CQC report explained · a nursing home
What the CQC found at Coxhill Manor Nursing and Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected by suitable staffing, recruitment and infection control arrangements. However, prescribed drink thickening agents were not always stored safely, which put people at risk of choking, and the provider acted immediately.
- Effective?
- Good
- People's needs were assessed and reviewed, staff were trained, and people received support with food, drink and healthcare. One mental capacity assessment was not decision-specific, although consent had been sought appropriately.
- Caring?
- Good
- People and relatives spoke positively about staff. Inspectors saw respectful, warm interactions, and found that people's privacy, dignity, independence and choices were supported.
- Responsive?
- Good
- Care was personalised to people's needs, preferences and communication requirements. The home offered flexible activities, involved people in care planning and responded to complaints in line with its procedures.
- Well-led?
- Good
- Inspectors found positive leadership, an open culture and systems to monitor quality. Managers and staff showed a commitment to personalised care and had an action plan for improvements.
What inspectors found, December 2019
Rated Good; inspectors found kind, personalised care, but thickening agents were not always stored safely.
This was an unannounced inspection on 05 September 2019. Inspectors observed care, spoke with people, relatives and staff, and checked care, medicines, recruitment and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People said staff were kind, respectful and quick to respond. Inspectors also found enough staff, good infection control, personalised care, suitable activities and positive leadership.
There was one safety concern. Drink thickening agents were not always stored safely, creating a choking risk. The provider acted immediately during and after the inspection. Inspectors also found one mental capacity assessment that was not decision-specific, although the person's consent had been sought appropriately.
The previous inspection in December 2016 also rated the home Good. This report says the ratings remained the same.
Kind and respectful care
People and relatives described staff as kind and caring. Inspectors observed staff treating people with warmth, respect and patience.
“People told us they felt cared for by a staff team that were kind and considerate.” from the report
Personalised support
Staff knew people's needs, preferences and communication requirements. Care plans were reviewed and bedrooms reflected people's interests.
“This enabled them to provide personalised care tailored to the needs and wishes of the individual.” from the report
Food and healthcare
People were offered varied food and choices at mealtimes. Staff supported access to healthcare professionals when needed.
“People were supported to eat a varied and nutritious diet.” from the report
Staffing and cleanliness
Inspectors found planned staffing levels were achieved and staff responded promptly. The home was clean and staff followed infection control procedures.
“Throughout the inspection there was a calm atmosphere and staff responded promptly to people who needed support.” from the report
Positive leadership
People spoke positively about the management team. Inspectors found a positive culture and a commitment to improving the service.
“The provider, managers and staff were enthusiastic and committed to further improving the service delivered for the benefits of people using it.” from the report
Unsafe storage of thickening agents
seriousDrink thickening agents were kept in some people's rooms and in communal cupboards that were easily accessible. Inspectors said this created a choking risk, although the provider acted immediately to address it.
“Prescribed drink thickening agents were not always stored safely which put people at risk of choking if they ingested the thickener.” from the report
Mental capacity record
minorOne mental capacity assessment was not decision-specific and did not follow good practice. Inspectors were satisfied that this was a documentation issue and that the person's consent had been sought appropriately.
“We found one example were a person's mental capacity assessment did not follow good practice in that it was not decision specific.” from the report
- 01How are prescribed drink thickening agents stored now, and how do you check that they cannot be accessed by people at risk of choking?
- 02What action was taken after inspectors found thickening agents in people's rooms and accessible communal cupboards?
- 03How do you make sure mental capacity assessments are specific to the particular decision being made?
- 04How are people's food choices, communication needs and personal preferences recorded and kept up to date?
- 05How do you use feedback from people and relatives to monitor and improve the service?
This was an unannounced inspection covering all five CQC questions; all five ratings were given and each remained Good from the previous inspection. This explanation was written from the published report of 18 December 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, December 2016
Rated Good; inspectors found safe, kind and responsive care, with some mixed views about the food.
This was an unannounced comprehensive inspection. Inspectors spoke with people living at the home, relatives, staff and the manager. They observed care and checked care plans, medicines records, staff files, training records, complaints, accidents and quality checks.
The inspectors found all five areas were Good: Safe, Effective, Caring, Responsive and Well-led. They found enough staff, safe medicines practice, suitable staff checks and training, personalised care plans, good access to health professionals and respectful care.
People were involved in activities, menu choices and decisions about the home. The report also records some less positive views about food, including that it could sometimes be cold or better. The previous inspection in February 2014 had found no concerns.
Staffing and safety
Inspectors found enough staff to meet people's needs. Staff knew how to recognise and report abuse, and risks were assessed and reviewed.
“There were sufficient staff present to meet people's care needs.” from the report
Kind and personal care
Staff knew people's histories, preferences and abilities. Inspectors saw warm interactions and care that supported privacy, dignity and independence.
“Interactions with people from staff showed kindness and compassion.” from the report
Personalised activities
People helped choose activities and staff adapted them to individual interests, hobbies and life stories.
“Dedicated activity co-ordinators spent time looking at people's needs and wishes and developed activities based on the people who lived at the home.” from the report
Open management
People and staff could give feedback and make suggestions. The home used audits and feedback to make changes.
“The quality assurance audits in place were robust and had been used as an opportunity to learn and improve for the benefit of people and staff.” from the report
Mixed views about food
minorMost people liked the food and had choices, but one person said it could sometimes be cold and a relative thought it could be better. Inspectors also noted that the kitchen was working to make pureed food more appetising.
“The food is good but it can sometimes be a bit on the cold side.” from the report
- 01What checks are now made to ensure meals are served at the right temperature?
- 02How do you respond when someone is unhappy with the food or needs a modified diet?
- 03How will my relative and our family be involved in monthly care plan reviews?
- 04How do you make sure staffing levels remain sufficient when people need two staff members or have changing needs?
- 05Which activities would suit my relative's interests, abilities and life history?
This was an unannounced comprehensive inspection covering all five key questions, and the previous inspection in February 2014 had found no concerns. This explanation was written from the published report of 9 December 2016 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 Coxhill Manor Nursing and Residential Home
2 rated inspections over 3 years: the service has held its Good rating throughout.
- December 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Coxhill Manor Nursing and Residential Home →
- December 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Coxhill Manor Nursing and Residential Home →
- March 2014
Report published without a new overall rating.
- July 2013
Registered with the Care Quality Commission on 4 July 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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