Oxford House is a care home for six adults with a learning disability. The home is a large, Victorian, detached house close to Worthing town centre. Rooms are single occupancy, four having en-suite facilities and one person is accommodated in a detached bungalow in the grounds of Oxford House. Communal areas include a large kitchen, dining room and sitting room. People have access to a rear garden.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Staff described procedures that were in place to safeguard the people they supported. They fully understood the safeguarding policies and procedures and felt confident to raise a concern and thought they would be listened to.

Recruitment systems at the home continued to be safe and robust. There were sufficient trained and competent staff to meet people's individual assessed needs. All staff undertook an induction at the start of their employment and completed shadow shifts to fully understand their role and the people they supported. The staff were supported by the management team through on-going supervision and team meetings.

Medicines were ordered, stored, administered and disposed of in accordance with best practice guidelines. All staff had undertaken medicines training and had their competency assessed annually or when needed. The registered provider had medicines policies and procedures in place.

The design and layout of the building was hazard free and met the needs of people who lived there. All areas of the home were clean and in a good state of repair with equipment maintained.

People received care that was personalised and responsive to their needs. People's needs that related to age, disability, religion or other protected characteristics were considered throughout the assessment and care planning process.

People were supported with their nutrition and hydration needs. Clear guidance was available for staff to follow when people had specific dietary needs. People spoke positively about their mealtime experiences and told us they were always offered choice.

We observed kind and caring interactions between people and staff. People living in the home and a relative praised the caring nature of the care staff and registered manager. People were supported to increase their independence and maintain strong links with their families. People were involved in planning their care and supported to undertake activities of their choice.

The registered provider had a clear complaints policy and procedure that people and their relatives were familiar with and felt confident any concerns would be listened to.

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.

The registered manager was accessible, supportive and had good leadership skills. Staff were aware of the values of the provider and understood their roles and responsibilities. Morale was good within the workforce.

The service had a quality assurance system and shortfalls were identified and addressed. There was a culture of listening to people and positively learning from events so similar incidents were not repeated. As a result, the quality of the service continued to develop.

Further information is in the detailed findings below.

The inspection took place on 11 November 2015 and was unannounced.

Oxford House is registered to provide accommodation and care for up to six people with a learning disability, Asperger’s syndrome and/or challenging behaviour. At the time of our inspection, there were six people living at the home. Oxford House is a large, Victorian, detached house close to Worthing town centre. Rooms are single occupancy, four having en-suite facilities and one person is accommodated in a detached bungalow in the grounds of Oxford House. Communal areas include a large kitchen, dining room and sitting room. People have access to a rear garden.

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.

Some people’s risk assessments had not been reviewed within a six month period, in line with the provider’s policy. Some staff had not received an annual appraisal. However, this did not impact on people’s care and welfare and both the provider and registered manager had identified these areas for improvement. People were involved in all aspects of the service and their feedback was obtained. Residents’ meetings were held. Staff felt supported by the management and spoke positively about working at Oxford House. Systems were in place to monitor the quality of care delivered. Shortfalls had been identified by the provider and were similar to what we found at inspection.

People were protected from the risk of potential abuse and harm and staff knew what action to take if they suspected abuse was taking place. Risks to people were identified, assessed and managed appropriately. Advice and guidance was available to staff on how to look after people safely and to mitigate any risks. There were sufficient numbers of staff on duty to support people. Safe recruitment practices were in place. Medicines were managed safely.

Staff had received all essential training and there were opportunities for them to participate in additional training or qualifications. New staff followed the provider’s induction programme and went on to complete the Care Certificate, a universally recognised qualification. Staff had received training relating to the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and put this into practice. People were not restricted unnecessarily and the registered manager had undertaken capacity assessments for people living at the service. Where people displayed behaviour that might challenge, staff used de-escalation techniques to calm people. People were supported to have sufficient to eat, drink and maintain a balanced diet. They had access to a range of healthcare professionals. People were involved in decisions and choices about the environment and had chosen decorations for their rooms and for communal areas.

Positive, warm, caring relationships had been developed between people and staff. Staff knew people well, how they wished to be supported and their likes and dislikes. Care plans were person-centred and provided comprehensive, detailed information and guidance for staff about people. People were treated with dignity and respect and their privacy was maintained.

People met with their keyworker every month to discuss their care. Keyworkers co-ordinated all aspects of their care and recorded discussions held at the monthly meetings, then people would sign the report. People were encouraged to stay in touch with their families and friends. They had access to the community and were involved in a range of activities, including attendance at college for some people. There was a complaints policy in place and complaints were managed appropriately.

We spoke with two people who lived there, one of whom lived in a bungalow on the premises, three staff members and the manager. We read two care plans, three staff files and other records. We observed interactions between staff and people who lived there, including those with people who did not communicate verbally.

People who lived there told us they were "very happy". One person said "it's a lovely house."

We saw staff treated people with dignity and respect and protected their privacy. We observed relaxed communication and interactions between the staff and people who lived there and examples of how people were involved in their own care and support and the running of the house.

The care plans we read contained detailed records. These included assessments of need, plans of care and support, risk assessments and other records necessary for staff to understand how to assist the people who lived there. We saw staff assisting people in a consistent way.

We saw and people who lived there told us they thought the home was clean. They were involved in the housekeeping if appropriate.

The necessary checks were completed in the staff files we looked at. Staff told us they felt "very well supported" by the manager. Not all staff had received the training which the organisation deemed necessary to carry out their work.

There were systems in place to monitor and review the quality of the service.

At the time of the inspection there were five people living at the service.

During our inspection there were two people were in the house the other three people were completing activities in the community.

We saw staff treating people in a sensitive, respectful and professional manner.

We saw evidence of the staff treating people who use the service with dignity. This was evident by the way they communicated with the people who use the service as they prepared to get ready for their outing into town. Residents were given support to chose appropriate clothing and in planning what activities they wanted to engage in whilst out.

We spoke to people who use the service and they said that they were treated with dignity and respect. One person we spoke to said “the staff are very warm and caring, and I feel safe living at the home, staff listen to what you have to say and I feel that I have a voice”.

We saw that the home at several measure in place to ensure that a hygienic environment was maintained, and cross-infection prevented where possible. There were several hand washing posters on the walls and in the toilet areas.

We saw evidence that the staff had completed Safeguarding training, as part of their mandatory training.

We saw that the home was adequately staffed. The manager told us that at present they employed seventeen care staff.

People told us that they liked living at Oxford House and were supported to take part in activities that they enjoyed.

People told us that they are supported to develop their skills and they felt respected as individuals.

Staff told us that they felt that they were supported and trained to carry out their roles and meet the needs of people who use the service.