Archived: Westmoor View Care Home

After receipt of the concerns there was a multidisciplinary team meeting chaired by the local authority to consider their serious concerns protocol. At this meeting the multidisciplinary team concluded that there were serious concerns about Westmoor View. Other meetings have been held to manage and monitor the serious concerns about the service. The registered provider has worked with the local authority to address the concerns. After the initial meeting the local authority placed a block on all new admissions, however, this was lifted to allow staged admissions (initially one person every two weeks) after the last meeting on 18 January 2017.

The local authority is currently undertaking an investigation into the concerns and allegations made. In addition the registered provider is also conducting investigations. However, we undertook a focussed inspection of the service on 21 December 2016 to make sure people were safe, happy and well cared for. This report only covers our findings in relation to those/this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Westmoor View Care Home on our website at www.cqc.org.uk”

Westmoor View Care Home is set within terraced grounds, located off Dixon's Bank in the residential area of Marton. The service provides care and accommodation to a maximum number of 36 people, some of whom are living with a dementia. The service also provides nursing care. Westmoor View Care Home is close to shops, pubs and public transport. At the time of the inspection there were 29 people using the service.

People told us they felt safe and staff were kind, caring and attentive. Staff were able to tell us about different types of abuse. Staff were aware of action they should take if abuse was suspected and were able to describe how they ensured the welfare of vulnerable people was protected through the organisation’s whistle blowing and safeguarding procedures. All staff we spoke with told us abuse and safeguarding was discussed with staff on a regular basis and that the registered manager encouraged staff to speak up if they had any reason for concern. Posters were placed in the staff room and on notice boards at the service, which encouraged staff to speak up if they had any concerns. Senior staff had held an open door session in which staff working at the service were encouraged to come and talk about any concerns or anything else they wanted to talk about. Other open door sessions had been planned.

Recently, staff had received training on dignity. Staff told us they had watched a DVD on 'A Crabbit Old Woman', which was about an elderly woman who was reflecting on their life and challenging nurses and care staff to see the actual person and who they were. Staff told us how this training had been thought provoking and made them reflect their practice.

Other information of concern was staff using poor moving and handling techniques and staffs lack of understanding of pressure are care. The registered manager and staff told us they had received updated training on moving and handling since receipt of the concerns. They told us there was a plentiful supply of slide sheets and other equipment required for the safe moving and handling of people who used the service. During the inspection we observed staff use a hoist to move a person from one place to another. We saw that staff followed safe practice, reassured the person and told them step by step what actions they were to take to move the person. People we spoke with did not raise any concerns about moving and handling.

During the inspection we looked at the positional change charts of some people who used the service. From examination of these charts we could see that staff were not always recording the position of the person. We spoke with staff about their understanding of pressure area care and relief. Staff were able to describe, in detail, individual people who used the service and the pressure area relief they required. The registered manager and staff acknowledged that they were not using the correct codes on positional change charts. The registered manager told us they would address this immediately.

Westmoor View Care Home is set within terraced grounds, located off Dixon's Bank in the residential area of Marton. The service provides care and accommodation to a maximum number of 36 people, some of whom are living with a dementia. The service also provides nursing care. Westmoor View Care Home is close to shops, pubs and public transport. At the time of the inspection there were 35 people using the service.

The home had a registered manager in place. 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.

There were systems and processes in place to protect people from the risk of harm. Staff told us about different types of abuse and were aware of action they should take if abuse was suspected. Staff described how they ensured the welfare of vulnerable people was protected through the organisation’s whistle blowing and safeguarding procedures.

Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety.

Risks to people’s safety had been assessed by staff and records of these assessments had been reviewed. This enabled staff to have the guidance they needed to help people to remain safe.

We saw that staff had received supervision on a regular basis and an annual appraisal.

Staff had been trained and had the skills and knowledge to provide support to the people they cared for. We received mixed comments from people and relatives when we asked if they thought there was enough staff on duty. During the inspection call bells were answered in a timely way.

Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards which meant they were working within the law to support people who may lack capacity to make their own decisions.

We found that safe recruitment and selection procedures were in place and appropriate checks had been completed before staff began work. This included obtaining references from previous employers to show staff employed were suitable to work with vulnerable people.

Appropriate systems were in place for the management of medicines so that people received their medicines safely.

There were positive interactions between people and staff. We saw that staff treated people with dignity and respect. Observation of the staff showed that they knew the people very well and could anticipate their needs. People told us that they were happy and felt very well cared for.

We saw that people were provided with a choice of healthy food and drinks which helped to ensure that their nutritional needs were met. Staff had undertaken nutritional screening to identify specific risks to people’s nutrition.

People were supported to maintain good health and had access to healthcare professionals and services. People were supported and encouraged to have regular health checks and were accompanied by staff to hospital appointments.

Assessments were undertaken to identify people’s care, health and support needs. Care plans were developed with people who used the service and relatives to identify how they wanted to be supported.

People’s independence was encouraged. People and relatives told us activities had improved in the last few months. Previously they felt that activities were limited but the introduction of a new activity co-ordinator had led to activities that were varied, interesting and stimulating. Activities for those people living with a dementia were limited.

