- Care home
Cossham Gardens - Care Home with Nursing Physical Disabilities
Assessment report published 6 August 2026
Contents
Ratings
Our view of the service
About the service
Cossham Gardens - Care Home with Nursing Physical Disabilities, is a care home registered to provide accommodation and personal care including nursing care for up to 22 people. At the time of our inspection 22 people were living at the home.
Who the service is for
Cossham Gardens - Care Home with Nursing Physical Disabilities is a specialist service supporting younger and older people living with physical disabilities, who require complex care and support.
Key findings
We carried out this assessment on 21 July 2026. This service was previously rated as good. We carried out this assessment to confirm whether the rating of good remains accurate. This report does not provide detailed information on areas where we found practice continues to meet a good standard. Instead, our findings focus on any areas where the service needs to improve or where we found exceptional practice.
People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that staff and management worked within the MCA. DoLS authorisations were appropriately applied for and overseen. People were not subject to unlawful or excessive restrictions and had choice, control and freedom over their lives.
People were supported by sufficient numbers of staff who had the skills, knowledge, and experience to meet their needs safely. The registered manager regularly monitored staffing levels at the home. Staff felt the home maintained safe levels of staffing. A staff member told us, “I do feel we have enough staff. It is a higher ratio here, due to people having complex needs.” Risks to people and the environment had been assessed and regularly reviewed to support the safe delivery of care. Effective systems were in place to help protect people from harm and safeguard people from abuse. This included clear processes for reporting, investigating, and learning from safeguarding concerns, accidents, and incidents. People’s medicines were administered safely and staff followed clear guidance to ensure people received their medicines as prescribed.
People’s needs had been assessed, and care plans were comprehensive and detailed, with information about how their needs affected each person in their day-to-day lives. People and, where appropriate, their relatives participated in assessments and regular reviews of care. Changes to people’s needs were recorded and care was adjusted, when needed to promote good outcomes for people. People were supported by a range of healthcare professionals to help monitor and review their ongoing care and support needs. The registered manager told us, “We are supported by the nearby GP practice who regularly visit the home. We also encourage people to attend the surgery in person.”
Staff understood the importance of promoting and maintaining people's independence wherever possible. A staff member told us, “We always look at how we can enhance people’s life’s, through support, encouragement and trying to source new equipment.” Staff treated people with dignity, kindness and respect and were knowledgeable about their needs.
People's needs, preferences and personal histories were clearly recorded within care plans, which were person centred. People were listened to and encouraged to express their views. The registered manager conducted daily walkarounds and regularly engaged with people to seek their feedback. Records demonstrated that feedback provided by people and those important to them was considered. Staff were committed to achieving positive outcomes for people and worked proactively to identify ways of enhancing their quality of life and independence. They took time to understand people's needs and goals.
The registered manager had a positive vision for the home, underpinned by a culture that placed people at the centre of care. Staff spoke proudly about their roles and were positive about the care and support they provided. A staff member told us, “I am proud to work here and enjoy my job. We provide good care to people.” Governance systems were clear, comprehensive and identified any areas for improvement. Audits were thorough and provided clear oversight of the quality and safety of the home. Where shortfalls were identified, action plans were developed and monitored. The provider maintained an overarching service improvement plan, which included clear objectives, actions and targets.
People's experience of this service
We spent time speaking with people and observing their interactions with staff. People were happy to share their experiences of living at the home and spoke positively about the care and support they received. We observed throughout the assessment, staff were consistently kind, and caring towards people living at the home, with call bell answered in a timely manner. Staff were attentive when assisting people during mealtimes and supported them to participate in activities.
We observed staff providing support in a timely and caring manner, ensuring people were encouraged to engage in activities that reflected their interests and preferences. Some activities were delivered in groups, such as a book club, which promoted social interaction, while others were tailored to individual needs. A person told us, “I like to go out, and the staff support me to do this.” Some people living at the home smoked cigarettes and being able to access the outdoor smoking area was important to them. People told us that staff regularly supported them to access the designated smoking area when they wished to do so. We observed staff responding promptly to people's requests.
Staff promoted people's independence wherever possible. A staff member told us, “It’s really important to encourage people in all aspects of daily life.” A person told us, “The staff encourage me to walk and encourage me to do so safely, which is important. I also use my scooter for longer distances like the garden.” Staff supported people with referrals and assessments to identify equipment that met their individual needs, including specialist wheelchairs, hoist slings, and other assistive equipment. This helped to improve people’s outcomes. People were supported with in-house physiotherapy and the appropriate referrals were made to occupational therapy, when needed, which helped to improve their comfort, independence, and overall quality of life. The outdoor grounds had been redeveloped to make them more accessible, including raised flower beds and wider, level pathways to accommodate people’s wheelchairs. During the assessment, we observed people enjoying and making use of the outdoor areas with support from staff, in line with their wishes and individual needs. A person told us, “Have you been outside, its lovely and I have helped with gardening, which has been nice.”
People’s dignity was respected by staff, for example, we observed the staff knocking on people’s doors before entering and closing people’s doors, when providing personal care. A staff member told us, “It is important we are respectful and I am mindful of this. Even when showering or bathing people, I do this in with a dignified approach.”
Staff sought consent from people before proving care and support to people, along with offering choice.A staff member told us, “I aways ask people for their permission and promote choice. If a person refuses care, I will go back and try again or ask another staff member for support.”
People felt they were listened to and encouraged to express their views. Each person had a designated keyworker, who had oversight of their care and support. A person told us, “Yes, I feel listened to and I speak to my keyworker regularly. I can also speak to the other staff to.” People and their relatives participated in regular review meetings about their care. During these meetings people’s care and support was discussed along with their achievements and goals. Any changes were updated in people’s care plan. A person told us, “Yes, I have review meetings and they ask my views.”