the registered manager.
People and their relative’s views were sought, and they were very involved in the running of the service. However, relatives felt communication and the management of the service could be improved.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was not always able to demonstrate how they were meeting some of the underpinning principles of right care, but were meeting the principles of right support and right culture. Oxbridge House did not always put people who used the service in the centre of the care provided. They did engage people to maximise their potential and staff demonstrated a clear understanding of the needs and challenges people with learning disabilities face within our society.
Right support:
• The model of care and setting did maximise choice, control and independence. People used the community and local attractions daily as well as going further afield. People chose and did what they wanted to do every day with support but without restrictions.
Right care:
• People did not always receive consistent person-centred care that promoted their dignity and human rights. Even though we found no harm to people we raised this with the provider who agreed to review peoples care. People were protected from the risk of abuse.
Right culture:
• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives. We saw meetings for people and staff were taking place. People were fully involved in how they wanted to live.
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 good (published19 December 2017).
Why we inspected
This was a planned inspection based on the previous rating.
We carried out a focused inspection of this service on 25 June 2021. This report only covers our findings in relation to the key questions safe and well led as we were mindful of the impact and added pressures of Covid-19 pandemic on the service.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
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 the provider needs to make improvement. Please see the safe and well-led sections of this full 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 Oxbridge House on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We have identified breaches in relation to the management of risk, medicines management and records at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and 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.
We last inspected the service on the 3 November 2015 and we rated the service as Good. At this inspection we found the service remained Good.
Oxbridge House 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. Oxbridge House accommodates up to 13 people in one adapted building providing support for people with learning disabilities who may also experience mental health needs. At the time of our inspection visit there were eight people using the service.
The care service had been developed and designed in line with the values that underpin the Building the Right Support and other best practice guidance. It underpins principles of choice, promotion of independence and inclusion. People with learning disabilities and autism using the service were living as ordinary a life as any citizen.
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.
We saw for two people who had moved to the service in 2017, they did not have Health Action Plans in place. A Health Action Plan is a requirement from the Department of Health for people with a learning disability and it supports people to remain healthy. We were contacted straight after the inspection by the team leader at the service who informed us these were now in place.
There were systems and processes in place to protect people from the risk of harm. Staff were aware of different types of abuse, what constituted poor practice and action to take if abuse was suspected. People told us they felt safe living at and receiving from the service.
Accidents and incidents had been appropriately recorded and monitored and risk assessments were in place for people who used the service and staff so that they remained as safe as possible.
Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety standards were maintained. We also witnessed staff using appropriate personal protective equipment and cleaning schedules were in place so that risks relating to infection control were well managed.
There were sufficient staff on duty to meet the needs of the people and the staff team were trained and supported to manage any behaviour that may challenge. Medicines were stored and administered in a safe manner.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
We saw that staff were recruited safely and were given appropriate training before they commenced employment. Staff had also received more specific training in managing the needs of people who used the service such as positive behaviour support (PBS) and diabetes.
There was a regular programme of staff supervision in place and records of these were detailed and showed the home worked with staff to identify their personal and professional development. However, some records in relation to staff induction and mandatory training were not instantly accessible as they were in different locations and although we saw staff were trained, records required collating to show they met the regulations.
We saw people’s care plans were person centred and had been well assessed. The home had developed care plans to help people be involved in how they wanted their care and support to be delivered. We saw people were being given choices and encouraged to take part in all aspects of day to day life at the home, from going to work placements to helping to do household cleaning tasks.
People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. Care records contained evidence of visits to and from external health care specialists demonstrating that people’s physical health was supported.
The service encouraged people to maintain their independence. People were supported to be involved in the local community as much as possible and were supported to independently use public transport and access facilities such as the local G.P, shops and leisure facilities.
We also saw a regular programme of staff meetings where issues were shared. The service had an easy read complaints procedure and staff told us how they could recognise if someone was unhappy. This showed the service listened to the views of people.
The service regularly used community services and facilities and had links with other local organisations. Staff told us they felt very supported by the registered manager and team leaders and were comfortable raising any concerns. People who used the service, family members and staff were regularly consulted about the quality of the service. People told us that management were approachable, supportive and understanding.
The service had a comprehensive range of audits in place to check the quality and safety of the service and equipment at Oxbridge House and actions plans and lessons learnt reviews were part of their on-going quality review of the service.
The inspection visit took place on the 3 November 2015. This was an unannounced inspection which meant that the staff and provider did not know that we would be visiting.
We last inspected the service on the 7 April 2014 and found the service was not in breach of any regulations at that time.
Oxbridge House is a 13 bedded residential service providing support for people with learning disabilities who may also experience mental health needs.
