Westdene Residential Home

Westdene Residential Home is a residential care home that was providing personal care to 35 people aged 65 and over at the time of the inspection, some of whom were living with dementia. The service can support up to 40 people.

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

People at Westdene Residential Home received a safe, effective and well led service.

Since the last inspection, the provider improved the quality of care records in relation to people’s safety. Care records contained information about people’s needs and risks. People’s preferences and choices were considered and reflected within records. Fire safety issues had been addressed and regular fire drills carried out to ensure people’s care needs were identified in the event of an emergency situation. Staffing levels had improved at night to meet people’s individual needs.

Improvements to the environment had been made to make the home more dementia friendly by adding name boards to people’s doors and painting the doors different colours to help people identify their own rooms.

Staff training was up to date, which meant staff had the appropriate knowledge and skills to carry out their role.

Medicines were managed safely. Staff received training and competency checks in relation to medicines.

Staff demonstrated a good level of understanding in relation to safeguarding. Appropriate referrals to the local safeguarding team had been made.

People, relatives and staff spoke positively about the registered manager and felt able to raise concerns and were confident that these would be addressed. People and relatives said they felt the service was safe and that people were well supported and received good quality care.

Staff knew people well and were knowledgeable about when to refer to other health professionals for advice and support. 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.

Good systems were in place to protect people from abuse. The service had implemented an electronic recording system which had improved recording and oversight of care such as food and fluid charts and medicines.

People enjoyed the food provided and were supported to make sure they had enough to eat and drink.

The registered manager and provider were responsive to feedback and committed to improving the service.

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 18 October 2021).

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.

At our last inspection we recommended that the provider reviewed staffing levels at night in order to support people’s safety needs. At this inspection we found improvements had been made to staffing levels.

At our last inspection we recommended that the provider considered best practice and national guidance to ensure the service was adapted to provide a dementia friendly environment. At this inspection we found improvements had been made to the environment which made the home more dementia friendly.

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.

The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

The provider has taken action to effectively mitigate the risks identified in the previous inspection.

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

Westdene Residential Home is a residential care home that was providing personal care to 39 people aged 65 and over at the time of the inspection, some of whom were living with dementia. The service can support up to 40 people.

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

People at Westdene Residential Home did not always receive a safe, effective and well led service. We identified concerns relating to people's safety. This included poor oversight of fire safety issues and the lack of guidance for staff on how to support people in the event of a fire emergency situation. This put people at risk.

The environment, which accommodated people who were living with Dementia, was not designed and decorated in line with best practice guidance. We made a recommendation about this.

Staffing levels at night did not meet the individual needs of people using the service in the event of an emergency situation. We have made a recommendation about this.

Staff training was out of date which meant staff may not have the appropriate skills and knowledge to support people’s individual care needs.

People did not always receive person-centred care and care records did not fully reflect their needs. Staff lacked guidance in relation to people’s individual fluid intake and records completed were inaccurate.

The provider had not effectively operated their quality assurance systems to oversee the safety and quality of the service.

Medicines were not always managed safely. The provider's policies and protocols were not being followed by staff and management.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; policies and systems in the service did not support this practice.

People and their relatives told us they were happy with the care and support they received.

Systems were in place to recruit staff safely.

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

Rating at last inspection

The last rating for this service was good (published 26 July 2019) at this inspection the service is rated requires improvement.

Why we inspected

The inspection was prompted in part due to previous concerns received about risk assessments within the service in relation to wheelchairs and the use of lap belts. Concerns were also raised in relation to safe recruitment and leadership of the service. A decision was made for us to inspect and examine those risks.

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.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safety of the service, need for consent, staff training and the provider's oversight and governance arrangements. Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Westdene Residential Home is a residential care home that was providing personal care to 38 people aged 65 and over at the time of the inspection, some of whom were living with dementia. The service can support up to 40 people.

The care home accommodates people in one adapted building that has been extended over the years and is on two floors. Bedrooms are mainly single occupancy, some with en-suite facilities. People share the lounges, dining rooms, activity rooms and gardens.

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

People were safely supported in terms of managing risks, staffing, safeguarding incidents, the suitability of the premises, handling medicines and maintaining good standards of hygiene.

Effective systems were operated for supporting staff with their care skills, training and supervision. The service was effective at offering people choice in their lives, good nutrition and hydration and support with their health care needs. The service was proactive when working with other agencies and ensuring appropriate premises design. People had maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The staff in the service were caring, understanding and treated people well. They understood about people’s diversity and individual needs and respected their privacy, dignity and independence. People expressed their views about their care and these were listened to.

People were supported in a person-centred way and had their individual communication needs assessed and met. They were encouraged to establish and maintain relationships with friends and family and had ample opportunity to engage in activities, pastimes and being occupied. Complaints were satisfactorily addressed and managed. People received responsive and compassionate care at the end of their lives.

The culture of the service was positive and lively. Staff understood about the effects of maintaining a quality service and managed risks well. The provider met their registration responsibilities and requirements, engaged and involved people well and looked for ways of improving the quality of care. They also worked well in partnership with other organisations and professional bodies.

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

Rating at last inspection

This service was registered with us on 2 July 2018 and this is the first inspection following a change of registered provider.

Why we inspected

This was a planned inspection.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.