Archived: West Cliff Hall Care Home

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

Is the service responsive?

Is the service safe?

Is the service effective?

Is the service well led?

If you want to see the evidence supporting our summary please read the full report.

We looked at the care records of six people, spoke with seven people that used the service, two relatives, five care workers, two registered nurses, the operations director, the manager, the maintenance person and the receptionist. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

Is the service safe?

People's care records contained assessments which covered the risks associated with staff providing the care and support they needed. This helped to ensure that people who used the service were safe because staff had taken action to identify and assess the risks to their health and welfare.

People told us that they felt safe. Safeguarding procedures were in place and staff understood how to safeguard the people they supported.

There were systems in place to help ensure that suitable and competent staff were recruited to care for people who used the service.

Systems were in place to ensure that the service learnt from incidents and accidents, comments and complaints.

Is the service effective?

People's needs had been assessed and care and support was planned and delivered in line with their individual care plan. Care plans were detailed and regularly reviewed to ensure they remained up to date. However, we found that the provider had not assessed people's capacity to make specific decisions, and that documentation relating to consent to care and treatment had not always been appropriately recorded. We have asked the provider to tell us what they are going to do to meet the requirements of the law.

Staff we spoke with were informed about people's needs and were able to tell us about the care they provided. This information was consistent with what was documented in people's records.

Is the service caring?

We observed that people were supported by kind and attentive staff. Staff treated people with dignity and respect and we saw that care was delivered in an unhurried and sensitive manner. One person told us that the staff were, 'helpful and always there when needed'. A relative told us, 'They look after my mother well'.

People's preferences, likes and dislikes were had been recorded and care and support was provided in accordance with peoples wishes.

We observed that people were well cared for and attention had been given to their appearance.

Is the service responsive?

The service had measures in place to review people's needs on a regular basis to ensure that their care plans remained up to date and reflected their current needs.

People knew how to complain and told us that they were confident that action would be taken where necessary.

Is the service well led?

The service has not had the consistency of a registered manager, however the operations director has been in place consistently and the acting manager is going through the registration process with us.

The acting manager was able to demonstrate a good knowledge of the needs of people who used the service and their care and support needs.

People knew how to complain and told us that they were confident that action would be taken where necessary.

Staff told us that they felt part of a team and that the manager was approachable. One care worker said; 'This is the best place I have worked at". Another said; 'I enjoy coming to work, there is always someone I can ask for help'.

The service had systems in place to monitor the quality of the service and identify where improvements could be made.

We previously inspected West Cliff Hall Care Home on the 19 and 23 August 2013 and found that records relating to people's repositioning needs were not always being documented.

At this inspection we looked at the repositioning records of five people who required pressure area care and found that documentation was completed appropriately and in line with their individual care plan.

The provider had appropriate recruitment procedures in place and was able to demonstrate that staff had undertaken relevant safety checks.

At this inspection we found that staff were knowledgeable about the pressure care that people required and that care plans were reviewed on a monthly basis. We found that food and fluid intake records were regularly completed, however we still found that records relating to the repositioning of people were not always completed.

We previously inspected the home on 12 December 2012 and found that people were not always being supported appropriately in relation to their individual care plan. Records showed that some people's care plans were not regularly reviewed. The provider had not always responded appropriately to safeguarding concerns and staff were not confident that concerns raised would be taken seriously by the manager. We found that there were not always enough appropriately skilled and experienced staff working in the home.

On this visit we found that some improvements had been made. Staff told us that they were positive that any safeguarding concerns would be taken seriously. Records showed that the provider had responded appropriately in relation to safeguarding concerns. We found that some people's needs had been regularly assessed; however we observed that the delivery of care was not always carried out in relation to people's care plan. We found that the care people received was not always documented.

We reviewed staff rotas, spoke with five members of staff and carried out observations. We found that there were enough skilled, experienced and qualified staff working in the home.

At this inspection we checked to see that the call bell system was working correctly and that the system was suitable and fit for purpose. During our inspection we spoke with eight members of staff, looked at call bell maintenance records and tested the call bell equipment. We saw that the call bell system had undergone maintenance work since our warning notice was issued and that the system was now working accurately. This demonstrated that people were protected from unsafe or unsuitable equipment because the provider had taken appropriate action.

We used various methods to help us understand the experiences of people using the service, because the people using the service had dementia and were not always able to tell us about their experiences. We spoke staff members, looked at records and used information from the local authority to support us with our judgments. We used the Short Observational Framework for Inspection.

People who use the service were not always protected from the risk of abuse, because the provider had not always taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. There was no clear guidance for staff on how they should support some people who became agitated or aggressive and so it was not clear that they were able to manage these incidents safely. People were not always assessed appropriately and care plans we looked at were not accurate.

We found that the call bell system was not working and this was impacting on people's welfare and safety. Staff members told us that responding to calls was at times confusing as the monitors were not accurate. We observed that there not sufficient numbers of suitably skilled, qualified and experienced members of staff to meet people's needs.

People who use the service understood the care and choices available to them. We spoke with four people who used the service. One person said "They treat me well, they smile and they are pleasant." Care was planned and delivered in a way that was intended to ensure people's safety and welfare. This was consistent in all four records we looked at. Care staff we spoke with had good understanding about the different risks to each person they supported. People we spoke with told us that they felt safe in the home and that their welfare was looked after.

There were effective systems in place to reduce the risk and spread of infection. The registered manager provided us with a tour of the care home. He told us that the home had cleaning staff who were responsible for the cleaning in all areas of service and the cleaning of people's bedrooms. Two people we spoke with told us that the cleaners regularly clean their bedrooms.

The care staff we spoke with told us that people have the opportunity to speak with staff about any concerns on a daily basis. One person we spoke with said "They come round once a week with that book asking if I am ok."