The inspection took place on 29 September 2016 and was unannounced. This was a comprehensive inspection.

Coxhill Manor is a nursing home providing support to up to 74 people. They provide care to the elderly, those with physical disabilities and people living with dementia. At the time of our inspection there were 54 people living at the home.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff understood their role in safeguarding people and had attended training. They demonstrated understanding of how to recognise signs of abuse and who to contact if they suspect abuse.

Accidents and incidents were being reported where appropriate. Staff routinely carried out risk assessments and created plans to minimise known hazards whilst encouraging people’s independence. Policies and procedures were in place to keep people safe in the event of emergencies.

There were sufficient staff present to safely meet people’s needs. Staff had undergone checks to ensure that they were of good character to be working with people. Staff had appropriate training and support to meet the needs of people living at the home.

People’s medicines were administered safely. Healthcare professionals had a lot of input into people’s care and staff observed their guidance in providing care to people.

People’s legal rights were protected as staff provided care in line with the Mental Capacity Act (2005). Correct procedures were followed when depriving people of their liberty. Staff followed the guidance of healthcare professionals where appropriate and we saw evidence of staff working alongside healthcare professionals to achieve outcomes for people.

Most people told us that they enjoyed the food and we saw evidence of people being provided with choice and also being involved in writing menus. People had a good selection of activities to be involved in.

People were supported by staff who knew them well. Information in records was detailed and staff demonstrated a good understanding of people’s histories. People and staff got on well.

Staff helped to create an inclusive atmosphere in the home. People were involved in decisions about their home environment and activities and events that they wished to participate in.

People’s records were kept thorough and up to date with detailed assessments when people were admitted to the home and regular reviews.

Staff felt very well supported by the registered manager. Staff were able to contribute to the running of the home and the registered manager created an open culture within the team.

On entering Coxhill Manor we found the atmosphere to be warm and welcoming. The provider is currently in the process of refurbishing existing areas and rooms and we noted people had no issues or concerns regarding the disruptions for example, wet paint on walls, and some hammering and banging.

We observed staffs understanding of the care and support needed. The people who use the service we spoke with said they home was "like a four star hotel for the disabled" and staff were "very kind and pleasant." We noted people's rooms were decorated with their personal belongings.

We looked at people's individual files which incorporated their personal profile, care plans and risk assessments and found they encompassed the safety and well-being of people who use the service. Family members and staff told us that they knew how to raise a concern or complaint and felt confident in doing so. They said if they had any issues or concerns they could "talk to the manager."

There were policies and procedures in place providing guidance and all staff had received relevant training courses which were identified on the training schedule. We looked at the management of medicines and the quality of the service and found that the provider had adequate systems in place to ensure they received feedback from people regarding the service provided whilst also maintaining people's safety in the administration of medicines.