We undertook an unannounced inspection of Oxenford House on 11 January 2018.

Oxenford 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. It is a member of the Abbeyfield Society and is a purpose built care home registered to provide care and accommodation to up to 25 older people. On the day of our inspection, 21 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:

The service continued to provide support in an extremely caring way. Staff supported people with exceptional kindness and compassion and went the extra mile to provide support at a personal level. Staff knew people very well and many referred to them as family. Staff respected people as individuals and treated them with dignity whilst providing a high level of emotional support. People, and their relatives, were fully involved in decisions about their care needs and the support they required to meet those individual needs

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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 at the service that valued people, relatives and staff and promoted a caring ethos that put people at the forefront of everything they did.

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.

People had access to information about their care and staff supported people in their preferred method of communication.

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 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 10 December 2015. It was an unannounced inspection.

Oxenford House is a residential home registered to provide care and accommodation to up to 25 older people. On the day of our inspection 24 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 told us they benefitted from caring relationships with the staff who knew how to support them. Staff were supported through supervision, appraisal and training to enable them to provide the high degree of care we observed during our visit.

Staff understood the needs of people, particularly those living with dementia, and provided care with kindness and compassion. People spoke positively about the home and the care they received. Staff took time to talk with people and provide activities such as and arts and crafts, games and religious services.

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 received their medicines safely as prescribed. Staff assessed risks associated with people's care and took action to reduce risks.

There were sufficient staff to meet people’s needs. The service had robust recruitment procedures in place which ensured staff were suitable for their role. Background checks were conducted to ensure staff were of good character.

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’s capacity to make decisions was assessed appropriately.

People told us they were confident they would be listened to and action would be taken. The service had systems to assess the quality of the service provided in the home. Learning was identified 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 their preference respected and acted upon.

People were supported to maintain good health. Referrals to healthcare professionals were timely and appropriate and any guidance was followed. Healthcare professionals spoke positively about the service.

All staff spoke positively about the support they received from the registered manager. Staff told us

they 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.

The service maintained links with the local community through local schools, groups and businesses. Volunteers worked in the home and people engaged with local events in the community.

The registered manager led by example and had empowered staff. Their vision that the service should be a home for people, where they were treated as family members, was echoed by staff.

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Oxenford House is currently registered for the regulated activity diagnostic and screening procedures. The home does not need to be registered for this regulated activity. This will be removed from the homes registration.

On the day of our visit we spoke with eleven people who used the service and two relatives. One person told us “It’s a really nice place to live”.

Staff had detailed knowledge about the people who lived at the home and they talked about them with respect. Care workers were friendly, sociable and spent time chatting with people. People told us that they felt Oxenford House was a safe place to live. Staff at Oxenford House had recently won an award from Age UK for demonstrating exceptional qualities of dignity in care for older people.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan which was person centred and regularly reviewed. There was a choice of suitable and nutritious food and drink. There were three choices of main meals and two puddings available on a daily basis. Drinks and snacks were also available in between meals.

People were protected against the risks associated with medicines because there were appropriate arrangements in place to manage medicines.

The manager and senior care workers monitored the quality of the service. Monthly quality checks were conducted which looked at all areas of the home, including people’s care, care plans and kitchen arrangements.

People we spoke with told us that they felt involved with the running of the home, one person told us “We are asked from time to time if we are happy with the care we are given” One person told us “they look after us very well”. Another said “my mother has received excellent care, staff are thoughtful and considerate.”

We also observed staff supporting people, treating people with respect and dignity and attending to people promptly. We also looked at records and spoke with staff who supported people living at the home. We spoke with four members of staff during our visit. Staff were seen to enjoy what they were doing and people being cared for were happy and relaxed. The atmosphere in the home was calm and ordered. We also observed a communal area and saw that staff were frequently in and out asking people if they were ok or wanted a drink.

We saw that medicines were kept safely and that appropriate arrangements were in place in relation to the recording and administering of medicines.

The home had enough staff on duty to meet the needs of the people. One person told us “we get well looked after”. Another person said “I like all the staff.”

One relative commented that “the standard of care at Oxenford House is most impressive especially to one whose previous knowledge of residential care was gleaned from adverse reports in the media”