Weston House

Updated 23 March 2024

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors and an Expert by Experience who made telephone calls to relatives after the inspection visit.

An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Weston House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Weston House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the CQC to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had been in post for about 7 months and had submitted an application to register. We are currently assessing this application.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 13 December 2023 and ended on 9 January 2024. We visited the service on 13 December 2023.

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. The provider did not complete the required Provider Information Return (PIR). This is information providers are required to send us annually with key information about the service, what it does well and improvements they plan to make. Please see the well-led section of the inspection report for more details. We used all this information to plan our inspection.

During the inspection

We spent time in communal areas observing the care and support people received to understand the experiences of people unable to speak with us about this. We spoke with 6 people. An Expert by Experience spoke with 3 relatives over the telephone after the home visit. We spoke with 12 staff including the manager, senior care staff, care staff, cook, and domestic staff. We spoke with a consultant who was supporting the home to identify and make improvements. We reviewed a variety of records. This included 3 people's care folders and multiple medicine records. We looked at 4 staff recruitment files. We continued to review information after the inspection relating to the management of the service, including quality audits and policies and procedures.

Updated 23 March 2024

About the service

Weston House is a residential care home providing personal care to up to 33 people. The service provides support to adults with mental health conditions. At the time of our inspection there were 27 people living in the home. People lived in 1 adapted building which consisted of 2 floors and a range of communal areas for people to enjoy.

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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Infection prevention and control was not effective throughout the building which meant people were at risk of catching and spreading infections. Quality checks were not always effective in identifying risks such as cleanliness and environmental safety.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. People’s medicines protocols did not always contain enough information for staff. People’s care plans and risk assessments were not always accurate and kept up-to-date, however, they were person-centred. Staff recruitment processes were not always robust.

Staff knew how to keep people safe from abuse and lessons were being learned when things went wrong. Staff knew people well. People, staff and relatives felt positive about the home management. Staff worked in partnership with other organisations.

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 2 April 2020) and there were 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 not been made and the provider remained in breach of regulations. This service has been rated requires improvement for the last 2 consecutive inspections.

Why we inspected

We received concerns in relation to people’s care and safety. As a result, we undertook a focused inspection to review the key questions of safe and well-led.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remains requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this report.

You can see what action we have asked the provider to take at the end of this full report.

The manager was responsive to feedback and addressed some of the environmental risks swiftly.

You can read the report from our last comprehensive inspection, by selecting the ‘All inspection reports and timeline’ link for Weston House on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to environmental safety, cleanliness, governance and oversight at this inspection.

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 continue to monitor information we receive about the service, which will help inform when we next inspect.