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Westgate House Care Centre Good

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Inspection report

Date of Inspection: 11, 12 June 2014
Date of Publication: 5 July 2014
Inspection Report published 05 July 2014 PDF

Overview

Inspection carried out on 11, 12 June 2014

During an inspection looking at part of the service

We looked at the personal care or treatment records of people who use the service, carried out a visit on 11 June 2014 and 12 June 2014, observed how people were being cared for and talked with people who use the service. We talked with carers and / or family members, talked with staff, reviewed information given to us by the provider and reviewed information sent to us by commissioners of services. We talked with commissioners of services.

We 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.

We were supported on this inspection by an expert-by-experience. This is a person who has personal experience of using or caring for someone who uses this type of care service.

What people told us and what we found

At our inspection on 03 and 04 March 2014 we found that the service was required to make improvements in relation to treating people with dignity and respect, their consent arrangements, the care and welfare of people who used the service, recruitment methods and the accuracy of people�s records. The provider submitted an action plan on 17 April 2014 which told us they would be compliant with the regulations by 15 May 2014.

We inspected Westgate House Care Centre on 11 and 12 June 2014 and found the provider had made some of the improvements, we had requested by 15 May 2014. At this inspection we were supported by three inspectors and one expert by experience. We looked at 12 people�s care records. We also spoke to the provider, manager, the unit managers for the three floors of the home, and 15 members of care staff on duty. We have served warning notices on the provider and manager requiring them to be compliant with the Health and Social Care Act 2008 by 18 July 2014. We will follow up this warning notice to ensure compliance has been reached.

We set out to answer five questions. These were whether the service is 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.

Is the service safe?

We found that care was not consistently planned and delivered in a way that was intended to ensure people�s safety and welfare.

We found on two floors that pressure mattress settings were consistent with the weights of people who used the service. However on one floor we found that all pressure settings were set to firm, regardless of the weight of people.

Is the service effective?

We saw that most of the risk assessments and support plans had been reviewed and updated following our last inspection. We looked at the care notes for people whose plans we had viewed and saw that in most cases care was recorded as being delivered in accordance with the plans. However these had not been completed for all people who used the service.

Overall people�s daily care records were up to date and reflected the care provided to people. However we found examples where the care plan had not been followed, reviewed or updated.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. Where applications had needed to be submitted at our previous inspection, proper policies and procedures had been followed. Relevant staff had been trained to understand when an application should be made, and how to submit one.

Is the service caring?

We observed staff interaction with people who used the service and noted that interactions were positive. Staff were attentive and kind and appeared to know the people well. However we also found that for two people who used the service, staff were unaware of their particular needs. These two people presented with particularly high and complex needs.

During our previous inspection we found that all the bedroom doors for people were left open, this did not promote people�s dignity and privacy. At this inspection we found that staff had reviewed this with people and their relatives and people�s doors were only open where they had requested this.

We found that staff were in the process of reviewing all people�s care records and were involving people who used the service and their relatives. This meant that they were able to seek the views of those people who best understood the needs of the person.

Is the service responsive?

The views of people who used the service were sought, encouraged and recorded in their care plan. However these views and preferences were not always carried out. We noted that preferences in relation to activities and bathing had not been provided for example.

The service listened to people�s experiences, concerns and complaints to improve the quality of care they received. We saw that recently the manager and staff had held meetings with residents and relatives to seek their views and opinions. However it was too early to determine how the manager had reviewed the responses and learned lessons from these views.

Is the service well led?

The service did not always promote a positive management culture that was positive, and open. We were provided with one record which we determined had been doctored during our inspection to provide us with a false impression of recruitment procedures. We confirmed the false entry made on the record with staff working on duty who had made the entry.

We found that recruitment processes for employing new care staff had been reviewed. We saw from records we looked at that staff employed at Westgate House Care Centre had been thoroughly vetted to ensure they were of good character and experienced to work with vulnerable adults.