Westmorland Court Nursing and Residential Home

Updated 21 March 2023

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 an inspector, a medicines inspector and Expert by Experience. 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

Westmorland Court Residential and Nursing Home 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. 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 Care Quality Commission 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 a registered manager in post.

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 (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 8 people who used the service and 2 relatives about their experience of the care provided. We spoke with 6 members of staff including the registered manager, clinical lead and care workers. We also spoke with a visiting social worker. We reviewed a range of records. These included 5 people’s care records and 8 medication records. We looked at staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including some policies and procedures.

Updated 21 March 2023

About the service

Westmorland Court Nursing and Residential Home is a residential care home providing personal and nursing care for up to 48 people aged 65 and over. At the time of this inspection the service was supporting 32 people. The service provides care for older people, older people living with dementia. The accommodation is provided over 3 floors.

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

Medicines were not always being managed safely. However, since the last inspection in 2019 where we found some similar concerns, we did find that some improvements had been made to address those concerns at that time.

Most risks relating to people's needs had been identified. However, some assessments for managing the risks were not in place. The registered manager took immediate action to ensure these were completed. There were enough staff to adequately support the number of people using the service. Recruitment processes in place ensured staff were suitable to work with vulnerable people.

Systems were in place to record accidents and incidents. These were consistently monitored to identify any lessons learned, themes or trends. Safeguarding incidents were identified and shared with the local authority. However, not all of the incidents had been notified, as legally required, to us. We have made a recommendation about submitting statutory notifications.

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.

Training records seen demonstrated appropriate and relevant training was completed. Referrals were made to other healthcare services where necessary. People told us they thought the care they received was very good and spoke positively about the staff who supported them. People told us the staff treated them with respect and dignity and were kind and caring towards them.

There was regular oversight of the safety and quality of the service. However, the processes in place did not identify all the concerns we found with the safe management of medicines. We have made a recommendation the provider further develops the systems and processes used to oversee the quality and safety of the service.

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 28 August 2019)

We carried out an unannounced comprehensive inspection of this service on 17 June 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe management of medicines.

At the inspection on 17 June 2019 we also made a recommendation about checking practical training for the management of medicines. We also made a recommendation at the last targeted inspection published 16 November 2022 about having a robust system in place for recruitment checks for agency staff. At this inspection we found the provider had acted on these recommendations and had made those improvements.

Why we inspected

This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

At this inspection we found the provider was in breach of regulation. We found no evidence during this inspection that people were at risk of harm from this concern.

The overall rating for the service has remained as 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.

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.

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

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Westmorland Court Nursing and Residential Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified a breach in relation to the management of medicines at this inspection.

Please see the action we have told the provider to take at the end of this report.

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 request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.