Westbury Court

Updated 14 January 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by one inspector.

Service and service type

Westbury Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager who was in the process of registering with the Care Quality Commission. It is a condition of the provider’s registration that they have a registered manager at Westbury Court. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave a short period notice of the inspection because we needed to check the status of the home regarding Coronavirus infection.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We reviewed notifications the provider had sent to us. Notifications are information about important events or incidents the provider is required by law, to send to us.

During the inspection

We received feedback from 12 relatives about their experience of the care provided to their family member. We observed how staff interacted with people. We spoke with the home manager, deputy manager and regional manager and received feedback from eight care and administrative staff.

We looked at a range of records. This included five people’s care records, medication records and risk assessments. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with three professionals who regularly visit the service.

Updated 14 January 2021

About the service

Westbury Court is a care home providing personal and nursing care to 45 people aged 65 and over at the time of the inspection. The service can support up to 60 people.

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

At our last inspection we found improvements were required to reduce risk to people’s safety. At this inspection we found new risk assessments had been developed.

Specific to each individual, risk assessments included, moving and handling, resistance to support, skin integrity, swabbing for Coronavirus and visiting of relatives.

People at risk of dehydration or malnutrition had risk assessments in place with a monitoring and recording system to identify changes. Risk assessments were reviewed and updated regularly.

People were protected from the risk of abuse and staff were trained in recognising the signs of abuse and what to do about it. Medicines were stored, administered and managed safely.

At our last inspection we found areas of the home were not clean. At this inspection we found the kitchen had a very good (5 star) hygiene rating, kitchenettes, bathrooms and toilets were all cleaned and well maintained. The home was clean and tidy and smelt fresh.

Due to the Coronavirus pandemic, extra cleaning of all areas of the home and particularly high touch areas was undertaken. Staff had access to plenty of personal protective equipment and were using it correctly. Staff were very aware and fully trained in infection control procedures.

At our last inspection we found consent was not always gained according to the law. At this inspection we found improvements had been made. Mental capacity assessments and their corresponding best interests’ decisions were in place where appropriate.

Staff training on all of the providers mandatory training topics had improved and overall, 93% of staff had completed their refresh in areas such as safeguarding and mental capacity. Staff knowledge and confidence had increased. Training had continued throughout the Coronavirus pandemic and staff had received extra training on infection control procedures.

At our last inspection we found care was not person centred. At this inspection we found improvements had been made. People were assessed before moving into Westbury Court. New care plans had been developed which were thorough, detailed and holistic.

The multi-disciplinary team had added their expertise to care plan information, for example occupational and physiotherapy and specialist mental health services. Care plans were person-centred and contained details of importance to people including their family history and choices and preferences.

At our last inspection we found management and leadership was not strong or consistent. At this inspection we found improvements had been made.

Westbury Court had a new experienced home manager who was processing their registration with the Care Quality Commission. The home and deputy managers worked closely and well together. They provided a good leadership team which had impacted well on the staff group.

Due to the Coronavirus pandemic restrictions, people's vulnerability and communication needs we did not speak with people directly in the home. We spoke with the relatives of people to gain feedback from theirs and their family members perspective. We received good feedback from relatives, who, despite the restrictions on visiting were confident the care their family member received was good.

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.

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

Rating at last inspection (and update) The last rating for this service was requires improvement (published 02 December 2019) and there were multiple breaches of regulation. We issued a warning notice to ensure the provider made improvements. 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

This inspection was carried out to follow up on action we told the provider to take at the last 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 coronavirus and other infection outbreaks effectively.

We carried out an unannounced comprehensive inspection of this service on 19, 20, 21 August 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, Good governance, Need for consent and Person-centred care.

We carried out a targeted inspection on 2 December 2019 to follow up on the warning notice and found the service remained in breach of the Regulations.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective, Responsive and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

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

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.