Westwood Care Home

Westwood care home is a care home providing personal and nursing care to up to 16 people. The service provides support to older people some of who are living with dementia. At the time of our inspection there were 16 people using the service. Accommodation is split across two floors within one building and has a stair lift in place.

People’s experience of using this service and what we found

Staff were not always trained and assessed as competent to administer medicines. This was identified at the last inspection and the provider had failed to make improvements. Protocols for “as and when required” medicines needed more guidance for those people unable to communicate their needs.

Staff were safely recruited and there were enough staff to meet people’s needs.

Systems were in place and regular audits and checks carried out to monitor and manage safety within the service. Work was ongoing to address issues identified with the environment such as the carpet which needed replacing on the ground floor.

There was a positive culture within the service led by the registered manager. Staff were confident in the management team and felt supported in their roles.

Some Improvements had been made since the last inspection and the registered manager and provider were keen to continue to further develop the service.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 12 May 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection whilst some improvement had been made, we found the provider remained in breach of regulations.

Why we inspected

We carried out an unannounced inspection of this service on 30 March 21. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and governance processes.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe and well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Westwood care home on our website at www.cqc.org.uk.

Enforcement

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 safe care and treatment at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

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.

Westwood Care Home is a residential care home providing personal care for up to 16 people aged 65 and over, some of whom may be living with dementia. At the time of inspection, the service was supporting 12 people. The accommodation is one building, with bedrooms across two floors, serviced by a stair lift.

People’s experience of using this service and what we found

Essential environmental health and safety checks were not always in place. This put people at risk of potential harm. Audits were not always in place or robust enough and did not highlight issues found on inspection. Where actions were identified these were not always completed. There was a lack of governance systems to ensure safety and drive improvement within the service.

Staff recruitment processes were not evidenced. There was no system to assess required staffing numbers however there appeared to be enough staff to keep people safe and meet their needs.

Staff had a good understanding of people’s medicines, however procedures were not always in place to provide guidance to staff. Medication audits did not ensure errors were identified and managed quickly and effectively.

The home was showing signs of wear and tear due to the age of the building, but it was clean and homely. People were happy and well cared for. The registered manager and staff knew people well and how to support them. A family member told us, “I would have no problem recommending the home to any vulnerable relative”.

The provider recently employed new staff to support the registered manager and address issues around governance and assurance processes

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 10 October 2019).

Why we inspected

We received concerns in relation to the environment and leadership. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Westwood care home on our website at www.cqc.org.uk.

Follow up

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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Westwood Care Home is a residential care home providing personal care to 16 people aged 65 and over, some of whom may be living with dementia. The accommodation is provided in one building separated over two floors.

People’s experience of using this service and what we found

The provider had not undertaken audits to monitor the quality or safety of the support provided and to promote best practice. Checks that had been completed had not consistently highlighted some of the points raised during the inspection. Immediate actions were taken during and following our visit to the service.

People and their relatives had confidence in the safe care provided by the staff. There were enough staff to respond to people’s needs and the staff team was consistent. Staff continued to be safely recruited. Staff supported people with their medicines and had a good understanding of their needs. The environment was clean and smelt fresh throughout.

Staff undertook training to ensure they had the skills, knowledge and approach to provide people with effective care. Staff felt supported in their role. A member of staff told us why they enjoyed working at the service; "We work as a team, everybody puts the residents first, we have great communication with professionals. I just love it."

People had access to healthcare professionals and staff were vigilant in ensuring any changes to people's needs were reported. Staff worked transparently with other health and social care organisations.

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.

Staff were kind, caring and patient in their approach towards people. They had established a rapport with people and their families and took an interest in their lives and emotional well-being. People were supported when making decisions about their lives.

There was a series of activities scheduled and activities were flexible dependant on what people wanted to do. People were confident in approaching the staff team or registered manager with any concerns or issues they wanted to address.

The registered manager was experienced and visible to people and the staff team. They knew people well and had a ‘hands on’ approach to their role. They were passionate about people receiving good quality, person-centred care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 16 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner. We will work with the local authority to monitor progress.

At the last inspection in January 2015, the service was rated Good. At this inspection we found the service remained Good.

People told us they felt safe and well cared for. Staff received safeguarding training and they were confident any issues of concern would be dealt with appropriately.

Staff had been recruited safely and there were enough staff to assist people in a timely way. People’s medicines were managed in a safe way.

Staff were well-trained. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People said they enjoyed good food. They were supported with their nutritional well-being and had access to a range of health services. A visiting healthcare professional said staff always contacted them in a timely way in response to people’s changing care needs.

People and relatives said staff were kind, patient and friendly. They treated people with dignity and respect. People were encouraged to be independent.

People received personalised care. Staff were knowledgeable about each person’s needs and preferences. There was a good range of activities to meet people’s interests. People were encouraged to help staff with daily living tasks such as carpet sweeping, folding laundry and ironing.

People told us the home was well-managed and organised. There was a registered manager who was supported by three team leaders. The registered manager and team leaders carried out checks on the quality and safety of the service. People and staff were asked for their views on a daily basis and their suggestions were used to continuously improve the service.

The service met all relevant fundamental standards we inspect against.

Further information is in the detailed findings below.

We spoke with two people living at the home and three visiting relatives, they all said they were happy with the care and support provided by the care staff. Comments we received included 'All of the staff are approachable.' And 'My relative has settled well, has put weight on and looks so well now.'

We looked at people's care records and saw consent had been recorded appropriately.

We saw from people's care plans that people were supported to live as they chose to within their limitations. Staff at the home had carried out an assessment of the needs of each person, and kept this under review, this helped to make sure appropriate care and support was given.

Appropriate arrangements were in place in relation to obtaining, handling, storing and administering medication.

We saw that there was enough skilled and experienced staff to meet people's needs in a timely way. This was confirmed by people we spoke with and by the staff.

There was an effective complaints system available to people and their representatives.