Oxton Manor

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 66 (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 proactive and positive culture of safety. Systems were in place to record and monitor accidents and incidents. Staff understood the process for reporting and recording events which occurred. Events were reviewed on a regular basis by the registered manager and reflections were recorded. This enabled them to analyse trends, identify any lessons learnt and work with people to identify why events had happened, and how to avoid situations in the future.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. Family members told us they were kept informed if a person’s needs changed or they needed to go to hospital. One family member told us, “I am notified if anything’s going on.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Systems were in place to protect people from the risk of abuse. Staff received training and understood the actions they must take if they felt someone was being harmed or abused. One staff member told us, “I’ve never had to raise concerns myself, but I feel if I ever did it would be dealt with.” Referrals had been made to the local authority safeguarding team when abuse had been suspected, and investigations had been completed. Information explaining how people could raise concerns if they felt someone was being abused was displayed.

Some people were being deprived of their liberty through the deprivation of liberty safeguards (DoLS) framework. Any authorised restrictions, including door sensors to alert staff to a person’s movements within the service were accurately reflected in peoples care plans.

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. One person’s bedroom was very cluttered. Staff had not always been proactive in encouraging the person to mitigate the potential health and safety risks this created. Care plans were detailed around people’s needs, however, some lacked sufficiently detailed risk assessments. These shortfalls were addressed when raised, and we were assured people received appropriate care. Family members told us they felt people received safe care. Appropriate care plans had been developed with people to mitigate other risk through positive behaviour support planning. This ensured any instances of distress were managed safely and, in a person-centred way.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care. Hallway lighting came on via a sensor however, the timer setting was too short to maintain sufficient lighting. This was immediately raised and addressed by the provider. Fire records were completed within different record templates, so it was difficult to gain assurance these had been completed. The registered manager had purchased a new fire book based on a recommendation of an external professional and told us this was being put in place to streamline the records. Routine checks on the environment and equipment were up to date and certificates were in place to demonstrate this. There were ample communal spaces for people to choose to spend time with others or have their own space. These areas were decorated and contained facilities which where appropriate to people’s sensory needs.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. Staff were safely recruited and inducted; appropriate checks had been made before applicants were offered employment. Staff received training to effectively support people with a learning disability and autistic people. A staff member told us, “There is enough training around people’s needs.” Staffing levels were safe, and there were enough staff on duty to support people to access a variety of activities both within the service and out within their local community.

The provider did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading or share concerns with appropriate agencies promptly. The home was generally clean and tidy, however, some parts of the environment including some net curtains needed cleaning and one mattress needed to be replaced. Some metal bins needed replacement. The registered manager took prompt action to address and resolve all the shortfalls we raised and was in the process of working through an action plan for improvements identified by the local infection prevention and control team following a recent visit. Staff had access to adequate supplies of the personal protective equipment (PPE) they needed when assisting people with care.

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. When able, people had given their consent to receive support with this aspect of their care. Records of administration were maintained and in line with best practice. This included when people were prescribed creams. Guidance was in place for all prescribed medicines administered on an ‘as required’ basis. This helped staff to understand why certain medicines were prescribed; and under what circumstances they should be offered to a person. The effective use of ‘as required’ medicines was monitored and reviewed by the management team and professionals who worked with people. This ensured people were not at risk of being over medicated. Medicines were stored securely and only administered by staff who were suitably trained.