CQC report explained · a nursing home
What the CQC found at Loxley Hall
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found medicines were safely managed, risks were reviewed, staffing met people's needs, and infection prevention arrangements were suitable. People said they felt safe and staff responded promptly.
- Effective?
- Good
- This key question was not inspected during this visit. Its rating was carried over from the previous inspection.
- Caring?
- Good
- This key question was not inspected during this visit. Its rating was carried over from the previous inspection.
- Responsive?
- Good
- This key question was not inspected during this visit. Its rating was carried over from the previous inspection.
- Well-led?
- Good
- Inspectors found robust audits, regular provider oversight and an approachable management team. People, relatives and staff were asked for their views.
What inspectors found, July 2023
Rated Good; inspectors found safe care and stronger management, after earlier problems with medicines and oversight were fixed.
This was an unannounced inspection over three visits in May and June 2023. The inspector spoke with people, relatives and staff, and checked care records, medicines, staff files and management records.
The home was rated Good overall, with Safe and Well-led both rated Good. Inspectors found that medicines and risk assessments were now managed safely, staffing met people's needs, and infection prevention arrangements were suitable.
The home had previously been rated Requires Improvement, with breaches relating to safe care and governance. Inspectors found enough improvement had been made and the home was no longer in breach of those regulations.
People felt safe
People said they felt safe and described staff as kind. Inspectors also found staff understood how to report possible abuse.
“People told us that they felt safe living at Loxley Hall. They said, "Oh yes I do face safe, I have no worried at all" and "Staff are very kind and I feel comfortable with them".” from the report
Staffing met people's needs
Staffing levels were maintained according to people's needs. Inspectors saw people being helped promptly.
“People told us that there was always staff available to assist them and "They [staff] always come quickly if I need something".” from the report
Stronger quality checks
The home had introduced regular audits covering care plans, medicines, risks, dependency and the environment. Actions identified through these checks were addressed.
“The provider had a robust audit system in place. This helped ensure people received consistent quality care.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you continue to check that medicines are given safely and that staff remain competent to administer them?
- 02What happens when audits identify a problem with a care plan, medicine, risk assessment or the environment?
- 03How do you assess and review my relative's risks, including nutrition, dehydration and emergency evacuation?
- 04How will you support my relative to remain as independent as possible and manage any medicines they wish to manage themselves?
- 05How will you keep our family informed about falls, changes in needs or other important events?
This was a focused inspection of Safe and Well-led, including infection prevention and control; the other ratings carried over from the previous inspection. This explanation was written from the published report of 6 July 2023 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, June 2022
Rated Requires Improvement; inspectors found caring staff, but medicines, risk records and oversight were not always safe.
The unannounced inspection took place on 19 April 2022. Inspectors reviewed care and medicine records, recruitment files, management records and infection control. They also observed care and spoke with relatives and staff.
The home had enough staff and relatives said people felt safe. Staff were kind and patient, and infection control, complaints, accidents and healthcare referrals were managed appropriately. However, medicines were not always recorded or administered safely. Some people's health risks were not properly recorded, and daily notes did not always show that planned care had been provided.
The home was rated Requires Improvement overall. Safe and Well-led were both rated Requires Improvement. This means inspectors found some important weaknesses and limited assurance that people were always protected from avoidable harm. The previous overall rating was Good, published on 4 September 2019.
Kind and patient staff
Relatives gave positive feedback and inspectors saw people appearing comfortable with staff. Staff interacted with people in a caring and patient way.
“It was observed during the inspection that people were comfortable and happy in the presence of staff who interacted with them in a caring and patient manner.” from the report
Enough staff
Inspectors found that staffing levels appeared sufficient to meet people's day-to-day needs safely.
“During the inspection there appeared to be an appropriate number of staff on duty to safely meet people's needs.” from the report
Infection control
Inspectors were assured that the home had suitable arrangements for preventing and managing infections, including COVID-19.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Safeguarding and incident monitoring
Systems were in place to protect people from abuse. Accidents and incidents were reviewed to identify patterns and reduce the chance of them happening again.
“Accidents and incidents were reviewed regular to establish patterns and to minimise future occurrence.” from the report
Medicines records and administration
seriousElectronic medicine records contained duplicate entries and did not match the medicine stock. Cream records and instructions for medicines given when needed were also incomplete, so inspectors could not be sure medicines were administered safely.
“This meant that we could not be certain what medicines had been safely administered to people.” from the report
Care risk information
seriousCare plans did not always explain people's health conditions, warning signs or the support they needed. Daily records did not always show that staff had completed important monitoring, exercises or repositioning.
“The provider had not ensured risks in relation to people's care were properly managed to prevent avoidable harm.” from the report
Weak quality checks
seriousThe home's audits did not identify problems with risk management, medicines or agency staff checks. This meant management systems did not reliably identify or correct safety issues.
“The provider had failed to operate effective systems to ensure the quality and safety of the service which placed people at risk of harm.” from the report
Agency staff information
needs fixingSome agency staff files did not contain evidence of identity, suitability or training. Important information about people's risks was not always communicated effectively to agency staff.
“Important information about people at risk was not always effectively communicated to agency staff.” from the report
- 01What changes have been made to stop duplicate electronic medicine entries and ensure records match the medicines held?
- 02How do you now check that creams and medicines given when needed are administered and recorded correctly?
- 03How are people's health conditions, warning signs, fluid intake, catheter output, exercises and repositioning recorded and checked?
- 04How do you make sure agency staff have verified identity and training, and understand each person's risks, including thickened fluids?
- 05What evidence can you show of the action plan and the checks now used to make sure these problems do not happen again?
This inspection rated Safe and Well-led only; the report does not give ratings for Effective, Caring or Responsive. This explanation was written from the published report of 1 June 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.
Every inspection of Loxley Hall
3 rated inspections over 4 years: the service has held its Good rating throughout.
- July 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2022Requires improvementSafe: Requires improvementWell-led: Requires improvement
- March 2021Inspected but not ratedSafe: Inspected but not rated
- February 2019GoodSafe: GoodWell-led: Good
- October 2017
Registered with the Care Quality Commission on 30 October 2017.
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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84 live-in carers within about an hour of Cheshire West and Chester
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 £1,260 a week. 76 can care for a couple. 10 years' experience on average.
“She is an exemplary carer, she is knowledgable empathetic and very respectful in the home.”
“It was clear that she genuinely cared and her warm approach really helped put our minds at ease.”
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.