The Care Quality Commission
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Archived: West House Care Home

Overall: Inadequate read more about inspection ratings

14-16 Quarry Road, Dewsbury, West Yorkshire, WF13 2RZ (01924) 469416

Provided and run by:
Northfields Care Homes Limited

All Inspections

9 June 2015

During a routine inspection

The inspection of West House Care Home took place on 9 June 2015 and was unannounced. We previously inspected the service on 15 April 2014. The service was in breach of the Health and Social Care Act 2008 regulations at that time.

West House Care Home is registered to provide accommodation and personal care for up to 37 older people. On the day of our inspection there were 27 people, many of who were living with dementia, resident at West House Care Home. The home provides accommodation on the ground and first floor.

The service did not have a registered manager in place. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staffing levels were insufficient to meet people’s needs and staff did not all have the necessary skills to support people properly.

Staff lacked knowledge and understanding of the Deprivation of Liberty Safeguards (DoLS) and the Mental Capacity Act 2005 (MCA). We saw evidence that people’s freedom of movement within the home was restricted by the use of locked doors. We were told that no DoLS applications had been made to the local authority in regard to the restrictions placed on people’s freedom. These examples evidenced a failure to comply with the requirements of the Mental Capacity Act 2005.

The premises had not been adapted to enable people who were living with dementia to live well. The home had bare décor, there was insufficient seating and the environment was not homely for people. Infection control measures were not sufficiently in place to ensure the home was clean.

There was a significant lack of sensory stimulation for people and people’s movement within the home was restricted by locked doors and lack of support to mobilise. There was limited evidence that people who lived at the home were purposefully engaged and people were bored.

Care records did not accurately reflect the care and support people required and there was a lack of dignity, respect and person-centred care, particularly in relation to people living with dementia.

There was no evidence that the registered provider had a system in place to evaluate and monitor the quality of the service provided to people or to respond to complaints.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014.

The overall rating for this provider is ‘Inadequate’. This means that it has been placed into ‘Special measures’ by CQC. The purpose of special measures is to:

Ensure that providers found to be providing inadequate care significantly improve.

Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.

Provide a clear timeframe within which providers must improve the quality of care they provide or we will seek to take further action, for example cancel their registration.

You can see what action we told the provider to take at the back of the full version of the report.

15 April 2014

During an inspection looking at part of the service

This was a scheduled inspection, which also followed up on our last visit in which three areas were non-compliant.

' Respecting and involving people who use services.

' Care and welfare of people who use services.

' Assessing and monitoring the quality of service provision.

We carried out the inspection with our five questions in mind. Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

Is the service safe?

On the day of our inspection we looked at the services' communal areas and five bedrooms. We found them to be clean, tidy and hygienic.

The service had policies in place for whistle blowing and safeguarding procedures.

When we spoke with the manager they were aware of their responsibilities in relation to safeguarding the people they cared for.

On the day of our inspection, we spoke with one relative, they told us, 'X is safe, they are well looked after.'

Is the service effective?

We saw a programme of supervision was in place for. Two staff we spoke with told us they had recently received supervision with the manager.

Not all mandatory training was up to date. We asked the provider to tell us what they are going to do to meet the requirements of the law in relation to ensuring all staff have received appropriate training.

During the morning of our inspection, people were not engaged in meaningful activity. In the afternoon we observed four people playing bingo with a member of staff. The manager told us plans were in place for a member of staff to have 12 to 18 per week dedicated to the provision of activities.

Is the service caring?

People were supported by kind and attentive staff. We saw care assistants showed patience and gave encouragement when supporting people.

People's likes, dislikes and preferences had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

One relative we spoke to told us, 'Any problem, I tell them and they sort it straight away.'

We saw the service had received one written complaint. We saw this had been investigated and the outcome of this complaint had been recorded.

We saw evidence from the care files that staff had taken medical advice when they detected a person had begun to lose weight. This meant people received appropriate care in a timely manner.

Is the service well-led?

The manager had taken a number of steps to address the concerns raised at the last inspection and put measures in place to improve the service.

We saw improvements had been made to the quality assurance system. However, records seen by us showed that not all of the shortfalls identified had been addressed. We have asked the provider to tell us what improvements they will make to ensure the information from the audits is analysed and used to bring about further improvements to the quality of the service.

18 September 2013

During an inspection in response to concerns

We carried out our inspection in response to information of concern we received, that the home had poor procedures to prevent the spread of infection, people's dignity was not promoted and staff did not appropriately attend to incidents.

We spoke with the acting manager, three staff and three people who lived there. We saw staff respected people's privacy and dignity in relation to their personal care. Staff consulted people before carrying out any tasks and were polite when speaking with them. We saw staff were kind and caring and they spoke with people at their eye level.

We saw adequate numbers of staff to meet people's basic needs and keep them safe. However,staff time was mostly spent completing care tasks with little time for other interaction.

We saw the premises were free from offensive odours and clean and tidy overall. Staff followed appropriate infection control measures.

People we spoke with told us they were bored. One person said 'it's alright, I can't grumble really'.

We found people's rights and choices were not promoted. People spent most of their time in lounge areas with little to do and limited interaction with staff. Some people's care needs were not met and care records were ineffective.

We found inadequate systems for assessing and monitoring the quality of the service provision.

25 June 2012

During a routine inspection

We used a number of different methods to help us understand the experiences of people using the service. This was because some of the people using the service had complex needs which meant they were not able to tell us their experiences. We visited the service and talked with three people using the service, the Registered Manager and three members of staff. We also used the short observational framework for inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

The two people we talked with were complimentary about the care and treatment they received, they told us the staff were 'Good' and 'They look after me well'. They both said staff made sure their privacy and dignity was respected.

Earlier this year the registered care provider wrote to the relatives and/or friends of the people using the service and offered to meet with them to discuss their views about the home. No one was able to meet with the provider but they received three e-mails and two letters. We reviewed the responses and found they were all complimentary about the service.