Archived: West Farm Care Centre

We found the following examples of good practice.

• The service had access to regular testing for staff and people using the service. Staff knew what to do should they suspect someone had Covid to reduce the risk of spreading the infection.

• The home was clean and odour free. Extra housekeeping staff had been employed to ensure additional cleaning was completed during the pandemic.

• Staff had received appropriate training in infection prevention control. Staff were observed wearing the required PPE and were able to explain the process of correctly putting on and taking off their PPE.

• Additional staffing was available to support people who were unwell to maintain their health. One to one activities were being provided to reduce the risk of social isolation. People were supported to maintain contact with their loved ones.

• Quality assurance audits were completed to ensure safe infection control practices were being followed and to identify any improvements. Staff spoke positively about the support they had received from the registered manager and provider during the pandemic.

Further information is in the detailed findings below.

People’s experience of using this service: Since the last inspection widespread improvements had been made. However, although staff had spoken to people and their relatives regarding their preferences and wishes for end of life care, this was not well documented in people’s care plans. We have made a recommendation about end of life care planning.

The clinical aspects of end of life care were well documented. A visiting palliative care nurse explained how proactive staff were in having conversations with people and their family members.

Care plans were detailed and promoted people’s independence and individual preferences for how they wanted to be supported. Risk assessments were completed and steps taken to minimise risk.

People 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.

People, and their visitors, told us they felt safe and well cared for. A range of activities were offered which people enjoyed, especially singing and the variety of animals that visited.

Medicines were well managed and safely stored and administered. Healthcare professionals were involved as needed and people were supported to maintain a healthy, balanced diet. Specialised diets and specific dietary requirements were catered for.

There were enough staff to make sure people’s needs were met. Staff were also able to spend quality time with people chatting and enjoying each other’s company.

Appropriate training had been offered which supported the improvements made since the last inspection.

There was an ethos of team working to ensure continuous learning and improvements. Staff said they were well supported and thought the management team were approachable.

Governance systems had been embedded since the last inspection which had led to the required improvements being made. A culture of continuous learning and improvement was being established and an action plan was in place to drive this forward.

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 requires improvement and we identified four breaches of regulation. (Report published 6 June 2018). 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: This was a scheduled inspection based on the previous rating of requires improvement. The service has improved its rating from requires improvement and is now rated good.

Follow up: We will continue to monitor the service and complete a further inspection in line with the rating of good. If any information of concern is received, we may inspect sooner.

West Farm Care Centre is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

West Farm Care Centre can accommodate 50 people in one adapted building across two floors. At the time of the inspection 48 people were resident. The first floor, known as the Shore unit, is for people living with a dementia, although some people living with a dementia also resided on the ground floor.

The service did not have a registered manager. The current manager had been in post since December 2017 and had not made an application to register with the Commission. The provider had notified us that the previous registered manager had left, however, they had not submitted an application to cancel their registration.

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.

During this inspection we found five breaches of regulations we inspected against.

An electronic care planning system was used. Care records contained generic information that was pre-populated by the system. In some cases, the information was not accurate, nor was it specific to the person. Care records were not detailed and did not provide staff with accurate and up to date information on people’s needs.

Risks were not always assessed or included within people’s care records. Specific information and guidance from healthcare professionals was not always used to update care plans and risk assessments.

Consent to care and treatment was not always sought in line with the Mental Capacity Act 2005 (MCA).

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; however, care documentation in the service did not support this practice.

Some incidents, including those staff found challenging, had not been investigated or analysed for themes or triggers for the behaviour. This meant care plans were not in place to support staff to manage the behaviour and minimise risks.

Safeguarding incidents had not always been reported to the local authority safeguarding team or notified to the Commission.

Quality assurance systems had not been effectively implemented to assess, monitor and improve the quality of the service provided to people.

You can see what action we told the provider to take at the back of the full version of the report.

Care staff knew people well and had developed dignified, respectful and compassionate relationships with people. People were complimentary about the care and support they received.

Staffing levels were appropriate to people’s needs and robust recruitment procedures were in place. Staff said they felt supported and had attended the training needed to make sure they could meet people’s needs.

Positive relationships had been developed with visiting care professionals.

Activities were currently being managed by the care staff and we saw people enjoyed socialising and engaging with each other.

A refurbishment plan was in place to develop the Shore unit so it was more dementia friendly. People had been involved in the decision making and plans were in place to minimise any disruption to people whilst the work was completed.

Meal times were a pleasant experience and people were offered a choice of freshly made meals using fresh ingredients. Staff were vigilant in offering people drinks and snacks in between meals.

The administration of medicines was safe. However, the documentation in relation to time specific medicines was not always completed.