Archived: Westmead Residential Care Home

Updated 28 December 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 checked 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 comprehensive inspection was unannounced and carried out by one inspector and two experts by experience on 24 October 2017. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. One inspector completed the inspection on 28 October 2017.

As part of the inspection planning process we looked at the information the Care Quality Commission (CQC) holds about the service. This included notifications of incidents reported to CQC and previous inspection reports. During the inspection we spoke with 16 people using the service, three care staff, reception, domestic and kitchen staff, the registered manager and a deputy manager.

We were provided with a tour of the premises before we began our inspection. We reviewed six care records and related medicines records. We also looked at other information related to the running of and the quality of the service. This included quality assurance audits, maintenance schedules, training information for care staff, staff duty rotas, meeting minutes and arrangements for managing complaints.

Updated 28 December 2017

This inspection took place on 24 and 28 October 2017. The first day of the inspection was unannounced. We informed the registered manager we would be returning to complete the inspection on 28 October 2017.

We carried out an unannounced comprehensive inspection of this service on 21, 22 and 23 June 2016 at which a breach of legal requirements was found in relation to infection control procedures. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach.

At our focused inspection on the 30 March 2017, we found that the provider had followed their plan and implemented improvements and legal requirements had been met in relation to infection control. We stated that the service was safe although further improvements were required to meet optimum levels of hygiene and cleanliness.

Westmead Residential Care Home is registered to provide accommodation and personal care for up to 42 older people, some of whom have dementia. The home is divided over two floors with lift access. People have their own rooms with a hand basin and shared bathroom facilities are available on each floor. At the time of our inspection 39` 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.

There were systems in place to protect people from abuse and keep people free from harm. The service had policies and procedures in place for safeguarding adults which were available and accessible to members of staff. Staff were able to demonstrate a good understanding of these policies and procedures and how they related to their roles and responsibilities.

People told us they felt safe and secure living in the service. Risks to people were identified and covered areas such as falls and mobility, moving and positioning and personal care needs. Risk assessments were reviewed in line with the provider’s policies and procedures.

Staff had received training on the Deprivation of Liberty Safeguards (DoLS) and the Mental Capacity Act 2005 (MCA). These safeguards are there to make sure that people receiving support are looked after in a way that does not inappropriately restrict their freedom. Services should only deprive someone of their liberty when it is in the best interests of the person and there is no other way to look after them, and it should be done in a safe and correct way. People were consulted with about their care and the service worked to the principles of the Mental Capacity Act 2005.

Family members and health and social care professionals were invited to contribute to the care planning process where appropriate. Care records contained enough information about people for staff to understand their needs and preferences and staff knew people on an individual basis. People told us the staff were kind and caring. However, not all staff members were aware of the levels of privacy people liked to maintain.

There were suitable arrangements in place for the safe storage and disposal of medicines and all medicines were administered by staff who had received the appropriate training to be assessed as competent.

Staff were suitably recruited, inducted, trained, supervised and supported. This enabled them to have the right skills and training to support people effectively. The home had a number of staff vacancies and used bank and agency staff to cover the vacancies. Staff felt the staffing levels were sufficient. Staff were given opportunities to develop and improve upon their skills.

Staff supported people to attend healthcare appointments as required and liaised with people’s family members, GPs and other healthcare professionals to ensure people’s needs were met appropriately.

People were supported to discuss their end of life wishes and where appropriate, 'Do not attempt cardiopulmonary resuscitation' (DNACPR) forms had been completed and reviewed by people's GPs.

People were provided with a choice of fresh food and drinks, and were supported to eat when this was required. People’s comments about the food were mostly positive. In July 2017 the home was awarded a ‘5’ star rating in food hygiene by the Foods Standards Agency.

The service employed a full time activities co-ordinator and people had access to a range of activities. However, people were not always being supported to follow their individual hobbies and interests.

Monthly audits were carried out across various aspects of the service; these included the administration of medicines, fire, health and safety checks.

There was a complaints policy which the registered manager followed when complaints were made to ensure they were investigated and responded to appropriately. Most people told us they were happy with the care provided and told us they felt able to express any concerns they may have.

People who used the service, staff and the majority of relatives were happy with the way the home was managed. The staff team were clear about their roles and responsibilities. The registered manager was described as accessible and approachable and acted as a positive role model.

The home was clean and tidy. Staff had access to disposable gloves, aprons and hand gels. Bathroom equipment such as toilet seat raisers were in good working order.