We carried out a review of the data available to us about Westlands Residential Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Westlands Residential Home, you can give feedback on this service.
We found the following examples of good practice.
Procedures were in place to prevent the transmission of infection to and from visitors.
Staff followed the guidance on how to use Personal Protective Equipment (PPE) and had supported people so that they also understood the need for this.
Whole home testing was carried out for staff including agency staff . The registered manager kept other information to make sure that staff were safe to return to work.
Cleaning of the home, including frequently touched surfaces, had increased to reduce the risk of transmission of infection.
The registered manager ensured additional staff were available and made sure agency staff did not work at other services to reduce the risk of transmission of infection.
The registered manager had created an area in the service to isolate people where they had tested positive for covid 19.
Further information is in the detailed findings below.
Westlands Residential Home is a residential care home providing personal and nursing care to 16 older people.
The care home accommodates up to 30 people in one adapted building over three floors.
People’s experience of using this service and what we found
People were always receiving safe care because actions had not been taken to reduce some of the identified risks.
People mostly had their medicines managed in a safe way, administration records were accurate and up to date and medicines were stored in the correct way. For one person who required a specific form of medication administering, we found staff were unclear about the guidelines for administration and there were no clear instructions in place.
Care plans required further detail to ensure staff all the required information about meeting peoples needs. Although care plans were reviewed not all identified changes to people’s care were transferred into the main care plan, so staff had the most up to date information available.
Sufficient numbers of staff were employed to meet people's needs. Staff received training which gave them the necessary skills and knowledge to carry out their roles and meet people’s needs. Although training for end of life care had still to be undertaken.
Staff delivered care and support that was personalised. Staff were kind, caring and motivated and people were complimentary about the care provided. Staff respected people’s privacy, dignity and independence and encouraged people to lead their life in the way they wanted to.
People were supported to maintain their health. Staff made referrals to health professionals when required. Staff were kind and caring and had developed good relationships with people using the service. People were supported to have maximum choice and control over their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People had access to food and drink based on their individual choice and preferences. People had access to a range of activities that reflected their specific needs and interests. There were plans to increase the activities offered especially for those living with dementia.
Systems were in place to ensure lessons were learnt when things went wrong. There was an open culture within the service, where people and staff could approach the registered manager who acted on concerns raised to make improvements to people's care.
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 11 August 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Following our previous comprehensive inspection in June 2016, we gave this location an overall rating of 'Requires Improvement’.
At that inspection we found that people’s risk assessments were not robust enough and the staffing levels were not sufficient to ensure people's needs were safely met. We also found the service was not always safe because people's medicines were not managed effectively. In addition to this we found some of the areas of the home and furniture were dirty and this exposed people to the risk of acquired infections. People were also exposed to hazards because cupboards with cleaning detergents were not always locked.
The service offered to people who lived at the home was not always effective because the requirements of the Mental Capacity Act 2005 were not met. We also found people were not always involved in decision making around their meals and meal times. From our observations, we found that care plans lacked involvement from the people who received care and did not take into account their wants, needs and were not person centred. People were bored and spent much of the time just sitting throughout the day which was punctuated by mealtimes or tasks delivering their personal care. People also told us they were not able to take part activities and hobbies that were of interest to them because there wasn't enough staff.
We found there was an area of concern whereby the lift had broken down, but this was not reported to the Care Quality Commission (CQC) as an event that stopped the service from operating as normal. You can read the report from this comprehensive inspection by selecting the 'all reports' link for Westlands on our website at www.cqc.org.uk.
The provider submitted an action plan to tell us how they would meet these regulations and the timescale they intended to have them met by. At the last inspection in June 2016 we asked the provider to take action to make improvements to the above issues and during this unannounced comprehensive inspection on 14 June 2017, we found that these actions had been completed
There was a registered manager in post. 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 was not strong leadership in the service and we found that people were unsure who the registered manager was. Quality monitoring systems were however in place. A variety of audits were carried out and used to drive improvement.
People using the service felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and felt confident in how to report them.
People had risk assessments in place to enable them to be as independent as they could be in a safe manner. Staff knew how to manage risks to promote people’s safety, and balanced these against people’s rights to take risks and remain independent. There were sufficient staff, with the correct skill mix, on duty to support people with their needs. Effective recruitment processes were in place and followed by the service. Staff were not offered employment until satisfactory checks had been completed. Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service.
The service was clean and there were no malodours. Cleaning products were locked away.
Staff received an induction process and on-going training. They had attended a variety of training to ensure they were able to provide care based on current practice when supporting people. They were supported with regular supervisions. People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of this guidance and correct processes were in place to protect people. Staff gained consent before supporting people. People were able to make choices about the food and drink they had, and staff gave support when required to enable people to access a balanced diet. There was access to drinks and snacks throughout the day.
People were supported to access a variety of health professional when required, including opticians and doctors, to make sure they received continuing healthcare to meet their needs.
Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People and relatives, where appropriate, were involved in the planning of their care and support. People’s privacy and dignity was maintained at all times.
People were supported to follow their interests and join in activities if they chose to. People knew how to complain. There was a complaints procedure was in place and accessible to all. Complaint had been responded to appropriately.
Westlands is a residential care home in Leighton Buzzard, providing accommodation and support for up to thirty older people. The home operates over three floors. The first and second floors are accessed by stairs and a lift. At the time of our inspection there were twenty-five people living at the home, some of whom were living with dementia.
The home had a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (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.
People who lived at the home were not always safe because the staffing levels were not sufficient to meet their care and support needs. Their medicines were administered as prescribed but there were unexplained gaps in medicines administration records and their risk assessments did not always provide adequate guidance to staff on keeping them safe. Risk assessments that related to the safe running of the home had not been reviewed since 2013. Staff were trained on safeguarding people and they understood the process they needed to follow, if there were concerns about people’s safety.
Some of the areas of the home and furniture were dirty and this exposed people to the risk of acquired infections. People were also exposed to hazards because cupboards with cleaning detergents were not always locked.
People’s care was not always effective because regular use of agency staff meant that they did not always receive consistent care. The requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards were not always met, and people were not involved in menu planning. Although staff were trained in areas that were relevant to their job roles, we found that the training was not always effective in meeting people’s care needs. People were supported to access other health and care services when required.
The service was not always caring because the interactions between staff and the people who lived at the home were mainly task led. People were advocated for by their relatives or social care professionals where needed but there was no evidence that showed people had support from independent advocacy services if required. Staff were spoke with people appropriately and called them by their preferred names. People’s privacy and dignity was observed.
Improvements were also required in the responsiveness of the service because people and their relatives were not fully involved in the assessment and planning of people’s care. People were not always supported by staff to take part in activities that were of interest to them.
There was an effective system in place for handling complaints, but improvements were required in senior management’s oversight of this home and the frequency of audits so that any issues could be addressed quickly.
The provider was not meeting the regulations in relation to consent, safe care and treatment, the safety of the premises and equipment, staffing, person-centred care, good governance and notification of other incidents. You can see what action we told the provider to take at the back of the full version of the report.