Archived: Westwood Park Residential Home

Westwood Park is a care home, which provides accommodation for 51 older people including some who may be living with a dementia related condition. The home is situated in the town of Beverley. The accommodation is provided over two floors. Seven bedrooms have en-suite facilities. There is a range of communal rooms on the ground floor. On the day of this inspection there were 51 people living at the service.

The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.

We found that robust quality assurance systems were not currently in place and therefore issues of concern in relation to the monitoring of people’s weights, the frequency that people fell and the temperature of the medication room had either gone undetected. Record keeping within the service also needed to improve. This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The registered manager had not informed the CQC of all significant events. This meant we could not check that appropriate action had been taken. This was a breach of Regulation 18 Notification of other incidents, of The (Registration) Regulations 2009.

The service failed to refer people to the falls team following multiple falls. We found the service’s policy in relation to falls had not been adhered to; therefore the service had not done all it could to mitigate risk to people using the service. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We found that one persons health needs were not met. They had experienced a sustained period of weight loss and although we saw that their weight was regularly monitored, no action had been taken to address the weight loss and there had been no contact made with any other professionals in relation to this. This was a breach of Regulation 14 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

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

We found that staff had a good knowledge of how to keep people safe from harm and there were enough staff to meet people's assessed needs. Staff had been employed following appropriate recruitment and selection processes.

Staff had received training in topics the registered provider deemed essential and they had access to supplementary training courses. The registered manager was able to show they had an understanding of Deprivation of Liberty Safeguards (DoLS) and we found the Mental Capacity Act 2005 (MCA) guidelines were being followed.

People had access to adequate food and drinks, but this was not always well recorded by staff. Most people enjoyed the food, although one person told us they did not.

People had their health and social care needs assessed and plans of care were developed to guide staff in how to support people. However, some elements of the care plans required further development. We saw people were encouraged and supported to take part in a range of activities.

There was a complaints procedure in place and people knew how to make a complaint if they were dissatisfied with the service provided.

Staff and people who visited the service told us they found the manager to be supportive and felt able to approach them if they needed to. There were sufficient opportunities for people who used the service and their relatives to express their views about the care and the quality of the service provided.

We observed good interactions between people who used the service and the care staff throughout the inspection. People were treated with respect and dignity, had their independence promoted and were provided with a choice about how their care was delivered.

At the inspection on 4 September 2014 we observed that record keeping had improved and that the registered provider was now compliant with this aspect of care provision.

Our inspector visited the service and the information they collected helped answer our five questions: Is the service safe? Is the service effective? Is the service caring? Is the service responsive? 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 and the staff supporting them and from looking at records. If you want to see the evidence supporting our summary please read the full report.

At the previous inspection in March 2014 we found the provider to be non-compliant with outcome 14: Supporting workers. The provider submitted an action plan to tell us what improvements they would be making to ensure that staff received appropriate training and development. At this inspection we found that action had been taken and compliance had been achieved.

Is the service safe?

Staff demonstrated an understanding of the different types of abuse and the action they needed to take if they became aware of an incident or allegation of abuse. They said that they would not hesitate to take action if they observed poor practice. On the day of our visit we saw there were sufficient numbers of staff on duty to meet people's needs. Staff had received appropriate training and development that equipped them to carry out their role safely and effectively and to meet the needs of the people who they supported.

Is the service effective?

People were supported to consult with health care professionals about their health care needs and any concerns about their general well-being. Any contact with health care professionals had been recorded and care plans had been updated to reflect advice given.

Is the service caring?

We saw that staff were caring and compassionate, and that there was good interaction between people who lived at the home and staff. People described staff as, 'Friendly', 'Courteous' and 'Nice.' People told us that staff protected their privacy and dignity and that any assistance with personal care was carried out sensitively.

Is the service responsive?

There was a complaints procedure in place and people who lived at the home told us that they would not hesitate to use it. People told us that if they had raised any concerns, these were listened to by the registered manager and staff. Appropriate records were kept of any complaints that the home had received.

Is the service well-led?

There was a registered manager in post and they carried out audits to ensure that the quality of the service was maintained. People who lived at the home were consulted about their care, as were relatives and social care professionals. The premises were safe and well maintained.

People told us 'The staff are very good and my relative is very happy here', 'They seem to have peoples' nutritional needs catered for, when asked staff are aware of this information and know when people's needs have changed,' and 'It is acceptable, there are no malodours and they are very aware of any thing like that.'

Information systems were in place to record some preferences for people who lived in the home, although life story work was not in place. We saw only limited evidence of individual involvement in care plans although we saw evidence of relative's involvement. Visitors told us they were kept up to date. Systems were also in place to support people with decision making.

People were supported to have their nutritional needs assessed and we saw that when necessary professional support, for example the dietician was also accessed. People were offered choices with their food and portions appeared adequate.

The home was clean throughout and some minor areas were to be addressed. There were domestic staff employed within the home and infection control policies were in place. Staff were provided with protective clothing to assist in infection control.

Staff were employed following established recruitment procedures which included verifying people's identity and suitability for the role.

Systems were in place to provide training for staff, although records for these were inconsistent and there were gaps in training which required addressing. Staff felt supported and able to raise concerns but supervision sessions were not fully established in the home.

There was evidence that where appropriate referrals were made to other services and medical and health professionals. The staff worked well with other providers and recorded details of interventions or advice in detail.

The environment was reasonably maintained and there were some adjustments made to enable those with dementia to be orientated to their surroundings.

Quality assurance systems were in place and these had been used effectively previously although had been carried out inconsistently in the period prior to the inspection. Paperwork and documentation was detailed but checks, reviews and updates of paperwork had been inconsistent more recently. This meant that it was not clear if the support people were receiving was appropriate for their current needs and of a high standard.

From what people told us, what we observed and noted as part of the review staff cared for the people who used the service appropriately.

Staff were suitably trained and supported to ensure they could offer the appropriate care to people. People were protected from harm and the risk of harm through staff training and risk assessments. Staff could tell us what they would do if they saw abuse happening or someone reported abuse to them.

Staff told us they tried to ensure that people's dignity and human rights were respected and we saw evidence of this during our inspection. There were appropriate systems in place to monitor and improve the quality of the service.

The people we spoke with said that they were satisfied with their care. One person said 'It's very nice, I've settled in, I've no complaints", another person said 'The staff look after me properly'. A relative said 'It is a marvellous place, the staff are lovely, they are always busy'.