Archived: Weston Park Care Home

Updated 12 August 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 12 and 14 July 2016 and was unannounced.

The inspection team was made up of one adult social care inspector and one inspection manager.

Before the inspection we checked the information that we held about the service. We looked at any notifications received and reviewed any information that had been received from the public. A notification is information about important events, which the provider is required to tell us about by law. We contacted the local authority contracts and quality assurance team to seek their views and we used this information to help us plan our inspection.

The provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. Prior to the inspection we reviewed this and other information we held about the service.

We used a number of different methods to help us understand the experience of people who used the service. During the inspection we spoke with 12 people who lived at the home and four relatives/visitors, to seek their views. We also spoke with staff including the registered manager, deputy manager, regional manager, four nurses, seven care staff, the head chef, the maintenance person and one of the activities co-ordinators.

We reviewed seven people’s care records and inspected other documentation related to the day to day management of the service. These records included three staff files, staff rotas, quality audits, meeting minutes, training records, supervision records and maintenance records. We toured the building, including bathrooms, store rooms and with permission spoke with some people in their bedrooms. Throughout the inspection we made observations of care and support provided to people in the communal areas and observed how people were supported over breakfast and lunchtime.

Updated 12 August 2016

We carried out an inspection over a period of two days on the 12 and 14 July 2016. The inspection was unannounced.

Weston Park Care Home is close to Macclesfield town centre. The home is a three storey building with accommodation for residents on the ground and first floors. The annexe (Silk Unit), and the ground floor of the home (Mulberry Unit), provide care and support for up to 64 older people with dementia. The first floor (Weaver Unit) provides nursing and support for up to 39 older people. The home had opened a fourth unit called the Tatton Unit, but at the time of the inspection the registered manager told us that they had taken the step to voluntarily closed this unit, due to difficulties in staffing the unit safely. At the time of our inspection there were 80 people living at the home. Weston park was last inspected on 26 February 2015 and was found to be compliant with all the areas inspected at that time.

There is a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We identified five breaches of the relevant legislation, in respect of staffing, safeguarding, consent, good governance and nutrition and hydration. You can see what action we told the provider to take at the back of the full version of the report.

We found that there wasn't always adequate staff to meet the needs of people. Staffing was affected by staff absences. The registered manager was recruiting new staff. Staff told us that the management team had made some improvements but we found that these had not been effective enough to ensure that staff sickness levels and other staff issues had been resolved.

Staff had received training in safeguarding and understood their responsibilities to protect people from harm and abuse. Staff knew how to report concerns, but some staff did not know where to report concerns to outside of their organisation. We found evidence that the service had not reported a safeguarding concern to the local authority, as required by the local Adult Safeguarding Policy and Procedures, therefore people could not be sure that they were fully protected from harm and abuse.

People’s medicines were administered safely. However, the storage of medicines was an issue because the home could not fully control the temperature of the treatment room, where medicines were stored. The provider was aware of the situation and told us that immediate steps would be taken to address this.

We found that most areas of the home were clean and well maintained. We noted some minor infection control issues. We saw that the registered manager was taking action to meet the requirements identified by the provider's fire risk assessment.

People's views of the food varied and some feedback was very negative about the quality and variety of food. We found that the dining experience was not a particular cheerful or sociable experience. We also unable to evidence from people's records and charts that they had always received adequate drinks.

Staff had received training in legislation such as the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. They were aware of the need to gain consent when delivering care and support. Not all staff had an understanding of the MCA and we saw that mental capacity assessments had not always been completed appropriately.

Staff received an indication and a new induction programme was being launched, to meet the requirements of the Care Certificate. Staff received on-going training. Although some staff did not feel that the training delivery method of e-learning was always effective.

Where a person was being restricted or deprived of their liberty, applications had been made to the supervisory body under the Deprivation of Liberty Safeguards. However we found that there were also other people who needed to be assessed under these safeguards.

People told us that staff were kind and caring, although some people told us that some staff were more caring than others. We saw that people were treated with dignity and respect, but found that further improvements were required. The registered manager had already taken some steps to address this and had introduced dignity champions.

Care records were personalised and they reflected the support that people needed so that staff could understand how to care for the person appropriately. Daily charts were not always completed fully or at the time that the care was provided. We saw that staff responded to people’s changing needs and sought involvement from outside health professionals as required.

Social activities were offered for people to participate in and enjoy but these needed to be further considered for all people's social needs to be met.

A complaints procedure was in place for people and their relatives to raise their concerns or complaints if they had a need to.

The registered manager was supported by a wider team. She emphasised that work had been undertaken to make improvements coming into post. She told us that there were further areas for improvements which they were focused on. Staff told us that they felt supported by the registered manager, they found her to be approachable and felt able to raise any concerns. We found that the provider had not made sufficient improvement to ensure people received a high standard of care that was consistently provided and kept people safe.