The registered provider had a system in place for responding to people’s concerns and complaints. People and relatives told us they knew how to complain and felt confident that staff would respond and take action to support them. People and relatives we spoke with did not raise any complaints or concerns about the service.

There were effective systems in place to monitor and improve the quality of the service provided. Staff told us that the home had an open, inclusive and positive culture.

People were involved in decisions about their care and support. Staff made appropriate referrals to other professionals and community services. We saw staff understood people's care and support needs, were kind and thoughtful towards them, and treated them with respect.

Care plans were individual to people and were reviewed regularly. This meant that information was accurate and up to date.

There were enough staff on duty to provide timely care and support to people.

Good practices were in place to ensure the quality of the service. People were kept up to date and included in changes which affected them. Risks to people were minimised because audits were carried out.

The inspection team who carried out this inspection consisted of one inspector. During the inspection, they worked to answer five key questions which are outlined below.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People told us they felt safe and secure living at Westmoor View. The staff we spoke to understood the procedures they needed to follow to ensure that people were safe. Procedures were in place in the event of an emergency.

We inspected the staff rotas which showed that there were sufficient staff on duty to meet people's needs throughout the day. People received a consistent and safe level of support.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care home. Proper policies and procedures were in place. Relevant staff had been trained to understand where an application should be made, and how to submit one.

Is the service effective?

Procedures were in place to monitor people's ability to consent to care and treatment. We observed staff asking for people's permission and people told us that they were always asked for their consent prior to any care and support being given.

People had individual care plans which set out their care needs. People told us they had been involved in the assessment of the health and care needs when moving into the home but not in regular reviews.

People had access to a range of health care professionals some of which visited the home. Staff and people we spoke with told us staff escorted them to healthcare appointments if needed.

People told us that they were happy with the care that had been delivered and their needs had been met. It was clear from our observations and from speaking with staff that they had a good understanding of the people's care and support needs and that they knew them well.

Is the service caring?

We were not sure if there was an advocacy service available if people needed it because no information was available in the home.

Staff were aware of people's preferences, interests, aspirations and diverse needs. Our observations of the care provided, discussions with people and records looked at told us that individual wishes for care and support were taken into account and respected.

People told us that they were happy with the care and support provided to them.

Is the service responsive?

People told us, that they were able to participate in a range of activities both in the home and in the local community. Activities were provided as a group and individually which met people's specific needs.,

Staff were knowledgeable about the procedures to follow when people became unwell.

Is the service well-led?

The home reacted quickly when people's needs changed. Referrals were carried out promptly. The service worked well with other agencies and services to make sure people received their care in a joined up way

The home had a system to assure the quality of service they provided. The way the service was run had been reviewed regularly. People told us they had completed a customer satisfaction survey. They confirmed they had been listened to and as a result of the survey changes to the menu had been made and refurbishment plans were in place.

What people said

During our inspection we spoke with five people, three relatives and four members of staff.

People who were able to express their views told us they were satisfied with the care and support they received. One person told us, 'The staff are very good. They are always available when you need them. I like it when they check on me at night.' Another person told us, 'Staff are very good, they often pop in and ask how I am. They are like my family.'

People we spoke with confirmed that they were happy with the care and supported provided at the home. People told us, 'I get lots of choice about what I do and what I wear,' and 'It's a lovely home.'

All relatives we spoke with told us that they were kept up to date with their relatives care. People were complimentary about the care given. One relative told us, 'The level of care is nice. When I visit I am always offered a drink.'

We found that people enjoyed the activities available at the home and expressed satisfaction with the variety of activities. Two relatives we spoke with told us, 'The social activities are very good here.'

During our inspection we found a calm and relaxed atmosphere. People spent time with each other in communal areas sitting, chatting or participating in activities. People told us, 'Staff are very attentive.' One staff member we spoke with told us, 'We look after people really well and we work together well.'

People told us that they were happy with the care and service received. One person talked about how they could easily get about in their electric wheelchair and enjoyed trips to the shops and the local pub. They said, 'The staff are always helpful and know me very well and how I like things done." Another person commented, "All the staff are very kind, I am very comfortable here."

We were able to observe the experiences of people who used the service. We saw that staff treated people with dignity and respect.

We saw that people had their needs assessed and that care plans were in place.

We saw that people lived in safe, accessible surroundings that promoted their wellbeing.

We saw that the service had appropriate equipment. We saw that regular checks and servicing of equipment was undertaken to ensure that it was safe.

We found there was an effective quality assurance system in the home.

You can see our judgements on the front page of this report.

Westmoor View Nursing Home employed staff with the correct skills experience and qualifications. Pre employment checks were carried out before staff were able to work with vulnerable people.

On the whole, maintenance checks were carried out on equipment used within the service. However appropriate checks and maintenance had not been carried out on wheelchairs, therefore leaving a number of them in use whilst unsafe.

The service had a clear complaints procedure and information was available to people and their relatives about how to complain. Where complaints were received, either formal or informal, they were acted upon appropriately and action taken when necessary.

Some records within the service were not fit for purpose and needed to improve to ensure the safety and welfare of people was maintained.