West Hill Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question Requires Improvement. At this assessment the rating has changed to Good. This meant the effectiveness of people’s care, treatment and support achieves good outcomes for people.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. Information relating to these were used to develop the person’s individual care plan. This gave guidance to staff on how to best care for the person. A staff member told us, “New people are given a basic care plan, their care needs and the natures of the care they prefer. However, we are all humans and things can change with time and the care plans will change.”

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. There was evidence in people’s care plans how people liked their care and of them making decisions in the support they received. People were weighed regularly to help ensure they maintained a healthy weight, in addition staff carried out Waterlow assessments which determined a person’s risk of developing skin damage, completed oral health checks and undertook a falls risk tool on each person.

The provider worked well across teams and services to support people. People had the involvement of their GP, dieticians, speech and language therapists, the optician as well as physiotherapists when required. In addition, the service could support people to hospital appointments when necessary.

Staff worked well together. When staff moved to work on a different floor they were given a good handover of people’s needs. A staff member told us, “I read the handover and people’s conditions. Good handovers makes it easier to switch floors if needed.” Handover notes contained detailed information for staff, including specifics of any appointments people had and the outcomes of those appointments.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. People were given a choice of foods in line with their preferences and any allergies or intolerances they had. Where people were at risk of losing weight their food was fortified with cream to improve their nutrition and provide health benefits to people. Relatives felt the meal arrangements were positive. One told us, “The fact that I can eat with her is really good. I find it helps her eat more.”

Where people were in pain or their health was deteriorating, staff engaged the GP or another appropriate health professional. On the day of our visit, the GP visited the service to review the needs of people.

The provider routinely monitored people’s care and treatment to continuously improve it. Some people’s health had improved since moving into West Hill and relative’s confirmed this. People also told us they were able to retain their independence where they could and make their own decisions. One person told us, “ I like a bacon sandwich so they make me one in the morning. Today's chicken casserole for lunch but I wanted sausage and mash so that's what I'm having.” They added, “All the staff have a sense of humour which I appreciate. I get waited on hand and foot I've never been looked after so well.”

Through the manager’s analysis of accidents and incidents, staff supervisions and training, there was a reduced risk of people obtaining skin tears due to staff’s previous poor understanding of moving and handling practices.

The provider did not always tell people about their rights around consent. We found the service had CCTV in communal areas but the provider was unable to provide us with evidence that people had consented to this or capacity assessments had been undertaken to check it was in people’s best interests. Although there were external signs about the CCTV, there was no signage internally to remind/notify people or their visitors of it.

Staff were not always following the principles of the Mental Capacity Act 2005 (MCA). Some people were on covert medicines (medicines given to people, in their best interests, without their knowledge) but there was no evidence of a capacity assessment or best interests decision taking place around this. Although we were sent some capacity assessments following our inspection we noted these has been done on the day after our visit. We also found other people did not have capacity assessments or best interests decisions for their bed rail, sensor mat or their low bed. In addition, some people who had capacity had mental capacity assessments in place which were not necessary.

The manager had identified the processes around the Mental Health Act had not consistently been followed and they had started work reviewing each person in relation to restrictive practices to check that capacity assessments and best interests decisions had been done. Some capacity assessments and best interests decisions had been completed by staff appropriately. In addition, where restrictions were in place for people, Deprivation of Liberty (DoLS) applications had been made. Staff told us, “It’s about being able to make your own decisions. We need to apply the MCA if we believe they don’t have capacity and look whether things need to be done in their best interest. With DoLS it’s about people having restrictions in their best interest for their safety.”