- Care home
West Cotes Residential Care Home
Assessment report published 18 August 2026
Contents
Ratings
Our view of the service
The assessment was completed between 27 May 2026 and 15 June 2026. This assessment was completed due to ongoing concerns we received about the care provided to people in relation to pressure areas, food and fluid and staffing levels. The provider was in breach of the legal regulation in relation to the safe management of medicines and good governance.
Care plans did not always provide clear guidance for safe medicines use, and information for some high-risk, PRN and variable dose medicines was missing. While medicines were generally managed safely, staff did not always record or follow up missed or refused medicines as required.
People were supported by staff who demonstrated kindness and a caring approach. Positive interactions were observed, and staff responded promptly to people’s needs, which supported their comfort and day-to-day wellbeing.
However, systems to monitor, assess, and improve the quality and safety of the service were not consistently effective. There were ongoing gaps in governance, auditing, and leadership oversight, which had resulted in repeated issues across areas such as care planning, training compliance, and risk management. These issues had also been identified at previous inspections and had not been fully addressed, reducing assurance that improvements were sustained.
Leadership arrangements did not consistently provide the level of oversight required to ensure safe and effective care. Whilst management were responsive to external guidance and there was a regular management presence within the home, this had not translated into consistent monitoring or proactive service improvement.
We have asked the provider for an action plan in response to the concerns found at this assessment.
People's experience of this service
People living at the service appeared comfortable and relaxed in their environment. Observations and feedback indicated that people were happy with the care they received and were treated with kindness and respect by staff. Staff interacted with people in a caring and responsive manner and took prompt action to meet their needs, supporting people’s comfort and wellbeing.
The service aimed to provide a homely environment where people could continue familiar routines, which contributed to a sense of stability and reassurance. Efforts had also been made to maintain communication and engagement, including the use of newsletters and opportunities for involvement in the service.
However, some aspects of people’s experience may have been impacted by the issues identified during the assessment. Limited activities provision reduced opportunities for meaningful engagement and social stimulation. Environmental concerns, including the condition of some areas of the home and the absence of a shower, limited choice and may have impacted people’s comfort, dignity, and independence.
In addition, inconsistencies in areas such as care planning, risk monitoring, and staff training reduced assurance that people’s needs were always met in a consistent and person-centred way.