About the service West Villa is a residential care home providing personal care to 29 people aged 65 and over at the time of the inspection. The service can support up to 32 people.
The home is over three floors, with communal living spaces on the first floor. People’s bedrooms are on all three floors.
People’s experience of using this service and what we found
People’s care was not provided safely. Individual risks to people and risks within the premises were not identified, mitigated or monitored. People who required support with moving and handling did not have individual equipment and no assessments had been carried out to ensure equipment was safe for them to use. Medicines were not managed safely, which put people at risk of harm. Fire safety was not given high priority and people’s individual emergency evacuation plans were not accurate. Recruitment processes were not always robust and there were insufficient numbers of suitability trained staff, especially at night. Accidents and incidents were not monitored and safeguarding procedures were not always followed.
People’s needs and choices were not assessed thoroughly. There were poor systems in place to support staff to provide effective care. Staff did not have appraisal or consistent supervision and there were no competency checks to make sue they had the right knowledge and skills to meet people’s needs. Consent to care and support was not consistently obtained, monitored or reviewed in line with legal requirements and national guidance.
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 and care documentation was not person-centred. Activities took place but some people were bored and at risk of social isolation.
Management systems were weak and there was a lack of oversight of the quality of service delivery. Audits were being done but they lacked rigour and had not successfully addressed the breaches since the last inspection. There were gaps in actions, dates and signatures. Accidents and incidents were not always reported to CQC as required.
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 14 August 2018).
We found four breaches of regulations relating to safe care and treatment, need for consent, good governance and fit and proper persons employed.
At this inspection not enough improvement had been made and the provider was still in breach of these regulations. We identified four further breaches of regulations relating to person-centred care, safeguarding service users from abuse and improper treatment, premises and equipment and staffing.
Why we inspected
This was a planned inspection based on the previous rating and to follow up on action we told the provider to take at the last inspection.
The inspection was prompted in part due to concerns received about staffing and safe care and treatment. A decision was made for us to inspect and examine those risks.
The overall rating for the service has changed from Requires improvement to Inadequate. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvement. Please see all sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for West Villa on our website at www.cqc.org.uk.
Enforcement
We have identified eight breaches in relation to: safe care and treatment; need for consent; good governance; fit and proper persons employed; person-centred care; safeguarding service users from abuse and improper treatment; premises and equipment; and staffing at this inspection.
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 meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.
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 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.