We carried out a review of the data available to us about Westvilla Nursing Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Westvilla Nursing Home, you can give feedback on this service.
Westvilla Nursing Home is a care home providing personal and nursing care for 24 people, at the time of the inspection. The service can support up to 34 people in one adapted building across two floors.
People’s experience of using this service and what we found
Management of medicines was inconsistent. We found people received their prescribed medicines on time, however documentation for medicines that were only given as required were unclear. Further work was needed to ensure staff had consistently clear instructions in order to give people their medicines safely. We have made a recommendation about the management of some medicines.
We were mostly assured the provider was following government guidance in relation to protecting people from COVID-19. The registered manager had developed an infection control action plan following a recent audit to address issues found. Storage issues which had been found prior to our inspection which made cleaning some areas of the service difficult had been addressed and action was being taken.
People told us they felt safe and well cared for by staff. Staff received training in safeguarding and were aware of who to report concerns to both internally and externally. Staffing levels were sufficient to meet the needs of the people who used the service on the day of the inspection. Staff received training to ensure they could work effectively in their roles.
People made choices about how they wanted to be supported and relatives had been involved in care planning meetings. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. The policies and systems in the service supported this practice. Where people lacked capacity, they were helped to make decisions. Where their liberty was restricted, this had been identified and action taken to ensure this was lawful. They received support and had access to health care services.
People, staff and relatives, felt supported by the management team. Systems and process were in place to carry out quality checks and any issues were addressed appropriately. Staff supervisions and meetings were held regularly. The service engaged and worked with health and social care professionals to ensure people received suitable 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 requires improvement (published 22 October 2019) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 13 September 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements. 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 ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Westvilla Nursing Home on our website at www.cqc.org.uk.
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.
Westvilla Nursing Home was providing nursing care for 34 people aged 65 and over at the time of the inspection. The service can support up to 35 people. The accommodation was provided over two floors.
People’s experience of using this service and what we found
Some aspects of fire safety were not robust. There were voids in two laundry cupboard ceilings which may have compromised safety in the event of a fire. Nottingham Fire and Rescue Services had undertaken an inspection in January 2019. They asked for fire training to be conducted for all staff, three staff had not completed this. Infection control required improving. These issues were being addressed. A range of quality checks and audits were undertaken to monitor the service. However, these had not been effective in finding the shortfalls we found during the inspection.
People were protected from the risk of harm and abuse. Safeguarding procedures guided staff about the action they must take if they suspected abuse was occurring. People’s risk assessments identify hazards to their health or wellbeing. Action was taken to reduce risks but maintain people’s independence and choice. There were enough staff to meet people’s needs. Incidents and accidents were monitored, and corrective action was taken to prevent re-occurrence. Recruitment was robust.
Staff undertook training to maintain and develop their skills which helped them meet people’s needs. Supervision and appraisal were undertaken for staff to maintain and develop their skills.
People had their capacity assessed and were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Staff were caring and kind. People we spoke with confirmed this. Staff provided comfort and support to people. Information was provided to people in a format that met their needs in line with the Accessible Information Standards.
Staff supported people to meet their health and nutritional needs. People were supported and encouraged to maintain their independence, where possible. Staff worked with health care professionals to maintain people’s wellbeing.
People felt able to raise concerns and were confident they would be addressed. A programme of activities was provided in line with people’s hobbies, preferences and interests. End of life care was positively promoted through joint working with the local hospice.
The management team were available to people. They listened to and acted on feedback provided about the service. Data security was maintained.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 23 February 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified breaches in relation to safe care and treatment, and premises and equipment at this inspection. We have issued two Requirement Notices for these breaches. We have also made two recommendations about undertaking fire training and quality monitoring of the service. You can see what action we have asked the provider to take at the end of this full report.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Westvilla Nursing Home on our website at www.cqc.org.uk.
Follow up
We will seek an action plan from the provider to make sure the environment remains safe for people and fire training is up to date. 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.
Westvilla Nursing Home is located in a pleasant residential area in Retford. The home is purpose-built and is registered to provide accommodation for a maximum of 35 people. On the day of our inspection 32 people were using the service.
The service had a registered manager. 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
People who used the service and staff at Westvilla knew who to report any concerns to if they felt anything untoward had occurred. People’s care records showed that any risk to their safety had been identified and measures were put in place to reduce these risks. There were enough staff with the right skills and experience to meet people’s needs. People’s medicines were stored and handled safely, but people could not be assured that their medicines were always administered as prescribed. However, the manager was aware of the difficulties and was taking robust action to improve standards with regard to the administration of medicines.
