CQC report explained · a nursing home
What the CQC found at Coxwell Hall and Mews Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Risks such as falls, fire, malnutrition, choking and distress were assessed, although inspectors found one open first-floor window and recommended better advice for medicines given covertly.
- Effective?
- Good
- People’s needs were assessed and reviewed, staff had relevant training, and people were supported with healthcare, eating, drinking and hydration. Some staff supervision sessions had been missed earlier in the year but had been rescheduled.
- Caring?
- Good
- Staff were respectful, kind and attentive. People’s dignity, privacy, independence, choices and individual communication needs were supported.
- Responsive?
- Good
- Care was planned around people’s preferences and needs. People were supported with activities, relationships, communication, complaints and end-of-life planning.
- Well-led?
- Good
- Interim management arrangements were working and an improvement plan was making progress. However, some quality checks did not yet analyse incidents, food and fluid records or behaviour records for patterns, and work on records, supervision and the environment was still in progress.
What inspectors found, October 2022
Rated Good overall; inspectors found kind, safe care, but the home’s leadership and some record-keeping needed improvement.
Inspectors visited without notice on 20 and 21 July 2022. They spoke with people living in the home, relatives, staff and a visiting professional. They observed care and reviewed care files, medicines records, staff files, training records, complaints and management checks.
The home was rated Good overall and was rated Good for Safe, Effective, Caring and Responsive. People were generally safe, treated with kindness and supported to have their health, communication, food, activities and personal choices considered.
The detailed report rated Well-led as Requires improvement, although the ratings table at the start of the report shows Good. Inspectors found that management changes and improvement work were progressing, but some quality checks, records and building work were not yet complete.
The overall rating fell from Outstanding at the previous inspection, published on 3 January 2020. The inspection was prompted partly by concerns about people’s care and the condition of the environment.
Kind and respectful care
Inspectors saw staff supporting people with compassion and respect. People’s privacy, dignity and independence were maintained.
“People were treated with compassion, kindness and respect.” from the report
Enough suitable staff
Inspectors found enough skilled and experienced staff to meet people’s needs and choices. Recruitment checks were also completed.
“There were enough skilled and experienced staff deployed to meet people's needs and choices and to support the smooth running of the service.” from the report
Support with food and drinks
People were positive about the food and were supported to choose what they ate and drank. Inspectors saw staff paying close attention to hydration during a heatwave.
“People were supported to make food and drink choices.” from the report
Personalised dementia support
The home used the Butterfly approach to understand people as individuals and tailor care to their needs and preferences. The building also used coloured doors and memory boxes to help people find their way.
“The care home had adopted the Butterfly approach to dementia care; this meant people's care was tailored to their individual needs and preferences.” from the report
Medicines hidden in food or drink
needs fixingSome people received medicines covertly, but staff had not obtained advice from a pharmacist or another appropriate source. This meant there was uncertainty about whether giving the medicines this way could affect how they worked.
“We recommend the provider, ensures, advice is taken from an appropriate source, on the safe administration of medicines, before these are added to foods or fluids.” from the report
Quality checks did not identify patterns
needs fixingRecords about food and fluid intake, behaviour and accidents were completed but were not being analysed for trends. The provider later described processes introduced to improve this.
“At the time of the inspection we were told by managers that although records pertaining to people's fluid and food intake, behaviour and accidents and incidents were completed, they were not analysed to look for trends and patterns” from the report
Repairs and refurbishment unfinished
needs fixingAudits had identified environmental improvements. Refurbishment had been delayed by the pandemic, and repairs to windows and the roof were still being organised.
“A program of refurbishment had been delayed due to the pandemic and was due to commence in September 2022.” from the report
Management and records still developing
minorThe registered manager was absent and an interim manager was running the home. Electronic care records, hospital passports and some staff competency and supervision records were still being developed.
“Some actions were still in progress at the time of the inspection, which included, for example, the development of electronic care records, the maintenance of staff competency and supervision records and the introduction of hospital passports.” from the report
- 01How are medicines given hidden in food or drink now checked, and has advice from a pharmacist or another appropriate source been obtained?
- 02How do you now analyse accidents, incidents, behaviour records and food and fluid records for patterns or changes in people’s risks?
- 03What work has been completed on the windows, roof and other refurbishment identified in the environmental audits?
- 04Has the electronic care records system been fully introduced, and are hospital passports now in use?
- 05Who is currently responsible for managing the home, and how are staff supervision and competency records being kept up to date?
This was an unannounced inspection covering all five key questions and infection prevention and control; the overall rating changed from Outstanding at the previous inspection to Good, while the detailed Well-led section said Requires improvement. This explanation was written from the published report of 1 October 2022 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, January 2020
Rated Outstanding; inspectors found exceptionally caring, personalised support and strong leadership, with safety rated Good.
This was an unannounced inspection by two inspectors on 6 November 2019. They spoke with people, relatives, staff and professionals. They observed care and reviewed care plans, medicines records, recruitment records and other management records.
The home was rated Outstanding overall. Effective, Caring, Responsive and Well-led were all rated Outstanding. Safe was rated Good and had stayed at that level since the previous inspection.
Inspectors found sufficient staff, safe medicines practice and good risk management. They also found highly personalised support for people with dementia, mental health conditions and other complex needs. The previous overall rating was Good, published in May 2017.
Support for complex needs
Staff were particularly skilled at understanding and responding to distress. Inspectors saw this improve people's wellbeing and, in some cases, reduce distressed behaviour.
“The staff excelled in managing people's complex needs, including distressed behaviours by using responsive techniques that had a positive impact on people's well-being.” from the report
Kind and respectful care
The home had a warm atmosphere. Staff spent time with people, valued their individuality and supported their dignity and independence.
“There was a warm, welcoming atmosphere that was promoted by caring, compassionate staff.” from the report
Personalised activities
Activities were part of everyday life and were adapted to individual interests. The whole staff team helped people take part.
“The whole team had an outstanding approach to providing and contributing to keeping people occupied.” from the report
Strong quality monitoring
The home used regular audits and action plans to monitor care and make improvements. Inspectors found these systems effective.
“There was a strong quality assurance framework in place providing robust reassurance to the provider that the quality of the service was constantly being monitored and improved.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you assess whether my relative's complex needs can be met before they move in?
- 02How do staff record and respond to my relative's triggers for distress or challenging behaviour?
- 03How will you involve my relative and our family in care plan reviews and important decisions?
- 04What activities and community opportunities would be available for my relative's individual interests?
- 05How do you monitor medicines, staffing levels and risks specific to my relative?
This inspection looked at the care home, including accommodation and nursing or personal care, and assessed all five key questions. This explanation was written from the published report of 3 January 2020 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 Coxwell Hall and Mews Nursing Home
5 rated inspections over 8 years: the service has held its Good rating throughout.
- October 2022Goodcurrent ratingdown from OutstandingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Coxwell Hall and Mews Nursing Home →
- January 2020Outstandingup from GoodSafe: GoodEffective: OutstandingCaring: OutstandingResponsive: OutstandingWell-led: Outstanding
Read what inspectors found at Coxwell Hall and Mews Nursing Home →
- May 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2016Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2014GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Outstanding
- May 2013
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 20 January 2011.
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
38 live-in carers within about an hour of Oxfordshire
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 £1,300 a week. 32 can care for a couple. 12 years' experience on average.
“We can all fully relax around Nyarai and she feels like part of our family, which is no mean feat!”
“She was v competent and confident and we felt our mum was safe in her care. She supported us through a difficult time.”
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.