We carried out an announced inspection of Oxford House on 2 March 2017.

Oxford House is a domiciliary care agency providing care and support to more than 100 people living in their own homes. On the day of our inspection 169 people were receiving a personal care service.

At our last inspection on 3 February 2016 we found medicines were not always managed safely, medicine records were not always complete. This was a breach of Regulation 12 Health and Social Care Act (Regulated Activities) Regulations 2014. We also found the provider did not have effective systems in place to ensure the quality of the service was monitored and improved to ensure the regulations were met. This was a breach of Regulation 17 Health and Social Care Act (Regulated Activities) Regulations 2014.

In addition we recommended the service took action to ensure people's care records identified how they would be supported in line with the principles of the Mental Capacity Act 2005.

At this inspection on 2 March 2017 we found the provider had made improvements and had addressed these concerns.

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.

We were greeted warmly by staff at the service who seemed genuinely pleased to see us. The atmosphere in the office was open and friendly.

People told us they were safe. Staff understood their responsibilities in relation to safeguarding. Staff had received regular training to make sure they stayed up to date with recognising and reporting safety concerns. The service had systems in place to notify the appropriate authorities where concerns were identified.

People were supported by staff who were knowledgeable about people’s needs and provided support with compassion and kindness. People received high quality care that was personalised and met their needs.

Where risks to people had been identified, risk assessments were in place and action had been taken to manage these risks. Staff were aware of people’s needs and followed guidance to keep them safe. People received their medicines as prescribed.

There were sufficient staff to meet people’s needs. Staffing levels and visit schedules were consistently maintained. People told us staff were usually punctual and they had not experienced any missed visits. The provider followed safe recruitment procedures and conducted background checks to ensure staff were suitable for their role.

Most staff understood the Mental Capacity Act 2005 (MCA) and applied its principles in their work. The MCA protects the rights of people who may not be able to make particular decisions themselves. The registered manager was knowledgeable about the MCA and how to ensure the rights of people who lacked capacity were protected.

People told us they were confident they would be listened to and action would be taken if they raised a concern. The service sought people’s opinions through regular surveys and telephone monitoring calls. The service had systems to assess the quality of the service provided. Learning needs were identified and action taken to make improvements which promoted people’s safety and quality of life. Systems were in place that ensured people were protected against the risks of unsafe or inappropriate care.

Staff spoke positively about the support they received from the registered manager and senior staff. Staff supervision and meetings were scheduled as were annual appraisals. Staff told us the registered manager was approachable and there was a good level of communication within the service.

People told us the service was friendly, responsive and well managed. People knew the registered manager and staff and spoke positively about them. The service

We carried out this inspection on 3 February 2016. This was an unannounced inspection.

Oxford House provides domiciliary care services to people who live in their own home. The service provides support to people with a variety of conditions including people living with dementia. At the time of our inspection there were 139 people using the service.

The service had 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.

Medicines were not always managed safely and medicine records were not always completed accurately. Systems for auditing the quality of the service had not identified these issues.

People's care records did not identify how they would be supported in line with the principles of the Mental Capacity Act 2005. We have made a recommendation in relation to the Mental Capacity Act.

The service promoted a caring culture, led by the registered manager. The service constantly looked for ways to improve and had recently implemented a new management structure. Staff were positive about the improvement in the support they received as a result of the change. People were complimentary about the management of the service and felt confident to raise any concerns.

People were supported by staff who had the skills and knowledge to meet their needs. Staff were kind and caring and knew how to treat people with dignity and respect. Staff had access to training and development opportunities and were well supported by the management team. People told us they felt safe and staff visited them when required to assist them with personal care.

Care plans were personalised and identified how any assessed risks would be managed. Where people required support with eating and drinking this was included in their care plans along with any specific dietary requirements.

We found one breach of the Health and Social Care Act 2008. You can see what action we told the provider to take at the back of the full version of the report.