All inspections: The Westbury Care Home

The Westbury residential and nursing home is registered to provide personal and nursing care for up to 51 people. At the time of our inspection there were 44 people living at the home. The inspection was unannounced and took place on the 24 and 25 November 2015.

The service had a registered manager who was responsible for the day to day running of the home and had been in post for approximately two months. 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 received their medicines on time; however, medicines were not kept safe as the medicine rooms were unlocked at the time of our inspection. The medicine rooms were not kept within the required temperature to maintain the integrity of medicines and some medicines were not disposed of appropriately. The recording of medicines highlighted a lack of signatures on the MAR charts. There was conflicting information in the records around the application of creams and how often they should be applied. Protocols were not in place for all medicines prescribed to be administered as and when required.

People and relatives told us the staff were very kind and caring and we observed that staff treated people with respect and dignity. Staff were enthusiastic about their role and were dedicated to giving people a good quality of care. People received good care at the point of delivery although care records were not person centred.

The service did not follow the requirements set out in the Mental Capacity Act 2005 (MCA) when people lacked the capacity to give consent to receiving care.

Staff received some training; however, we found that staff had not received sufficient training in relation to the MCA, Deprivation of Liberty Safeguards, supporting people with dementia and positive behaviour management. Staff were supported through a system of supervision and appraisals.

People were able to take part in activities within the home if they wished to. People told us the food was good and we observed people were given drinks and snacks throughout the day.

People said they felt safe living at the home. Staff were aware of their responsibilities towards safeguarding people and showed a positive attitude to this.

There was a complaints procedure in place; the service investigated complaints and responded in a timely way.

People and relatives told us they did not feel there were sufficient numbers of staff at all times. The provider recorded call bell response times however this information was not fully analysed in order to ascertain the reason for long call bell response times. Some audits did not fully identify the issues we found.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. One person living at the home said 'they give a choice'. One relative said that staff 'give a choice of changes of clothes and of when to go to bed'.

One person living at the home said 'you wouldn't find a better home'. The relative of one person living at the home said 'there is always a friendly, kindly approach'.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

There were enough qualified, skilled and experienced staff to meet people's needs.

The provider had an effective system to regularly assess and monitor the quality of service that people receive.

People and their relatives were very happy with the service they received.

People were able to make choices about their daily lives and their rights to privacy and dignity were fully promoted.

People looked comfortable and well cared for. They were given assistance to eat and drink in a sensitive, attentive manner. Those people being nursed in bed had their position changed at regular intervals, to minimise their risk of developing a pressure ulcer.

Staff interacted with people in a friendly, respectful way. They were attentive to people's needs. Staff gave people time without rushing and answered call bells without delay.

The environment was clean and systems were in place to minimise the risk of infection. Staff received infection control training and regular audits took place.

The number of staff on duty during the day had recently increased. Staffing levels were regularly monitored and appropriate for the current needs of the people living at the home.

Care plans demonstrated people's basic care and nursing needs and how they were to be met. A process of replacing all care documentation was in place yet not fully completed.

People told us they were happy with the care they received and the way in which staff supported them. They said their rights to privacy and dignity were maintained and staff spoke to them in a polite, friendly and respectful manner.

People looked relaxed and well supported. They were encouraged to make decisions and choose their preferred routines. People were supported to have regular drinks and a choice of food which met their individual preferences. People being cared for in bed were generally supported to change their position at identified times to minimise their risk of developing a pressure ulcer. Attention was given to people's social needs and a range of group and individual activities were provided. Some people had their call bell within easy reach. Those people who could not use their call bell received regular checks from staff to ensure their well being. People generally said staff came to them quickly when they called them.

People told us they liked the staff and there were good interactions taking place. Staff told us they had very good opportunities to undertake training which helped them to do their job effectively. They felt well supported and were aware of their responsibilities to recognise and respond to an allegation or suspicion of abuse.

People told us they felt safe within the home and were aware of how they could raise a concern. They said they were asked about their views of the service and were encouraged to give suggestions about how the home could be improved upon. The home had clear systems in place to check the quality of the service people received.

These older reports are from our old approaches to inspection, including those from before CQC was created.

Archived: The Westbury Care Home

All Inspections

24 and 25 November 2015

During a routine inspection

11, 12 January 2014

During a routine inspection

7 March 2013

During a routine inspection

15 March 2012

During a routine inspection

Reports under our old system of regulation