Westside Nursing Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question Requires Improvement. At this assessment the rating has remained Requires Improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulation in relation to need for consent.

This service scored 58 (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 did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

Care plans did not consistently contain sufficient detail about people’s needs, which meant there was a risk care was not always planned or delivered in line with people’s current requirements.

A range of care plans were in place and were regularly reviewed but care records did not always include sufficient information to support staff to recognise and respond appropriately to changes in people’s condition, For example, people with diabetes.

There was limited evidence of people being involved in reviews of their care. Some care plans showed people’s views were considered but this was not consistent.

A relative said, “I have regular reviews with the local authority and have all the information I need.”

The provider did not always follow current evidence-based good practice and standards.

Care and treatment mostly reflected current best practice and guidance; however, staff had not consistently supported a person to change position in line with their care plan. We were told that the person had not suffered harm, however, this lack of consistent support meant that there was a greater risk of harm.

We observed lunchtime on the first day of our assessment. During the lunchtime observation, people remained seated individually around the lounge and were not supported to use the dining room. Opportunities to promote social interaction during the meal experience were limited. People did not speak with each other during the meal and their individual tables did not have any placemats, napkins or condiments. There was limited explanation of meals by staff when serving food and there was a long wait for desserts for some people with limited dessert alternatives available.

People’s weights were regularly monitored and a relative said, “All the cooks are amazing. They make sure the food is well cooked and to the correct consistency.”

Staff were confident in referring to other organisations and where concerns were observed, appropriate referrals to partner healthcare partners were made in a timely way.

Staff described effective communication within the service and that managers were described as knowledgeable and approachable. A staff member said, “The staff work together to help each other, if staff working in one area finish first then they help the others. The nurses and manager help, they will always check the resident if care staff are worried about them.”

A professional commented, ‘The communication with the home has always been excellent. The [registered manager] is always very prompt in responding when I email or call her for anything.’

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control.

Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support. A range of external health and social care professionals were involved as required. However, there was currently no dental care offered for people in the service, although we were told that some people were taken by their relatives to private dentists.

During our visit we checked people’s bedrooms and saw that one person had a dry toothbrush. We checked their records which stated that the person had received oral care that morning. The manager checked this and it was confirmed that record was not accurate and the person had not been supported with oral care that morning. Not all staff had completed oral health training.

Records showed support for people with healthy eating and a relative said, “The doctor comes in when needed.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Regular reviews of people’s care all considered outcomes and how to improve outcomes for people. External professionals were involved in helping to address these needs.

Clinical monitoring tools were in place to monitor people’s conditions and to identify and address any emerging concerns. However, staff did not use a tool to identify pain in people who were unable to express this themselves. Staff agreed to put this in place.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

We found an example of a shared room arrangement where appropriate mental capacity assessments and best interest decision-making documentation had not been completed for one person. The leaders had not considered the potential impact on the individuals sharing a room and if that was in fact in their best interest. We discussed this with the registered manager, who took action to ensure the necessary documentation was put in place. The registered manager also told us that alternative room arrangements would be considered when a suitable room became available.

Other mental capacity assessments were completed and best interest decisions were recorded. A policy was in place, and training was provided but not all relevant staff had completed this.

We observed staff checking with people before providing support. Policies were in place and advanced decisions were documented in care records.