Archived: Westcroft Nursing Home and Domiciliary Care

Updated 12 January 2017

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 between on 6 October 2016 and was unannounced. The inspection was undertaken by one inspector and a specialist advisor. Specialist Advisors are senior clinicians and professionals who assist us with inspections.

Prior to the inspection, we viewed information we held about the service, including information of concern and statutory notifications. Statutory notifications are information about specific important events the service is legally required to send to us.

We spoke with four people that used the service, four relatives and three members of staff. We also spoke with the registered manager and the provider.

We reviewed the care plans and associated records of six people who used the service. We also reviewed documents in relation to the quality and safety of the service, staff recruitment, training and supervision.

Updated 12 January 2017

We carried out a comprehensive inspection of Westcroft Nursing Home and Domiciliary Care on 14 December 2015. Following this inspection, we served a Warning Notice for a breach of Regulation 12 of the Health and Social Care Act 2008 relating to Regulation 12 (1) (2) (h) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014). Safe care and treatment. In addition to this, we also found an additional six breaches of six other regulations of the Health and Social Care Act 2008 during that inspection. Many of the breaches related to the nursing home part of the service.

Following the inspection the service was placed into special measures. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. 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 at its next comprehensive inspection and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

You can read the report for previous inspections, by selecting the 'All reports' link for ' Westcroft Nursing Home and Domiciliary Care' on our website at www.cqc.org.uk

Following the inspection in December 2015 the provider wrote to us to say what they would do to meet the legal requirements. We undertook another comprehensive inspection on 6 October 2016 to check the provider was meeting the legal requirements for the regulations which they had breached. At this inspection the provider had made sufficient improvements to be removed from special measures.

Westcroft Nursing Home and Domiciliary Care is registered to provide nursing and personal care for up to 21 people and also to provide personal care to people who live in their own homes. At the time of our most recent inspection the nursing home had been closed since March 2016 and the provider had applied to de-register the home. The provider continued to run the domiciliary care service and at the time of our October 2016 inspection the service was providing personal care to 14 people in the local community.

There was a registered manager in post for the domiciliary care service. 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.

The quality and safety monitoring systems were not fully effective in identifying and directing the service in ensuring the quality of records and service provision. Three of the regulatory breaches identified at the last inspection in December 2015 been not been remedied.

The provider’s staff recruitment process was not robust. The poor operation of the system meant that records relating to recruitment were incomplete and risk assessments had not been undertaken and recorded when the provider was unable to obtain satisfactory references.

People’s needs were regularly assessed however care plans were not personalised and did not contain individual information and references to people’s daily lives.

Staff told us they had received training to support people to be safe and respond to their care needs. We found however that records demonstrated that some staff had not completed suitable training before undertaking their role.

Medicines were managed safely and staff were aware of the service’s safeguarding and whistle-blowing policy and procedures.

There were enough staff to meet people’s needs. Staff demonstrated a detailed knowledge of people’s needs.

Training in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) had been provided to staff. These safeguards can only be used when a person lacks the mental capacity to make certain decisions and there is no other way of supporting the person safely. Staff had variable knowledge about the protection of people’s rights.

There were positive and caring relationships between staff and people at the service. People praised the staff that provided their care. We also received positive feedback from people's relatives. Staff respected people's privacy and people said that staff worked with them in a kind and compassionate way when responding to their needs.

People had access to healthcare professionals when required, and records demonstrated the service had made referrals when there were concerns.

The provider had a complaints procedure, and people told us they could approach staff if they had concerns.

The provider had made appropriate notifications to the Commission; notifications tell us about significant events that happen in the service. We use this information to monitor the service and to check how events have been handled.

We found three breaches of regulations at this inspection. You can see what action we told the provider to take at the back of the full version of the report.