Westerley Care Home

Westerley Care Home is a residential care home providing accommodation and personal care to up to 30 people. The service provides support to older people, some of who may be living with dementia. At the time of our inspection there were 28 people using the service.

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

People and their relatives told us the service was safe and expressed their satisfaction with the care provided. Staff had received training in safeguarding and felt confident in reporting any concerns to the provider or to external organisations. The provider had effective systems in place, had made referrals and investigated any concerns where appropriate.

Assessments of any risks to people’s safety and welfare had been completed and plans put into place to help mitigate these risks. Staff were aware of the action they needed to take to help keep people safe and had access to up-to date guidance. Any incidents or accidents were recorded and monitored by the provider to ensure appropriate action was taken in response.

There was enough staff. Members of staff were seen to be attentive and able to respond promptly to people. The provider monitored staff deployment and ensured safe staffing levels were maintained. Staff recruitment was safe and pre-employment checks completed.

Medicines were managed safely and regular audits completed. We were assured by the measures taken to help ensure the prevention and control of infection.

People’s needs and choices were assessed before admission to the service and they were supported to express their views and preferences regarding their care.

People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff were trained and felt supported in their roles. Daily handovers, regular team meetings and supervision sessions provided staff with the opportunity to reflect on their practice and offer feedback or suggestions to the management team.

People, relatives and staff spoke positively about the management of the service. We were told the management team were approachable and supportive. There were regular opportunities provided to people, relatives, staff and visiting professionals to communicate with the provider, who confirmed they used all information received with a view to improve the service.

The provider used a range of audits and checks to monitor the quality of the care at the service. They had identified ways in which these could be improved and had plans in place to address this. The provider was keen to be able to demonstrate more efficiently a clear audit trail of the quality assurances processes and the action taken to improve outcomes for people.

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 requires improvement (published 10 March 2021).

Why we inspected

We received concerns in relation to safeguarding and staffing. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

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 changed from requires improvement to good based on the findings of this inspection.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Westerley 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.

Westerley Care Home is a residential care home providing accommodation and personal care to 26 people some of whom lived with dementia. The service can accommodate 30 people over three floors.

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

People told us they felt safe and staff supported them the way they liked it. Relatives were very positive about how staff and management in the home kept people safe and met their needs safely.

Staff received training relevant to their roles and their competencies to provide care to people safely and following best practice were observed.

Risk assessments were in place to ensure if measures were needed to keep people safe these were implemented.

Staff were wearing personal protective equipment (PPE) in line with current guidance and areas in the home were clean. However, we observed that social distancing was not maintained, and people were sitting close to each other.

Relatives told us staff made efforts to facilitate video calls and face time with people in the home throughout lockdown. They praised staff and management for the good communication, and the commitment to meet people’s needs effectively.

Governance systems and audits in place helped managers monitor the quality and the safety of the care and support people received. Feedback from relatives and people was obtained and improvements were made to the service when needed. Regular meetings and supervisions were in place for staff and people to ensure they were contributing their views about the running of the home.

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 requires improvement (published 18 May 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 26 March 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.

We undertook this targeted inspection to check they had followed their action plan and to confirm they now met legal requirements. Targeted inspections do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

The overall rating for the service has not changed following this targeted inspection and remains Requires Improvement.

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

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 coronavirus and other infection outbreaks effectively.

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.

People’s experience of using this service:

People told us they felt safe living at Westerley Care Home. However, we identified some shortfalls in relation to infection control practices by staff and a lack of action taken in response to risks for people. The environment in which people lived required some improvement, however the registered manager was able to evidence they were working hard to address this. More work was needed to ensure the surroundings were suitable for people living with dementia.

Although we received good feedback from people about the food, the way in which people were expected to choose the foods they ate, did not always give people full autonomy and choice.

People were cared for by staff who had gone through a robust recruitment process and staff who followed good medicine management practices.

People gave us positive feedback about staff and told us they were kind and caring. Although we observed this with staff when they spoke with people, we found that the registered manager had not always ensured staff were following best practice. We found that people were not always receiving the social stimulation that they wished and there was a lack of social interaction by staff. However, activities did take place.

People’s care plans contained good information and guidance for staff and staff demonstrated they knew people well. People could feedback their views through meetings and surveys.

People’s consent was sought in line with the Mental Capacity Act 2005 and where people required the input of health professionals staff enabled this.

Although management of the service was such that it was open and transparent and it was evident they were keen to improve the service, we identified shortfalls which had not been picked up through the audits process.

During our inspection we identified four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also made four recommendations to the registered provider.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: We last inspected Westerley Care Home on 13 & 14 July 2016 where we rated the service as Good. We published the report on 13 August 2016.

Why we inspected: This was a scheduled fully comprehensive inspection carried out in line with our inspection methodology which is based on last inspection rating.

Follow up: We found at this inspecting that the service had not continued to meet the rating of Good. We have asked the registered provider to send us an action plan to tell us how they planned to address the concerns we identified. We will carry out a further inspection in line with our inspection methodology to check that the registered provider has taken actions to address the shortfalls found.

Westerley Care Home provides care and support for up to 30 people who are physically and mentally frail; some of whom may be living with dementia. There were 30 people living at the service when we visited.

The service has a registered manager. 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.

People felt safe living at the service. Staff were aware of the processes in place to report incidents of abuse; and had been provided with training on how to keep people safe from abuse and harm. Processes were in place to manage identifiable risks and to promote people’s independence and safety.

The service’s recruitment procedure was robust to ensure that staff were suitable and fit to be employed. Systems were in place to ensure people’s medicines were managed safely and given at the prescribed times.

Staff were provided with induction and essential training to keep their knowledge and skills up to date. They had regular one to one meetings to support them in their roles and yearly appraisals.

People’s consent to care and support was sought before any care was provided. This was in line with the requirements of the Mental Capacity Act (MCA) 2005. They were supported with food and drinks to maintain a balanced diet. When needed, staff supported people to access health care facilities.

People had developed good relationships with the staff team who treated them with kindness and compassion. Systems were in place to ensure that their views were listened to; and their privacy and dignity was upheld.

Before coming to live at the service people’s needs were assessed. This was to ensure that the care provided would be responsive to their needs. The service had a complaints procedure which was accessible to people and their relatives.

There was a positive, open, inclusive and transparent culture at the service. Arrangements were in place for the service to maintain links with the local community. There was a quality assurance system in place to monitor the care provided and to drive continuous improvements.

All people had a thorough needs assessment documented in their care records which covered many aspects of daily living, a detailed personal profile, risk assessments and associated daily logs all of which had been regularly updated. One staff member we spoke with said " We are very proud of our electronic care record system, gone are all the problems with trying to read other's handwriting".

Staff we spoke with told us about the importance they attach to ensuring the health and welfare of the people who used the service. One staff member we spoke with said "We have regular health and safety briefings from our manager and team leaders".

All staff we spoke with demonstrated their awareness of their role and responsibilities in relation to safeguarding. All people we spoke with who used the service said they felt confident to raise a concern. One person who used the service said "yes I would feel comfortable to raise a concern if I needed to".

During our visit we saw evidence of audits which had been undertaken and associated action plans which had been developed. We saw how changes had been made to improve the quality of service provision.

We found that the provider ensured that people and their relatives were involved in decisions related to their care. People's care plans and risk assessments were reviewed regularly, to ensure people were receiving the care they needed. We saw that the provider had policies and procedures in place, to ensure medicines were managed appropriately. We also found that there was a robust complaint process in place. The provider had an effective recruitment process to recruit staff who were competent and of good character.