Westcliffe Care Home

Westcliffe Care Home is a residential care home providing the regulated activity of personal care to up to 19 people. The service provides support to older adults some of whom were living with dementia. At the time of our inspection there were 17 people using the service. Westcliffe Care home accommodates people in 1 adapted building across 2 floors, the ground floor has a large living space and conservatory overlooking the large garden.

People’s experience of using this service and what we found

People told us they felt safe living at Westcliffe Care Home. Risks associated with people’s individual needs had been fully assessed and were well managed. Medicines were managed safely. People told us they were supported by enough kind and caring staff who knew them well. Staff were recruited safely. The provider ensured infection outbreaks were effectively prevented and managed. Incidents were used as learning opportunities to ensure the safety and quality of care improved.

People were supported to have maximum choice and control of 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 and their relatives were fully involved in their care and felt staff and the management team listened to their views and wishes. The registered manager understood their responsibility to be open and honest with people and apologised when things went wrong. The registered manager understood their role well and told us they were well supported by the provider. Lessons were learnt, and action taken to improve the quality of 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 10 October 2017).

Why we inspected

The inspection was prompted in part due to concerns received about risk management. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the Safe section of this full report.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained as good, this is based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Westcliffe Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At the last inspection, in September 2015, the service was rated Good. At this inspection we found that the service remained Good.

People continued to feel safe and there were systems in place to reduce the risks to people’s health and safety. There were sufficient numbers of staff to meet people’s needs in a timely manner and systems were in place to support people to take their medicines.

Staff received relevant training and felt supported. People were asked for their consent and appropriate steps were taken to support people who lacked capacity to make certain decisions. People were supported to eat and drink enough to maintain good health and when people’s health changed staff made referrals to external health professionals.

Positive and caring relationships had developed between people who used the service and the staff who supported them. Staff promoted people’s choices and valued their privacy and dignity.

People’s needs were responded to by staff who had a clear understanding of people’s current support needs. Care plans were in place which provided information about the care people required. People felt confident to raise concerns and felt these would be acted on.

There was an open and transparent culture which empowered people and staff to speak up and make suggestions for improvement if they wished to. The management team provided leadership and direction to staff. There were systems in place to monitor the quality and safety of the service.

Further information is in the detailed findings.

We spoke with three people using the service. They told us staff looked after their medication for them and they were happy with the arrangements for their medication. They told us they got it on time and had no concerns.

We also spoke with a relative. They told us they had no concerns with the medication arrangements for their family member.

We spent 30 minutes in the dining room during the morning and observed a staff member administering medication. We saw they checked the medication against the information on the MAR charts before giving people their medication. We saw that the staff member waited with people until they had taken their medication.

However, we found that people were not fully protected against the risks associated with medicines. We looked at the medication administration record (MAR) charts for eighteen people from 18 November 2013 until 25 November 2013. MAR charts are used to record when people have or have not taken their medication. We found some gaps on the MAR charts for ten people. We also found gaps on the topical medication administration record (TMAR) charts that staff used to record when creams were applied to people's skin.

We also found that the fridge containing medication was not locked. This meant medication had not been kept securely.

We spent 45 minutes in the dining room in the morning. We saw that the atmosphere was relaxed and we observed positive interactions between staff and people using the service. We saw staff spoke with people in a warm and kind way and asked them about their food and drink preferences. We saw that staff provided the support people needed.

People using the service who we spoke with told us they felt safe with staff and would inform staff or the manager if they were worried about anything.

People told us staff looked after their medication for them, they were happy with the arrangements and they always got their medication on time. However, we found some gaps in the medication records.

We found that people were protected against the risks associated with unsafe or unsuitable premises.

We found that staff received inductions, training, supervision and appraisals.

People using the service who we spoke with told us they felt the service was good. One person said, 'Well I think it's very good'. We found that the provider had systems in place to monitor the quality of the service provided.

We found care plans were person-centred and described the care needed to meet people's needs.

People using the service told us they felt safe at Westcliffe Care Home and felt their finances and belongings were protected. However, we found gaps in safeguarding training. This meant there was a risk staff did not have up-to-date knowledge about how to recognise and to respond to abuse appropriately.

We found medicines were not always safely administered. We also saw there were gaps in recording. This meant there was a risk creams and ointments were not being applied in accordance with doctor's instructions.

We found staff received an induction, supervision and appraisals. However, we found gaps in training. This meant there was a risk staff did not have appropriate knowledge to provide safe care.

We found people were made aware of the complaints system. We saw the complaints policy on display on the wall in the reception area. The provider also showed us a comments, compliments, concerns and complaints book.