People were supported by staff who had received the training they needed to support people effectively. People had consented to the care that they received. People’s rights were protected because staff acted in accordance with the Mental Capacity Act 2005. The principles of the Deprivation of Liberty Safeguards were understood and applied correctly.
People spoke positively about the food they received. They were able to have choice in what they ate at each meal and received support to eat if required. People had regular access to their GP and also other health care professionals when required.
People were supported by staff who were caring and treated them with kindness, respect and dignity. Staff encouraged people to remain independent wherever possible and where people showed signs of distress or discomfort, staff responded to them quickly. There were no restrictions on friends and relatives visiting their family members.
People received the care they needed in a way that met their needs. We saw staff provide planned care well. Care plans were written with the involvement of each person and their family. They were reviewed regularly to ensure staff responded appropriately to any change in need a person may have. A wide range of group and individual activities were available for people to participate in if they wished. People were also encouraged to maintain their hobbies and interests and a wide range of community based opportunities were used. A complaints procedure was in place and people felt comfortable in making a complaint if needed.
The atmosphere within the home was warm and friendly. People living in the home were asked for their opinions with regard to the service that they received, which meant that their views informed decisions to improve the service. Staff understood the values and aims of the service and spoke highly of the registered manager. The registered manager had clear processes in place to check on the quality of the service and to ensure that any improvements identified were made and sustained
We performed the unannounced inspected at the service on 05 and 06 November 2014. Westvilla Nursing Home is registered to provide accommodation for a maximum of 35 older people. On the day of our inspection 30 people were using the service.
The service had a registered manager in place at the time of our inspection. 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 and associated Regulations about how the service is run.
When we last inspected the service on 07 November 2013 we found there were improvements needed in relation to how people gave consent to their care. The provider sent us an action plan telling us they would make these improvements by January 2014. We found at this inspection that this had been completed and the provider had made improvements in line with the action plan.
We found systems were in place to protect people from the risk of abuse and staff were aware of their roles and responsibilities in this area. The registered manager also shared information with the local authority when needed.
People received their medicines as prescribed and the management of medicines was safe.
Staffing levels were maintained at appropriate levels to support people’s individual needs and people received care and support when needed.
People made decisions and choices where they were able to and staff were aware of legislation to protect people who lacked capacity when decisions were made in their best interests. We also found staff were aware of the principles within the Mental Capacity Act 2005 (MCA) and had not deprived people of their liberty without applying for the required authorisation.
People were protected from the risks of inadequate nutrition and dehydration and specialist diets were provided when required. Referrals were made to health care professionals when additional guidance was needed.
People were encouraged to contribute to the development of their care plans and were involved in the planning of their care.
People were treated with dignity and respect. Staff were proactive in promoting people’s choice and were kind and caring when supporting people with their individual needs.
People were encouraged to be involved in decisions about the service and systems were in place to monitor the quality of service provision. People felt they could report any concerns to the management team and they felt their concerns would be responded to and taken seriously.
People told us that staff obtained their consent before any interventions were performed. One person told us, 'They (care staff) are very respectful. We can do what we want really.' Another person said, 'I cannot fault any of the staff. I feel safe and well looked after. They always tell me what they are doing so I can agree.'
We found that improvements were required to ensure that documentary evidence was available to show that people's plans of care were discussed and explained to them so they could provide informed consent. We also found that where it was suspected that person lacked the capacity to make informed decisions about their care package appropriate assessments had not been undertaken in all instances.
We found that suitable and nutritious food and drink was available in sufficient quantities to meet people's individual needs and preferences.
People told us they were very satisfied with the staff and found them to be caring and attentive to their needs. One person told us, 'All the staff are marvellous and they look after us well.' Another said, 'I cannot fault it here the staff are all very kind.'
Systems were in place to manage any concerns and complaints and people felt confident in reporting any issues to the management team.
Another person said 'My relative has settled really well and is quite content.'
We spoke with three people who were living at the home. One person told us 'I'm well looked after and the carers are very nice. The food is lovely and I get plenty to eat. '
We spoke with three members of staff who all said they were happy working at Westvilla. They told us 'The training is very good and there is always new training planned.'