A healthcare watchdog has downgraded its rating of mental health services for children and adolescents at an Oxford NHS trust, flagging them as requiring attention.

The Care Quality Commission conducted a surprise assessment of inpatient child and adolescent mental health services at Oxford Health NHS Foundation Trust in November 2025.

The review encompassed all three locations: The Meadow and Highfield wards situated at Warneford Hospital in Oxford, as well as Marlborough House in Swindon. The watchdog launched the investigation following reports that raised concerns.

Inspectors found the service breached four distinct regulations covering person-centred care, safe treatment, safeguarding vulnerable patients, and good governance.

Following the assessment, the CQC revised its ratings for safety, responsiveness, and leadership from good to requires improvement, while keeping effectiveness and caring at good.

Serena Coleman, CQC deputy director of mental health for the southern region, said during the visit, inspectors found a service where managers had not exercised adequate oversight of certain areas, and the young people receiving care were suffering as a result.

Every young person spoken to described feeling unable to participate in decisions about their own care.

Half of the care plans reviewed consisted of generic templates that did not reflect individual needs or wishes.

There were serious concerns about restraint methods. Records did not reliably show that staff had first explored other options, and two young people recounted negative experiences during restraint.

Blanket restrictions were applied uniformly across all three sites, meaning every young person faced limitations on food, drinks, and going outside, regardless of their personal situation or risk profile.

Such limitations should only apply to particular individuals when there is proper justification.

Inspectors also discovered the service had prescribed medication to four young people who were detained under the Mental Health Act without the correct treatment authorisation being in place, and staff did not reliably inform detained young people of their rights.

It emerged that eight young people at two locations had not received an explanation of their rights since being admitted, with one person going six months without this information.

Ms Coleman added that what made these findings more worrying was that many of these problems had not been identified through the trust’s own internal oversight systems, meaning these issues risked continuing.

However, inspectors also noted positive elements at the trust.

Ms Coleman remarked staff worked well together across different disciplines, and many warm and respectful interactions between workers and young people were observed during the visit.

Families gave positive comments about the service, and the facilities for young people’s physical wellbeing, including gym equipment, yoga classes, and regular health check-ups, were adequate.

At Marlborough House, staff had developed a creative outdoor therapeutic programme in collaboration with a local Wildlife Trust.

The trust has been made aware of the areas needing improvement, and inspectors will continue to monitor their progress to ensure young people remain safe during this period.