Coxwell Hall and Mews Nursing Home

People were accommodated in two parts of a building which were linked together. One part, purpose built called Lavender Court and the other, in the older part of the building called, The Folly. People had access to gardens from each building.

We have made a recommendation in relation to the covert administration of medicines.

Risk management processes were in place to mitigate or reduce risks to people's health and safety. This included falls from windows of height. A fire safety assessment had been completed by an external company and recommendations from this had been completed. People told us they felt safe and their relatives were reassured by the measures staff took to keep their relatives safe.

Safeguarding arrangements were in place to help protect people from abuse. Managers and senior staff worked with external health and adult social care professionals to safeguard people.

The service was staffed accordingly so people's needs were met and the running of the service overall, maintained. There were arrangements in place to keep the environment clean and to reduce the risk of infection.

People's care was delivered equally and without discrimination. The environment was adapted and decorated in a way which supported people who lived with dementia. Staff worked with a wide range of health and social care professionals to support people's access to health assessments, specialist treatments and appointments.

Staff were supported and trained to deliver people's care and treatment in line with best practice. People's eating and drinking needs were well supported.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were treated with compassion, kindness and respect. Those who were important to people were made to feel welcome and their involvement encouraged and seen by staff as being integral to maintaining people's wellbeing. People's dignity and privacy was maintained, and their information treated confidentially.

People's care and treatment was planned around their physical, emotional and spiritual needs. People's individual preferences, choices, aspirations and wishes were explored and incorporated into the planning of their care. This included at the end of their life to support a pain free and dignified death.

People had opportunities to take part in social activities and staff remained aware of the risk of loneliness and self-isolation for others.

Concerns and complaints could be raised and there was a process in place to acknowledge and address these.

The registered manager was absent from the service so interim management arrangements were in place and working well. During the pandemic the provider's quality monitoring of the service had been through virtual assessment and regular conference calls with managers, for information gathering and support purposes. The provider had subsequently commissioned an audit of the service, by an external company, to enable them to assess the service's performance. This had resulted in an improvement plan, which the interim manager and team had made good progress against by the time of the inspection.

Audits had been completed by managers, which had identified areas for required improvement to the environment and premises. The provider explained that the refurbishment and repair work was due to commence in September 2022, having been delayed by the pandemic. At the time of the inspection general maintenance work was in progress.

The provider was making significant improvements to their IT systems which will make various management tasks easier and, for example, make record keeping easier.

Satisfaction surveys had been sent out to gather feedback from people and their relatives, on the services provided, but information had yet to be fully collated from these.

The service continued to work with commissioners including health and social care professionals to support people's access to the service as needed. This close working had benefitted people with complex needs where other care placements had not been successful.