We carried out a review of the data available to us about Westbourne House Nursing Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Westbourne House Nursing Home, you can give feedback on this service.
Westbourne House Nursing Home is a care home which provides personal and nursing care for up to 71 people with a range of medical and mental health needs. At the time of the inspection there were 47 people living at the home. The home also provides intermediate care for people who are admitted to the service from the community or from local hospitals. Intermediate care is undertaken via a National Health Service contract to help ease the pressures on the acute health care services in the area. People receiving intermediate care were receiving rehabilitation to support them to return home or to an alternative care setting. At the time of this inspection the service was caring for 30 people who were using the service on a temporary basis; some of whom only used the service for a very short period after being discharged from hospital.
People’s experience of using this service and what we found
People were very happy with the care they received, and they told us they felt safe when receiving care from the service. The home had a process in place to safeguard people from the risk of abuse. Staff were knowledgeable about safeguarding and knew what action to take if they suspected abuse.
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.
Risks associated with people's care had been identified and assessments were in place to minimise risks occurring. The provider had a robust recruitment system in place to ensure appropriate staff were employed.
The registered manager and provider could evidence maintenance checks had been carried out to ensure the building was meeting health and safety requirements. Accidents and incidents were analysed to ensure trends and patterns were identified to minimise future incidents. People received their medicine as prescribed.
The premises were clean and there was good infection control practice in place.
The provider had a quality assurance system in place and ensured audits were carried out frequently to identify and actions and resolve them.
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 and there were two breaches of regulations (report published 26 June 2019). The provider completed an action plan after that inspection to show what they would do, and by when, to improve. The service was inspected but not rated at our inspection in October 2020 (published 13 November 2020) but it had improved and met the breaches identified in 2019.
Why we inspected
We undertook this inspection as part of a random selection of services which have had a recent Direct Monitoring Approach (DMA) assessment where no further action was needed. We were seeking assurance about this decision and to identify learning about the DMA process.
For those key questions not inspected, we used the ratings awarded at the last inspections to calculate the overall rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Westbourne House Nursing Home on our website at www.cqc.org.uk
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Westbourne House Nursing Home is a care home which provides personal and nursing care for up to 71 people with a range of medical and mental health needs. At the time of the inspection there were 41 people living at the home. The home also provides intermediate care for people who are admitted to the service from the community or from local hospitals. Intermediate care is undertaken via a National Health Service contract to help ease the pressures on the acute health care services in the area. People receiving intermediate care were receiving rehabilitation to support them to return home or to an alternative care setting.
At the time of this inspection the service was mainly caring for people who were using the service on a temporary basis; some of whom only used the service for a very short period after being discharged from hospital.
People's experience of using this service and what we found
The service was safe, and people received care from staff who were safely recruited and inducted into the role. Medicines were managed safely, with minor improvements needed to record keeping. Personal protective equipment was readily available to staff and all staff were trained on how to keep people safe from the risk of infection and use PPE correctly. Through observation and discussions with staff, it was clear training was well embedded. The home was clean and tidy. There were enough staff available to keep people safe and meet their needs in a timely manner.
The management team were well thought of and staff told us they felt well-supported. The management team were committed to providing good quality care and completed a range of audits and checks to ensure continuous improvement of the service. There was limited evidence to demonstrate what steps the provider had taken or planned to take to improve the service’s environment.
Rating at last inspection and update
The last rating for this service was requires improvement (published 26 June 2019) and there was a breach 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 we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We undertook this targeted inspection to check whether the Requirement Notice we previously served in relation to Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met and because of concerns we had about staffing levels, risks assessments, reporting to CQC and audit processes. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.
CQC have introduced targeted inspections to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
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 coronavirus and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Westbourne House Nursing Home on our website at www.cqc.org.uk.
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.
Westbourne House Nursing Home is a care home which provides personal and nursing care for up to 71 people with a range of medical and mental health needs. The home also provides intermediate care for people who are admitted to the service from the community or from local hospitals. Intermediate care is undertaken via a National Health Service contract to help ease the pressures on the acute health care services in the area. People receiving intermediate care were receiving rehabilitation to support them to return home or to an alternative care setting.
