Westin Care Home

Updated 7 May 2022

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 Health and Social Care Act 2008.

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

The inspection team was made up of two inspectors and one Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Westin Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Westin Care Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a registered manager in post.

Notice of inspection

The first day of this inspection was unannounced, the second day was announced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with ten people about their experiences of care provision at Westin Care Home. We spoke with eight staff, including the manager, nominated individual, care staff and unit managers. We spoke with one physiotherapist who was working in the service. We reviewed eight care plans, three staff recruitment files and various policies and procedures in relation to the running of the home.

The nominated individual is responsible for supervising the management of the service on behalf of the provider.

After the inspection

We continued to have contact with the manager who updated us about changes made in response to our findings. We spoke with relatives of eight people.

Updated 7 May 2022

About the service

Westin Care Home is a nursing home providing regulated activities (personal and nursing care) to up to 52 people. The service provides support to older people, people with dementia and mental health needs, and people with physical disabilities and sensory impairments. At the time of our inspection, there were 38 people using the service.

The service is laid out across two floors; the ground floor is named oak unit and the first floor is named willow unit. Both units offer communal dining, lounging, bathroom and toilet facilities. Bedrooms on both floors can be accessed by a lift, stairs or stair-lift. There is level access to the garden from the ground-floor. The manager’s office is located adjacent to the reception area.

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

The provider failed to implement a robust approach to infection prevention and control (IPC) practice. This meant people were placed at increased risk from the spread of infection. We identified gaps in relation to risk assessment, management and associated guidance. This placed people at increased risk of experiencing avoidable harm. There were sufficient numbers of suitably qualified staff to meet peoples’ needs, and employment checks were in place to prevent unsuitable staff working in the service. Staff spoke confidently about how they would protect people from harm and abuse. Safeguarding processes meant actions were taken if potential safeguarding concerns were identified.

The registered manager was not involved with the day-to-day running of the service. Audits and checks had not always been used effectively and had failed to identify the concerns, errors and omissions we found during our inspection. Staff spoke about people in a person-centred way, we observed kind and caring interactions between people and staff. The manager was introducing new ways of working to improve continuity of care.

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 good (published January 2022).

Why we inspected

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 inspection was prompted in part due to concerns received about pressure ulcer management. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

After our inspection, the manager contacted us and told us about changes and improvements they had made in response to our feedback and findings at this inspection.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement and Recommendations

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 and will take further action if needed.

We have identified breaches in relation to how the quality and safety of care provision is monitored, managed and assessed.

Please see the action we have told the provider to take at the end of this report.

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 from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.