This inspection took place on 13 April 2016. It was unannounced.Westlands Care Home provides a service for up to 28 people who have a range of care needs including dementia, mental health, sensory impairment and physical disabilities. There were 18 people living in the home on the day of this inspection. The service is also registered to provide a domiciliary care service to people in their own homes, but this was not happening at the time of this inspection.
At our last comprehensive inspection on 19 February 2015, we found that the service was in breach of legal requirements in a number of areas. We followed up on these areas at another inspection on 29 September 2015 and found improvements had been made. Although we found that the service was no longer in breach of legal requirements at that time, we did not change the overall rating for the service because to do so would require consistent good practice over a sustained period of time.
We therefore checked all the areas where legal breaches had occurred previously during this inspection, and found that the improvements had been sustained.
Although we did identify some new areas for improvement during this inspection, the area manager was able to demonstrate that she had already identified these through a recent internal audit, and confirmed she had a plan in place to address these.
A registered manager was not 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. A new manager had been appointed who was planning to take up their post the following month. Appropriate managerial support and oversight was being provided by the area manager in the interim.
Risks were managed so that people’s freedom, choice and control were not restricted more than necessary. We did find some anomalies in terms of how risks were managed and reviewed however, which meant people were at risk of not having identified risks managed in a consistent way.
There were sufficient numbers of suitable staff but improvements were needed to ensure people got the right support at key times of the day such as meal times.
The provider carried out robust checks on new staff to make sure they were suitable to work at the service. However, not all legally required checks were in place.
Systems were in place to ensure people’s daily medicines were managed in a safe way and that they got their medication when they needed it. Improvements were required however regarding the recording of PRN (as required) medication.
People received personalised care that was responsive to their needs. However, some care records needed reviewing; to ensure the care and support being provided to people was still appropriate for them.
People felt safe living at the service. Staff had been trained to recognise signs of potential abuse and keep people safe.
People received effective care from staff that had the right skills and knowledge to meet their needs.
We found that the service worked to the Mental Capacity Act 2005 key principles, which meant that people’s consent was sought in line with legislation and guidance.
People had enough to eat and drink. Support was provided to those who needed help with eating and drinking, in a discreet and helpful manner.
People’s healthcare needs were met.
Staff were motivated and provided care and support in a caring and meaningful way. They treated people with kindness and compassion and respected their privacy and dignity at all times.
People’s social needs were provided for and they were given opportunities to participate in meaningful activities.
People were given opportunities to be involved in making decisions about their care and support.
People received personalised care that was responsive to their needs. Staff encouraged people to be as independent as possible.
People were supported to raise concerns about the service and these were responded to appropriately.
There were effective management and leadership arrangements in place.
Systems were also in place to monitor the quality of the service provided.