At the time of this inspection the service was mainly caring for people who were using the service on a temporary basis; some of whom only used the service for a very short period after being discharged from hospital. On the first day of this inspection there were eight people living in the service on a permanent basis and 50 people using the service on a temporary basis. On the second day of this inspection, six of the people using the service on a temporary basis had been discharged back to their own homes. There were therefore 52 people using the service when we concluded this inspection.
People’s experience of using this service:
Most people using the service only resided there temporarily whilst they improved their health or regained independent living skills. They had access to a range of health professionals who were based at the service to support the provision of intermediate care. Staff worked alongside these health professionals to help rehabilitate people.
People told us they felt safe. Staff understood how to protect people from abuse and they were confident the manager would act upon any concerns they raised.
There were enough staff deployed to keep people safe, however people and their relatives told us they thought the service was sometimes short staffed, particularly during the night. Staff told us they thought there were enough staff to meet people’s needs.
People’s medicines were not always managed safely. We found the service was in breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014; safe care and treatment.
People told us staff were kind and caring. We observed staff treated people with dignity and respect. Staff knew people well and they provided care and support in accordance with people's preferences. Staff supported people to remain independent.
People were supported to have maximum 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 and their relatives said staff appeared to be well-trained and knew what they were doing. Staff told us they were happy with the training they received. They thought it supported them to deliver effective care to people.
People knew how to make a complaint if they had any concerns about the care and support they received. People were provided with information about how to complain if they needed to.
The care plans and risk assessments for people using the service on a temporary basis needed to be more personalised. However, the care records for people using the service on a permanent basis were better quality as staff had had more time to develop them.
The provider and registered manager understood most regulatory requirements however they had not notified the Care Quality Commission of some events they were required to tell us about. This was a breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009.
The managers monitored the quality and safety of the service. However, the quality assurance system had not identified all issues we found during this inspection in respect of medicines management and the quality of some care plans. Improvements to the quality assurance system are therefore required.
We received positive feedback about the way the home was run. Staff and health professionals based at the service told us about the registered manager’s commitment to the service.
More information is in the full report.
Rating at last inspection:
At the last inspection the service was rated good (published 21 November 2016).
Why we inspected:
This was a planned inspection based on the rating awarded at the last inspection.
Enforcement:
Please see the 'action we have told the provider to take' section at the end of the full report.
Follow up:
We have requested an action plan from the provider, where the provider must confirm the action they will take to make the necessary improvements to the service. We will check the action plan to make sure we are satisfied with the provider’s proposals.
We will continue to monitor the intelligence we receive about this service until we return to visit as part of our re-inspection programme for those services rated requires improvement. If any concerning information is received, we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Westbourne House is registered to provide accommodation for 71 people who require nursing or personal care with a range of medical and mental health needs. It is in the Fir Vale area of Sheffield, close to all local amenities. The service can take people who are living with dementia. At present 29 beds are allocated for the provision of intermediate care for people who are admitted to the service from the community or from local hospitals. This is a provision undertaken via a National Health Service contract which commenced at the service in August 2016. The intermediate care beds have been allocated at the service to help ease the winter pressures on the acute health care services in the area. One unit of 14 beds is located on the ground floor, as well as 15 beds on the first floor of the service. On the ground floor of the service a 20 bedded unit was provided which cared for people living with dementia, there were 17 people living on this unit at the time of our inspection. Rooms on the first floor were used for residential, nursing and intermediate care.
The service has a registered manager. 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Staff knew how to protect people from abuse and knew they must report concerns or potential abuse to the management team, local authority or to the Care Quality Commission (CQC). This helped to protect people.
Staffing levels provided on the day of our inspection were adequate to meet people’s needs. Staff understood the risks to people’s wellbeing and knew what action they must take to help minimise risks to people’s wellbeing.
Staff helped people to maintain or increase their independence working alongside health care professionals. This enabled some people to leave the intermediate care beds at the service and go back home or reside in other local care services.
Staff were provided with training in a variety of subjects which was updated periodically to help develop and maintain the staff’s skills. Supervision and appraisal was provided to all staff which helped support them and identify further training or development needs.
