CQC report explained · a residential care home
What the CQC found at Coxbench Hall
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, June 2018
Rated Good; inspectors found safe, kind and responsive care, with some minor record-keeping issues.
This was an unannounced inspection on 27 February and 6 March 2018. Inspectors spoke with people living in the home, relatives, staff and health professionals. They observed care and checked care records, staff files, medicines systems and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People told inspectors they felt safe and well cared for. Inspectors found that medicines, staffing, risk management, food, health support and safeguarding were generally handled well.
The inspection followed an earlier Requires Improvement rating and a Warning Notice linked to medicines. Inspectors found that medicines management had improved. They did identify some minor recording errors, including medicine fridge temperatures and one person's dietary information, and these were raised with staff.
Safer medicines
Inspectors found that medicines were now managed safely after earlier concerns. Staff had training, guidance and checks to support safe administration.
“People's medicines were managed safely and in accordance with professional guidance.” from the report
Kind and respectful care
People described staff as kind and helpful. Inspectors saw calm care that respected people's privacy, dignity and choices.
“People felt supported by staff who provided care in a good-humoured, friendly, dignified and compassionate way.” from the report
Individual support
Care plans included people's preferences, life histories and communication needs. Activities were offered around what people wanted to do.
“The provider offered a range of group and individual activities that met people's preferences.” from the report
Suitable staffing and training
Inspectors found enough staff and saw evidence of recruitment checks, induction, ongoing training and competency checks.
“There were enough staff to provide the care and support people needed.” from the report
Good involvement and listening
People and relatives were involved in care reviews and were given regular chances to comment or complain. The provider acted on feedback.
“People and relatives had regular opportunities to provide feedback on the quality of their care.” from the report
Medicine records
needs fixingMedicine fridge temperatures were not always recorded daily, and there were other minor recording errors. Staff took action when inspectors raised these points.
“We identified that medicine fridge temperatures were not consistently recorded every day, and raised this with the manager.” from the report
Confidential information
minorA computer containing confidential care information was left unlocked on two occasions. Staff secured it after inspectors raised the issue.
“We noted two occasions when a computer in a lounge, containing confidential information about people's care, was left unlocked.” from the report
Dietary information
needs fixingThe quality checks had not identified a gap in one person's care records. Staff said they would make sure dietary information was consistently available to kitchen and care staff.
“We identified that the audit system had not picked up a gap in one person's care records, and spoke with staff about this.” from the report
No registered manager
minorThere was no registered manager in post during the inspection. The manager's application to become registered was in progress.
“Coxbench Hall did not have a registered manager in post at the time of our inspection visit.” from the report
- 01How do you now check medicine fridge temperatures and other medicine records every day?
- 02How do you make sure each person's dietary needs are clearly available to kitchen and care staff?
- 03Has the manager's application to become the registered manager been completed, and who is legally responsible for the home now?
- 04What safeguards are in place to stop computers containing care information being left unlocked?
- 05How are people's individual activities, family contact and end-of-life wishes recorded and reviewed?
This was an unannounced comprehensive inspection of all five key questions, following earlier concerns about medicines and risks linked to falls. This explanation was written from the published report of 8 June 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.
What inspectors found, March 2017
Rated Requires Improvement; inspectors found improvements but medicines were not always stored, given or recorded safely.
This was an unannounced focused inspection on 4 January 2017. Two inspectors, including a pharmacy inspector, reviewed medicines records for 12 people, checked medicine stocks for four people and examined the auditing process.
Some improvements had been made since the previous inspection. Care plans and risk assessments had been updated. Medicines were stored securely and stock levels were checked, but there were still problems with fridge temperatures, opening dates, medicine records and as-needed medicines.
The home was rated Requires Improvement overall. Safe and well-led were both rated Requires Improvement. The inspection only looked at these two areas, so it did not provide new ratings for Effective, Caring or Responsive.
Updated care records
Care records had been updated and risk assessments were complete. The home also had a system for continuing to improve care records.
“Care records had been updated and risk assessments were complete.” from the report
Secure medicine storage
Medicines were stored securely, and medicine stock levels were checked during each medicine round.
“Medicine stock levels were checked at each medicine round to help ensure an effective stock management system.” from the report
Previous warning concerns resolved
The report says improvements had resolved the concerns linked to the warning notice issued after the earlier inspection.
“At this inspection we found improvements had been made and the concerns raised around the Warning Notice issued had been resolved.” from the report
Medicine storage
seriousSome medicines needing special storage were not kept at the correct temperature. Opening dates and fridge temperatures were not always recorded, so staff could not be sure medicines remained safe and effective.
“We saw medicines had not been stored in line with the manufacturers guidelines and this put people at risk from receiving unsafe or ineffective medicines.” from the report
Incomplete medicine records
seriousThree of the 12 medicine administration records did not have all the required staff signatures. In some cases, records did not clearly show whether medicines had been given as prescribed.
“We were unable to identify clearly whether people had received their medicines as prescribed.” from the report
Creams and as-needed medicines
seriousRecords did not clearly show where creams had been applied or when as-needed medicines had been given. This created a risk of treatment being missed or given too soon.
“Where medicines were required to be given 'as required' there were not consistent records kept of these.” from the report
Audits did not find all gaps
needs fixingThe home's checks had improved but did not identify the continuing problems with medicine records. The CQC said the home needed to demonstrate consistent good practice over time.
“Audits had failed to alert the registered manager to this.” from the report
- 01How are you now recording fridge temperatures, including maximum and minimum temperatures, for medicines that need refrigeration?
- 02How do you check that every medicine administration record is signed accurately and shows whether each medicine was given as prescribed?
- 03How do you record the opening date and disposal date for medicines with a short shelf life after opening?
- 04How do you record where creams are applied and the timing of as-needed medicines so doses are not missed or given too soon?
- 05What action did you report to the CQC after this inspection, and what evidence shows that the medicine problems have been fixed?
This was a focused inspection of Safe and Well-led only; Effective, Caring and Responsive were not assessed in this visit. This explanation was written from the published report of 29 March 2017 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 Coxbench Hall
4 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- June 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2017Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- January 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- July 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 6 December 2010.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
62 live-in carers within about an hour of Derbyshire
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 £1,010 to £1,260 a week. 51 can care for a couple. 12 years' experience on average.
“Ernest is an amazing professional carer who delivers care from the heart.”
“We particularly appreciate the companionship Dawn gives in the evenings when she plays cards and Scrabble with my mother.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.