There is 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.
There were systems and processes in place to protect people from the risk of harm. Staff were aware of different types of abuse, what constituted poor practice and action to take if abuse was suspected. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety.
There were policies and procedures in place in relation to the Mental Capacity Act and Deprivations of Liberty Safeguards (DoLS). The registered manager and staff had the appropriate knowledge of how to apply the MCA ,when an application should be made and how to submit one. This meant people were safeguarded.
We saw that staff were recruited safely and were given appropriate training before they commenced employment. Staff had also received more specific training in managing the needs of people who used the service such as epilepsy and schizophrenia. There were sufficient staff on duty to meet the needs of the people and the staff team were supportive of the management and of each other. Medicines were also stored and administered in a safe manner.
There was a regular programme of staff supervision in place and records of these were detailed and showed the home worked with staff to identify their personal and professional development.
We saw people’s care plans were person centred and had been well assessed. The home had developed care plans to help people be involved in how they wanted their care and support to be delivered. We saw people were being given choices and encouraged to take part in all aspects of day to day life at the home, from going to work placements to helping to make the evening meal. One person had very recently transitioned into the home and we saw this had been planned and assessed so it was as smooth as possible.
People’s nutritional needs were met, with people being involved in shopping and decisions about meals. People who used the service told us that they got enough to eat and drink and that staff asked what people wanted. Staff told us that they closely monitored people, would contact the dietician if needed and carried out nutritional monitoring.
People were supported to maintain good health and had access to healthcare professionals and services. Professionals we spoke with confirmed the service supported people well and there was good communication between the service and themselves. People told us that they were supported and encouraged to have regular health checks and were accompanied by staff to hospital appointments.
The service encouraged people to maintain their independence. People were supported to be involved in the local community as much as possible and were supported to independently use public transport and access facilities such as the local G.P, shops and leisure facilities.
We also saw a regular programme of staff meetings where issues where shared and raised. The service had an easy read complaints procedure and staff told us how they could recognise if someone was unhappy. This showed the service listened to the views of people.
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
People were treated with respect and dignity by the staff. People told us that they were happy with the care and support delivered to them. Comments made to us included, 'If I had any problems I would speak with the staff, they are approachable and they listen to me.'
The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards and there was evidence to show that this had been followed appropriately. Staff had been trained to understand when an application should be made, and in how to submit one and this training was updated annually. This meant that people were safeguarded as required.
Recruitment practice was safe and thorough. Policies and procedures were in place to make sure that unsafe practice is identified and people are protected.
Is the service effective?
People's health and care needs were assessed with them, and they were involved in the development and updating of their plans of care. People said that they had been involved in them and they reflected their current needs. Their care plans were very comprehensive and clearly person centred.
Staff knew how and when to involve other health and social care professionals. We saw lots of evidence of this during our inspection.
Is the service caring?
People were supported by kind and attentive staff. We saw that staff engaged with people in a positive way and showed respect and kindness. People commented, 'The staff are brilliant, I love it here.'
People's needs had been assessed and care plans put in place which detailed people's needs and preferences. These records provided guidance to staff on what care and support was needed.
People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.
Is the service responsive?
People had regular opportunities to be involved in a range of activities in and outside the service, which provided development of a range of skills and of their independence. These were well recorded within people's care plans along with regular evaluations and updates. The home has its own transport, which helped to keep people involved with their local community.
There was clear evidence contained within people's care plans to show how they worked with other health and social care professionals. We observed people being supported to attend appointments on the day of our visit.
Is the service well-led?
The service worked well with other agencies and services to make sure people received their care in a joined up way.
The home had a registered manager, who was supported by regional staff and the directors. Audits and checks were completed regularly to monitor the quality of service provision.
People using the service, their relatives, friends and other professionals involved with the service completed a six monthly satisfaction survey.
Staff were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and were knowledgeable about people's needs. This helped to ensure that people received a good quality service at all times.
During the visit, we met seven people who used the service. All were extremely complementary about the staff and the service. People said 'They have been great here, I have learnt so much', 'I go to college now and that is down to the staff being so helpful' and 'It is great here.'
We found that staff continually sought people's views and asked their opinions. We saw they worked in partnership with people and tasks such as cooking were completed in a collaborative manner. Staff told us the home was run much like a large family. We found that staff had a good understanding of how to best meet each person's care needs.
We found that the provider had ensured staff were equipped to meet people's needs. Staff understood the requirements of the Mental Capacity Act 2005 and Mental Health Act 1983 (amended 2007). A system was in place for dealing with concerns and the complaints procedures were well understood by all.