11 September 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the registered provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection was carried out by one inspector and an ‘Expert by Experience’. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type:
Westleigh is a ‘care home’. People in care homes receive accommodation and nursing or personal care. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with CQC. This means that they and the registered provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
The inspection was unannounced.
What we did:
Before the inspection we reviewed the information we held about the service. This included any statutory notifications sent to us by the registered provider about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send to us by law. We also contacted local commissioners of the service to gain their views. We used the information the provider sent us in the ‘provider information return’. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to formulate a ‘planning tool’; this helped us to identify key areas we needed to focus on during the inspection.
During the inspection we spoke with the registered manager, four members of staff, one kitchen chef and nine people who were living at the home.
We also looked at care records belonging to three people, three staff recruitment files, medication records, and other records and documentation relating to the management and quality monitoring of the service.
In addition, a Short Observational Framework for Inspection (SOFI) tool was used. SOFI is a way of observing care to help us understand the experiences of people who could not talk with us.
11 September 2019
About the service:
Westleigh provides accommodation and personal care for up to 20 people who require mental health support, the service also provides support to some older people. The service is provided by Warrington Community Living, a registered charity and non-profit making organisation. There were 16 people living at the home at the time of the inspection.
Accommodation can be found across two floors; there is a communal living and dining area, well maintained garden areas and an accessible passenger lift.
People’s experience of using this service and what we found:
People's support needs and areas of risk were assessed from the outset, however we found that some care records did not contain the relevant risk assessments and not all risks were effectively recorded or monitored.
Measures were in place to monitor the quality and safety of care people received but these were not always effective. We identified a number of concerns during the course of the inspection in relation to the provision of care being delivered.
Medication processes were in place; although we found that some areas of practice needed to be improved. We have made a recommendation regarding this.
People were supported to have maximum choice and control of their lives and staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. However, we found one person's restrictions were not monitored as regularly as they should’ve been.
Up to date safeguarding and whistleblowing policies were in place. Staff told us how they would raise any concerns and were familiar with the reporting procedures.
Staffing levels were routinely analysed and assessed in relation to the dependency support needs of people who were living at Westleigh. Pre-employment checks were carried out and people received care by staff who had been appropriately recruited.
Staff told us they were supported on a daily basis and training, learning and development opportunities were available. Staff received regular supervision and annual appraisals.
We observed staff providing kind and compassionate care. Staff were familiar with the support needs of people who were living at Westleigh and told us how they developed positive relationships with the people they cared for.
An activities co-ordinator was employed at the home. The co-ordinator helped to arrange a variety of different group and one to one activities. Activities were tailored around people’s likes and interests.
An up to date complaints procedure was in place. People were provided with complaint information from the outset and complaints were responded to and managed in line with organisational policy.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection:
The last rating for this service was ‘good’ (published 01 March 2017) At this inspection we found the quality and safety of care being provided had deteriorated and the provider was in breach of regulations. The service was rated ‘requires improvement’.
Why we inspected:
This was a planned inspection based on the previous rating.
We have identified breaches of regulation in relation to safe care and treatment and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up: We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.