Background to this inspection
Updated
24 December 2020
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.
The service had been identified for use by the Local Authority as a designated care setting in response to the Winter Plan for people discharged from hospital with a positive Covid-19 status. This inspection was to ensure that the service was compliant with infection control and prevention measures.
This inspection took place on 16 November 2020 and was announced. We completed a remote follow up to the inspection by video call on 30 November 2020 to check that all agreed changes had been made.
Updated
24 December 2020
This unannounced comprehensive inspection took place on 21 and 26 November 2018
Westholme is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service provides nursing and personal care for up to 74 people, including people living with dementia. The home is located on the outskirts of Winchester town centre and is arranged into three units; residential, nursing and discharge to assessment. Each unit has communal areas, including dining rooms and lounges.
The discharge to assessment unit can accommodate 10 people who require a period of care and treatment on leaving hospital before moving back home or into another supported living setting. At the time of our inspection there were 69 people living in the home.
There was a registered manager in post who had overseen the management of the whole service for many years. 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.
The service had an open and friendly feel. People commented positively on the home and the care received.
The provider and registered manager had taken action to make improvements identified at the last inspection, ensuring the service provided to people was compliant with the Mental Capacity Act 2005 (MCA).
People were treated with kindness, respect and compassion. Staff respected people’s privacy and promoted their dignity. People and relatives we spoke with told us staff were kind and caring. There were many positive interactions observed with staff showing compassion and understanding when supporting people.
Care staff and managers knew and cared about people who used the service.
Relatives and friends could visit whenever they and the person liked, although the service promoted a ‘protected lunchtime’ to enable people to concentrate on their main meal.
People and, where appropriate, their relatives were involved in regular care planning reviews.
Wherever possible, staff promoted people’s independence.
Staff were attentive, noticing when people looked uncomfortable or upset. They were quick but discreet in offering the care and support needed.
People received care and treatment that met their individual needs. Care was planned and delivered based on people’s individually assessed needs and preferences. Assessments and care plans were reviewed and updated regularly, with the involvement of people and their relatives.
People were supported to eat and drink enough to maintain a balanced diet. They had a choice of meals and drinks. Special dietary needs and preferences were catered for. Where people needed assistance to eat or drink, staff helped them attentively and with sensitivity.
People’s risk of malnutrition was monitored regularly. People were weighed at least monthly, or more frequently if there was concern about weight loss. Prompt action was taken to address weight loss.
People had access to healthcare services and were supported to manage their health.
People had access to activities that made their individual needs and helped them maintain community links.
Staff worked with GPs and district nurses to provide the support people needed at the end of their life, for example ensuring that strong pain-relieving medicines were in place.
People and staff told us there were enough staff to provide the care and support they needed.
Medicines were managed safely and people were administered the medicines prescribed by their GP. Medicines were stored securely.
Recruitment systems were robust and helped ensure only suitable staff were recruited.
Staff had the knowledge and skills needed to carry out their roles. They had access to the training they needed.
Information about people’s individual risks was comprehensive and up to date.
People were protected from abuse and neglect. Staff understood their responsibilities in relation to safeguarding adults. They knew how to raise concerns about poor practice.
People’s rights were protected because staff worked in accordance with the Mental Capacity Act 2005.
People were protected from the risks of cross infections.
The premises and equipment were kept clean and in good order. There was a team of maintenance staff and a regular maintenance programme.
There was a system for bringing about learning and improvement following accidents and incidents.
Complaints and concerns were taken seriously and used to improve the quality of care.
Quality assurance processes were in place to monitor the service’s performance and drive improvement. There was a programme of monthly audits within the service, with additional snapshot audits by the service manager who visited the service at least every four to six weeks to do quality/governance. The service manager also visited the service regularly to support the registered manager.
The service worked openly and cooperatively with other organisations to ensure people were safe and received the care and support they needed.
People’s and relatives’ ideas and wishes were actively sought for activities and there were periodic surveys carried out to seek improvement.
The inspection rating from the last inspection was clearly displayed on both sides of the building and on the provider’s website.