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Archived: Westcotes Rest Home Inadequate

Inspection Summary


Overall summary & rating

Inadequate

Updated 5 January 2019

Westcotes Rest Home is a care home. People in care homes receive accommodation and nursing or person care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Westcotes rest home can accommodate up to 20 people in one adapted building. At the time of the inspection 14 people, some people of whom were living with dementia were in residence. The accommodation is provided over three floors with a passenger lift for access.

This inspection took place on 15 October 2018 and was unannounced. We returned announced on 16 October 2018 and unannounced on 1 November 2018.

There is no requirement for a registered manager to be in post at this service as the owner is a sole provider. The provider has the legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At the previous inspection of 17 and 18 July 2018, we issued the provider with a warning notice. The warning notice detailed the failings of the provider with regards to Regulation 17. Good governance, of the Health and Social Care Act Regulated Activities Regulation 2014. We set a compliance date for 17 September 2018.

In addition, the previous inspection of 17 and 18 July 2018, identified 2 further breaches. Regulation 15 Premises and equipment and Regulation 12. Safe care and treatment. We asked the provider to complete an action plan to show what they would do and by when to improve the key question. Is the service safe to at least good. The provider did not submit an action plan.

We found minimal improvements had been made.

The overall rating for this service is 'Inadequate' and the service is therefore in 'special measures'.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, it will be inspected again within six months.

The expectations is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not, enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social service care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it no longer rated as inadequate for any of the five key questions it will no longer be in specialist measures.

The provider did not have systems and processes in place to assure themselves of people’s safety with regards to their health, care and welfare. Potential risks to people were not effectively assessed and accidents and incidents were not considered when reviewing people’s safety. This placed people at continued risk. People were at risk as medicine administration processes were not robust. The monitoring of people’s health, safety and welfare following a medicine incident were not consistently carried out.

People’s safety was compromised as personal emergency evacuation plans were not reviewed and in some cases contained conflicting in

Inspection areas

Safe

Inadequate

Updated 5 January 2019

The service was not safe.

The process for determining potential risks to people's safety, health and welfare were inadequate. The risk assessment process did not follow a clear risk assessment process.

Accidents and incidents were not analysed and were not considered when reviewing people’s assessments and care plans to mitigate risk.

People did not consistently receive their medicine as prescribed. The medicine administration process was not robust.

Improvements were needed to the cleanliness of the service.

Effective

Inadequate

Updated 5 January 2019

The service was not effective.

Staff were not supervised and their competence to carried out their role was not assessed.

The service did not follow up on referrals to health care professionals to ensure people’s dietary needs were met in order that people required support from the appropriate health care professional.

People were positive about the meals.

The premises required improvement both internally and externally. Bathing and shower facilities did not meet the needs of people with mobility difficulties.

Training had not been provided to enable staff to assess people’s competence to make informed decisions. A DoLS authorisation had been applied for.

People were positive about the meals.

Caring

Requires improvement

Updated 5 January 2019

The service was not consistently caring.

People’s privacy and dignity was not always maintained as the premises were not well maintained.

People’s rights to privacy through the safe storage of documentation was compromised.

People were positive about the care they received and were complimentary about the staff.

People told us their privacy and dignity was respected by staff.

Positive interactions between people using the service and staff were observed.

Responsive

Requires improvement

Updated 5 January 2019

The service was not consistently responsive.

People’s care plans did not provide a comprehensive record of people’s care needs. People’s views were not sought or used to develop and review their care plans.

Opportunities for people to engage in activities were very limited. People’s ideas for activities were not acted upon.

People were aware of how to raise a concern.

Well-led

Inadequate

Updated 5 January 2019

The service was not well-led

The provider had not kept under review the day to day running of the service, this had compromised people’s health, safety and welfare and placed them at risk and unsafe care.

The provider had not kept under review the maintenance of the premises, to ensure people were safe and their needs were met.

The lack of oversight of the service had resulted in areas of improvement not being identified.

The provider did not have systems in place as to the governance of the service. There were no reliable and effective systems to assure people's views were sought or opportunities given to influence the service they received.

Poor and ineffective record keeping and communication impacted on the on the safety and quality of the service provided.

External stakeholders had identified improvements were needed.