Westmorland Court Nursing and Residential 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 people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 63 (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 did not always ensure people’s care and treatment were effective because people’s health needs were not consistently reflected in their records, which meant staff did not always have clear guidance on how to meet these needs.

Although pre‑admission assessments were completed, some identified health conditions did not translate into care plans or risk assessments.

Some care plans lacked important information about people’s needs and how staff should support them, and one contained conflicting next‑of‑kin details.

People and their relatives were involved in assessments and care planning, and care plans were generally person‑centred. One visiting professional said about a person they placed at the home, “[Registered manager] phoned up and assessed, was very quick to assess, went the extra mile. She was very dedicated. Really cared about this person. The assessment was very good. Good rapport with family and interaction with the GP. [Registered manager] made the whole process seamless. I was very reassured. We worked together about how to manage the person's risks, and they did this very well.”

A range of clinical assessment tools were used effectively, and people’s communication needs had been recorded. One person told us, “When I came into the home I was asked about my health, medications and my likes and dislikes.”

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Information needed to support the safe and accurate administration of medicines was not always recorded in people’s medication documents.

The provider used recognised nutritional screening tools, such as MUST, to assess people’s risk of malnutrition and Waterlow to assess skin pressure risk. Some care plans reflected recommendations from these tools and were updated in line with best practice guidance.

However, for one person, information about the required International Dysphagia Diet Standardisation Initiative (IDDSI) level for thickened fluids was inconsistent, and thickened fluids were prepared using incorrect ratios. This meant care was not delivered in line with professional recommendations and increased the risk of choking.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

The provider had recently introduced Person Centred Software (PCS), an electronic care management system and was nearing completion of transferring care plans onto it. Care staff had access to people’s care plans on mobile devices, and daily care notes were updated electronically. Health and social care professionals told us they worked well with staff and management, and that they were receptive to advice.

The staff we spoke to, told us they were confident communicating with management and felt the registered manager was always approachable. The management and staff team had twice daily handovers where all issues, concerns and ideas were discussed. There were longer staff meetings held once a month. The registered manager had worked closely with the Local Authority to improve some of the services systems and procedures.

One visiting professional told us, “I think there's a few individuals who are proactive and they make sure communication is good. When I'm there, they make sure there's a staff member to assist me. They're proactive in engaging with us. They self-refer if they want a review.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

We spoke to health care professionals who told us the service worked well with them to ensure people had access to healthcare when needed and that the service worked well with the GP practice. One person told us, “If I need a doctor the home deals with that. Usually the doctor comes here.”

The service kept relatives up to date about concerns, changes or requirements in relation to people’s health and wellbeing. A relative told us, “[Person’s] health can be a bit up and down but the home are always on the ball and get any issues sorted.” Another said, “My [relative] has had doctors to see her, and I am always told the outcome. I am informed of any changes.”

We saw people enjoying the food and being supported to eat and drink. Feedback about the food was positive. One person told us, “I do enjoy my food which is plentiful and tasty. You can have a drink whenever you want one.” A family member told us, “The food is very good. I was here for Christmas lunch, and you could not have asked for better.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The provider monitored people’s weight regularly and used this information to identify early signs of malnutrition. Where monitoring showed a person was losing weight, staff provided targeted support and records demonstrated this led to a healthy weight gain for the individual.

The service monitored people’s meal consumption and identified that many were leaving their main meal at lunchtime. The manager sought people’s views through a survey, which showed a strong preference for having the main meal in the evening. The provider implemented this change and told us there had been improved meal intake as a result.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

Mental capacity and best interest processes were not always effective. For one person, who lacked the mental capacity to make their own decisions, a sensor mat was being used to reduce the risk of falls, but there was no evidence a best interest decision had been completed. Mental capacity assessments were not always in place for decisions relating to CCTV.

For another person, their mental capacity records contained conflicting information about who had been consulted, which meant we could not be assured that decisions were being made in line with the Mental Capacity Act 2005.