About the service 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.