Westwood Lodge Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. ​ At our last inspection we rated this key question inadequate. At this inspection the rating has changed to requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The breaches of safe care and treatment and premises and equipment from the last inspection have been closed as sufficient improvements had been made. However, at this inspection the service was in breach of legal regulations in relation to medicine management and record keeping.

This service scored 59 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. Any incidents about people's safety were discussed with staff in a timely way, with action taken to reduce further risks. A staff member commented, “We are encouraged to report incidents and accidents.”

Staff at the service worked with people and healthcare partners to design, establish and maintain safe systems of care, in which safety was always well managed and monitored. A professional commented, “I found the staff approachable and friendly, responding to communication promptly.” Staff made sure there was continuity of care, including when people moved between different services. Detailed information was collected before people started to use the service, and ‘passports’ were available with information to take when attending hospital or other health appointments.

Staff at the service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared safeguarding concerns quickly and appropriately.A staff member commented, “The nurse on duty would be responsible for any referrals to the local authority, in the manager’s absence.” People told us they felt safe, they would speak with staff if they were worried. A person told us, “I feel safe, staff look after us.”

Improvements had been made to the management of risk. Staff worked with people to understand and manage risks by thinking holistically. Staff provided care that met people’s needs and was safe, supportive and enabled people to do the things that mattered to them.A person commented, “Staff remind me about risks. I smoke, but not in my room, you go outside to smoke.” Most risks were identified and transferred to care plans, including for the management of distress and agitation to reduce risks and help to keep people safe. A professional commented, “I found the staff very understanding of [Name]’s needs. The previous aggression stemmed from frustration with a language barrier. Staff took time to use technology to communicate with [Name] and were extremely patient.” We discussed risk assessments and care plans not in place where people’s cigarettes were restricted and retained by staff for safety reasons and staff issued them as people requested a cigarette. Risk assessments and care plans were also not in place where people refused personal care. The provider told us this would be addressed. Staff supported people safely and appropriate equipment was available where people needed assistance.

Improvements had been made to the environment since the last inspection. The provider demonstrated awareness of potential risks within the service and implemented measures to mitigate those risks. Equipment was regularly serviced for safety. However, we found areas of risk which still needed to be addressed. For example, doors were propped open during the inspection which increased the risk to people if there was a fire. Although, the provider addressed these concerns during the inspection more work was needed to ensure a safe environment.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. Staff members confirmed they received opportunities for training and development. Their comments included, “Training opportunities have increased with training available for care staff to complete the care home assistant practitioner course [CHAP] and National Vocational Qualification {NVQ] training”, “There are lots of development opportunities” and “Since the new manager came into post, training for staff is better.” People told us they felt safe with staff support, and people thought there were sufficient staff. Their comments included, “There are enough staff, they ask if I am okay” and “It is safe here.” Staff were recruited safely.

Improvements were needed to infection prevention and control. Some areas of the home were showing signs of wear and tear, and a programme of refurbishment was taking place around the service, which needed to be competed in a timely way. Not all areas of the building were clean including stairwells, floors and surfaces. Infection prevention control was compromised where flooring and tiles were cracked in some bathrooms, lavatories and seals broken between flooring and the walls, marked carpets and furniture in communal areas. The provider told us this was being addressed. Staff confirmed they had received infection control training assessed and managed the risk of infection. They told us personal protective equipment (PPE) and all cleaning materials needed were available.

Staff at the service did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences.

At the last inspection improvements were needed to medicine management. At this inspection some improvements had been made but further improvements were required.

Whilst people, relatives and staff raised no concerns about medicines management; we identified shortfalls in the records and care plans for medicines. Records did not always evidence that an effective system was in place to ensure medicines were safely managed and administered.

Medicine records were not always clear, where non-administration codes were used, they were not always clearly defined. A running balance was in place for assurance but where staff had identified that stock did not balance with records this was not escalated for investigation. This meant we could not be sure medicines were administered as prescribed.

Some people were prescribed medicines to be taken on a ‘when required’ basis or with a variable dose. Since our last inspection guidance for how these medicines should be administered was now available however, they were not always person-centred, and some were still missing.

Records were not in place for all creams applied by care staff as part of personal care. Patch application records were not always available to demonstrate rotation in line with manufacturers guidance to prevent side effects.

Care plans for medicines needed further updating when changes occurred and to make them more person centred.

Medicines were stored securely and safely including controlled drugs.However, one controlled medicine was not accurately detailed in the record book.

Comprehensive policies and procedures were in place to support the administration of medicines. Management completed audits, these had identified some of the issues we found at inspection.