Background to this inspection
Updated
30 September 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was carried out by two inspectors and two medicine team inspectors.
Service and service type
West Hill is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. West Hill is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
Inspection activity started on 09 August 2022 and ended on 11 August 2022. We visited the service on 09 August 2022, 10 August 2022 and 11 August 2022.
What we did before the inspection
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We sought feedback from the local authority and professionals who work with the service. We received feedbacks. We used all this information to plan our inspection.
During the inspection
We spoke with three visiting relatives and seven people who used the service about their experience of the care provided. We spoke with nine members of staff including, support workers, senior support workers, nurses, chef, activities coordinators, the registered manager and director. We reviewed a range of records. This included three people's care records, and four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed. We observed medicines administration round. We continued to seek clarification from the provider to validate evidence found.
Updated
30 September 2022
About the service
West Hill Care Home is registered to provide nursing and personal care for up to 77 people. At the time of the inspection, the service was occupied by 36 people who were living with a range of health and support needs. These included: diabetes, epilepsy and dementia.
People’s experience of using this service and what we found
Medicines practice was not always safe. Guidance for ‘when required’ [PRN] medicines did not provide staff with specific information about when and how medicines should be administered. PRN protocols had not always been reviewed. Medicines were not accurately recorded in the care plan when reviewed.
We found that staff were not always adhering to government guidance on Covid-19. We observed some staff not wearing masks correctly in the service.
Staff received regular training. However, staff supervision had not always been provided as is necessary to enable staff to carry out their duties. The registered manager provided a schedule of staff supervision after our inspection.
People and relatives told us they felt safe in the service. One person said, “I feel safe. Staff are ever so good.” Another said, “I trust people. I am happy here.” A relative said, “She feels safe and happy here.” Another relative said, “They are kind and nice. I cannot fault them.”
People were protected from the risk of abuse at West Hill Care Home. Staff knew what their responsibilities were in relation to keeping people safe from the risk of abuse. Staff recognised the signs of abuse and what to look out for. People received the support they needed to access healthcare services.
Each person had a personalised care plan, which set out how their care and support needs should be met by staff. These were reviewed regularly.
People were supported to eat and drink enough to meet their needs.
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.
Relatives and visitors were welcomed at the service at any time. People were supported to maintain their relationships with people who mattered to them.
Staff showed they were caring, and they treated people with dignity and respect. Staff ensured people's privacy was maintained particularly when being supported with their personal care needs.
The registered manager ensured the complaints procedure was made available if people wished to make a complaint. Complaints were addressed to the satisfaction of those concerned.
The registered manager provided leadership. They checked staff were focused on people experiencing quality care and support.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 18 March 2021 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to medication management and management of the service at this inspection.
Please see the action we have told the provider to take at the end of this report.
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.