CQC report explained · a residential care home
What the CQC found at Oxton Manor
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, October 2019
Rated Requires Improvement; inspectors found kind, respectful care, but safety checks, staff training, temporary care plans and management systems needed improvement.
This was an unannounced inspection on 21 and 23 August 2019. One inspector observed care, spoke with a person using the service, relatives, staff and visiting professionals, and checked care, medicines, recruitment and management records.
The home was rated Requires Improvement overall. Safe, effective, responsive and well-led were also Requires Improvement. Caring was rated Good. Inspectors found people were treated kindly and respectfully, but some safety checks were missed, staff induction and training were not always strong, and some temporary residents did not have suitable support plans.
The manager accepted the feedback and took immediate action on several issues after the inspection. However, the home remained Requires Improvement, the same overall rating as at the previous inspection published on 23 August 2018. It had held this rating for two consecutive inspections.
Kind and respectful care
Inspectors saw that people were comfortable with staff and able to interact positively. Relatives said staff were caring and kind.
“On the day of the inspection we observed that people living in the home looked comfortable with the staff.” from the report
Choice and independence
People could move around freely, make choices about their care and access some household items independently. Staff supported people in the least restrictive way possible.
“This encourage people to carry out daily living tasks independently and when they chose to.” from the report
Communication support
The home recorded people's communication needs and provided information in different formats, including an easy-read complaints procedure.
“The service was meeting the Accessible Information Standards as they assessed, recorded and shared information regarding people's communication needs.” from the report
Healthcare and safeguarding
People were referred for healthcare assessments promptly when needed. Staff understood safeguarding and whistleblowing procedures.
“People had access to healthcare services when they needed it.” from the report
Missed safety checks
seriousSome safety systems were not reliable. An assistive technology device was not monitored, the annual gas check was overdue, and window restrictors were not appropriate.
“However, we identified that one person had assistive technology in place that was not monitored.” from the report
Medicines records
needs fixingOver-the-counter medicines had not been discussed with a GP. The temperature of refrigerated medicines was monitored but not recorded, although both issues were addressed after inspection.
“However, although the temperature was being monitored for refrigerated medicines this was not being documented.” from the report
Staff induction and recruitment
needs fixingNew staff induction was not robust and training was under review. Some recruitment documentation was incomplete, and some staff lacked experience in learning disability settings.
“The induction for new staff was not robust.” from the report
Temporary residents' plans
needs fixingPeople staying temporarily did not have suitable support plans for a significant period. The manager said this would be addressed immediately.
“However, those people who were staying on temporary basis did not have appropriate support plans in place and had not had for a significant amount of time.” from the report
Management oversight
needs fixingStaff did not always pass on information about people's care needs to the manager. The provider also did not send requested information before the inspection, and quality systems had not found the issues inspectors identified.
“Quality assurance process and systems had not identified issues we found during inspection.” from the report
- 01What evidence can you show that the gas check, window restrictor checks and assistive technology monitoring are now completed and reviewed?
- 02How are over-the-counter medicines discussed with a GP, and how are refrigerated medicine temperatures recorded?
- 03What induction and learning disability training does each new member of staff complete before working with residents?
- 04How do you make sure people staying temporarily have a complete support plan from the start?
- 05How are staff expected to report changes or problems in people's care to the manager, and how is this checked?
This was an unannounced planned inspection that looked at all five CQC questions, the premises and the care provided. This explanation was written from the published report of 24 October 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, August 2018
Rated Requires Improvement; inspectors found kind and effective care, but risks, care records and management checks were not always strong enough.
This was an unannounced inspection on 12 June 2018. Inspectors reviewed care files, staff files, training records, medicines records and management information. They looked around the home and spoke with people living there, a relative, the manager and staff.
The home was rated Good for effective care and for caring. Staff were trained, understood the rules about decision-making, and treated people with kindness and respect. People had choices, access to activities and support to become more independent.
The home was rated Requires Improvement for safety, responsiveness and leadership. Some risk assessments and care plans lacked important detail. Fire doors were found open because foot releases were not working, and some audits had not identified problems.
The home had improved since an Inadequate rating in October 2016. Enforcement action from that earlier inspection was cancelled after improvements were found in April 2017. CQC said further improvements were still needed at this inspection.
Kind staff
Inspectors saw caring and respectful interactions. People were supported discreetly and their privacy and dignity were maintained.
“We observed kind and caring interactions between staff and people using the service.” from the report
Safe medicines
Medicines were stored securely and administered by trained staff. Records included people's photographs, allergies and guidance for medicines needed at particular times.
“The administration of medication was safe and medication was stored securely at the home.” from the report
Training and support
Staff had training suited to their roles, regular supervision and support from the manager. Inspectors saw a broad range of training, including safeguarding and medicines.
“Staff received training appropriate to their role. They told us that they felt well supported and effective in their roles.” from the report
Choice and activities
People could choose when to get up, what to wear and what to eat. The home provided outings, swimming, discos and other social activities.
“We saw the quality and variety of activities available at the home.” from the report
Improvement since earlier inspections
The report records substantial improvement since the Inadequate inspection in October 2016. The manager and staff had improved the culture, staffing and environment.
“We found that Oxton Manor continued to improve however we identified that further improvements were needed.” from the report
Fire door safety
seriousTwo fire door foot releases were not working and doors were open. This had not been identified by maintenance checks or audits before inspectors raised it.
“We found that foot releases on two of the fire doors within the home were not working and fire doors were open” from the report
Care plans lacked detail
needs fixingCare plans used different formats and gave varying information. Some did not accurately describe people's current circumstances or explain how staff should respond.
“Care plans did not always reflect the needs of the people living in the home.” from the report
Inconsistent staff guidance
needs fixingStaff gave different accounts of how to support one person and whether another person showed certain behaviours. The report said this needed clarifying for safe and consistent care.
“This needed clarifying, so that there would be consistency and to ensure the person's care was safe and responsive to their needs.” from the report
Checks missed problems
needs fixingMonthly care-file audits had not found some information that needed updating. Audits also missed issues identified with risk assessments and fire doors.
“Some audits had not recognised issues that were identified during our inspection.” from the report
Recruitment records
needs fixingMost recruitment systems were in place, but the evidence for some safe recruitment decisions was not strong enough. One application was completed after the person started, and one DBS result had not been risk assessed.
“The registered manager was recruiting people known to her to positively influence the culture of the service; however, checks and evidencing of safe recruitment decisions to protect people using the services needed to be improved.” from the report
- 01How have you completed and scored the risk assessments for epilepsy and behaviours that challenge since this inspection?
- 02What checks now make sure fire doors and their release mechanisms are working and reported promptly?
- 03How do you make sure every care plan reflects the person's current needs and gives staff the same instructions?
- 04How do your audits now identify missing or out-of-date information in care files?
- 05What evidence do you keep to show that recruitment decisions are safe, including decisions based on DBS results?
This was an unannounced inspection covering all five CQC questions, including the premises and care provided; inspectors examined four care files, three staff files and a sample of medicines records. This explanation was written from the published report of 23 August 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Oxton Manor
5 rated inspections over 4 years: the service has slipped, from Good to Requires improvement.
- October 2019Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2017Requires improvementup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2016Inadequatedown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- March 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2014Inspected but not rated
- December 2013
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- February 2013
Registered with the Care Quality Commission on 12 February 2013.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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40 live-in carers within about an hour of Wirral
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,230 a week. 37 can care for a couple. 8 years' experience on average.
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