Archived: Westcotes Residential Care Home

Updated 8 November 2019

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 Care Act 2014.

Inspection team

The inspection team consisted of two inspectors and an assistant inspector.

Service and service type

Westcotes Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

We spoke with three people who lived at the home about their experience of the care provided. We spoke with two members of staff and the provider. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two professionals who regularly visit the service.

Updated 8 November 2019

About the service

Westcotes Residential Care Home is residential care home providing personal and nursing care to 14 people aged 65 and over at the time of the inspection. The service can support up to 17 people.

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

There was a lack of effective management at the home and there had not been a registered manager in post for over a year. While the provider had arranged some management cover it was not effective. Systems to monitor the quality of care provided were not maintained. Incidents in the service were not monitored and action was not taken to keep people safe from future incidents.

Risks to people receiving care and from the environment had not been fully identified. Where action had been identified to keep people safe guidance was generic and contained conflicting information. This did not support staff to provide safe care. Medicines and infection control were not well managed and increased the risks to people.

Staffing levels did not support people’s needs and had impacted on the care they received. Staff had received training in how to provide safe care for people. However, we saw that they did not always work in line with their training, including in how to keep people safe from harm. The provider had not always ensured prompt effective action was taken when concerns were raised.

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; the policies and systems in the service did not support this practice.

Care plans showed staff had a limited understanding of how people living with dementia were able to identify and assess risks to themselves. In addition, people living at the home were not shown how to understand people living with dementia.

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 29 May 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvements. Please see the key question sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches in relation to the poor management of risks to people, people’s not having assessments and care plans which were regularly reviewed and reflected their needs, the provider’s inability to safeguarding people from harm, people’s ability to make decisions, insufficient staffing levels, the poor quality of the premises and the ineffective management of the home at this inspection.

Due to the concerns identified we imposed conditions of the provider's registration to increase the level of monitoring of the home.

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.

Special Measures:

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe, and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions of the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions, it will no longer be in special measures.