People’s nutritional needs were assessed and monitored. Their special dietary needs were provided. Staff encouraged and assisted people to eat and drink, where necessary. Advice was sought from relevant health care professionals to ensure people’s nutritional needs were met.
People were supported by staff to make decisions for themselves. Staff reworded questions or information to help people living with dementia understand what was being said. We saw people chose how to spend their time and gave consent to their care and treatment.
People who used the service were supported to make their own decisions about aspects of their daily lives. Staff followed the principles of the Mental Capacity Act 2005 when there were concerns people lacked capacity and important decisions needed to be made.
Activities provided at the service were varied and creative which helped to stimulate people. People were encouraged to maintain their hobbies and interests, where possible.
General maintenance occurred and service contracts were in place to maintain equipment so it remained safe to use.
A complaints policy and procedure was in place. This was explained to people living with dementia or to their relations so they were informed. People’s views were asked for formally through surveys and informally on a daily basis by the staff. Feedback received was acted upon.
A variety of audits were undertaken to monitor the quality of the service. Issues found were addressed quickly. This included the issues we found regarding recording the medicine storage room and fridge temperatures, displaying people’s dietary needs in the dining rooms and issues relating to the recording of one person’s refused medicines.
The registered manager had an open door policy and an on call system was in place out of office hours to support people, relatives, visitors and staff. There was a homely and welcoming atmosphere within the service.
People told us that they were happy living at the home and satisfied with the care and support they received. Their comments included,' Lovely staff,' 'I'm so happy here,' 'Would recommend this place to anyone,' 'I can't fault any of them [staff] I couldn't be happier,' and 'They [staff] are kind, I'm settled here.'
Relatives we spoke with said that they were happy with the care their loved one received. They told us, 'We're very happy with the care, we visit every day and we can go home relaxed knowing he is safe and well cared for' and 'He has some special carers [staff] who mean a lot to him.'
At this inspection we saw that staff had positive interactions with people, they spoke patiently and kindly whilst offering choices and involving people.
We found that people's needs were identified in care plans. Records showed that people had been involved in the care planning process.
Medication records checked were up to date and medication was stored securely.
The provider had an effective recruitment and selection procedure in place to ensure that staff were appropriately employed.
We found people were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records had been maintained.
People's files contained documentation showing that they agreed to each care package that had been devised.
Where people needed specific equipment as part of their care delivery, for example to help with their mobility, it was readily available. Where staff were using equipment to help people they did so in a safe and appropriate manner.
Staff were encouraged to identify areas for growth and development, and managers gave meaningful feedback to staff to help them develop their skills.
A thorough investigation was carried out by the provider in response to any complaints they received. We saw that individual responses were sent to complainants when the investigation had been completed.
Due to people's communication needs we used a formal method of observation during the site visit. We call this the 'Short Observational Framework for Inspection (SOFI). This involved us observing up to five people who use services for a period of up to one hour and recording their experiences at regular intervals. This included people's mood, and how they interacted with staff members, other people who use services, and the environment.
Throughout the observation we saw all staff treat people with dignity and respect by using a positive, friendly and kind approach. We observed examples of good communication skills by staff that utilised eye contact and touch to engage people who use services. For example, one person who was sitting quietly regularly had their hand held while the carer talked to them and assisted them to have a drink.
We were able to talk to a number of people who use the service at this home, including relatives. Generally people told us they were very happy with their care and felt staff were friendly and supportive. We were told how the people's rooms and the home are kept very clean and the majority were very happy with the food they received.
We spoke with 6 relatives who were visiting the home and they confirmed that they were very satisfied with the care provided. One told us "We have no worries or concerns about the home and think it's good in every aspect." And another confirmed that "Our mother's quality of life is much better here than it was before she came to live in the home."
One relative said 'This a wonderful and a very special home, the care is excellent and we couldn't wish for better.'
A visiting health care professional said that they visited regularly and said 'The care is very good here.'
We spoke with Sheffield Local Authority, Contracting, Commissioning and Safeguarding and they told us that they had not identified any concerns at the home.