Archived: Westbury Court

Updated 13 August 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

We carried out this inspection over two days on the 26 and 27 July 2016. The first day of the inspection was unannounced. This inspection was carried out by one inspector, a specialist nurse advisor and an 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 service. On the second day of our inspection a pharmacist inspector attended. During our last inspection in June 2015 we found the provider did not meet some of the legal requirements in the areas that we looked at.

Before we visited, we looked at previous inspection reports and notifications we had received. Services tell us about important events relating to the care they provide using a notification. We reviewed the Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We used a number of different methods to help us understand the experiences of people who use the service. This included talking with 14 people who use the service and nine relatives about their views on the quality of the care and support being provided. During the two days of our inspection we observed the interactions between people using the service and staff. We used the Short Observational Framework for Inspection (SOFI). We used this to help us see what people's experiences were. The tool allowed us to spend time observing what was going on in the service and helped us to record whether people had positive experiences.

We looked at documents that related to people’s care and support and the management of the service. We reviewed a range of records which included 12 care and support plans and daily records, staff training records, staff duty rosters, staff personnel files, policies and procedures and quality monitoring documents. We looked around the premises and observed care practices.

We spoke with the regional support manager, manager, deputy manager, two registered nurses, eleven care staff, and two activity co-ordinators. We spoke with housekeeping staff and staff from the catering department.

Updated 13 August 2016

Westbury Court provides accommodation which includes nursing and personal care for up to 60 older people, some of who are living with dementia. At the time of our visit 46 people were living in the service. The rooms were arranged over three floors .There were communal lounges and dining areas with satellite kitchens on the first and second floors and a central kitchen and laundry.

We carried out this inspection over two days on the 26 and 27 July 2016. At a previous inspection which took place in June 2015 we found the provider did not meet the legal requirements for person centred care. They had not designed care and treatment plans to include people's preferences and accurate information to ensure their needs were met. They wrote to us with an action plan of improvements that would be made. We found on this inspection the provider had not taken all the steps to make the necessary improvements in this area.

The registered manager had recently left the employment of the service. A new manager had been recruited and was in the process of submitting their application to become the 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.

People using the service, their relatives and staff did not always feel there were enough staff available to meet the needs of people especially on the weekends. Whilst we saw staffing rotas reflected the staffing levels identified by the dependency tool the service was consistently left short staffed at weekends due to staff absences.

Care plans did not contain all of the relevant information that staff required so they knew how to meet people’s current needs. Risks to people’s safety had not always been updated to reflect their changing needs and plans in place to minimise these risks sometimes lacked detail.

People were not always supported to have enough to eat and drink. Food and fluid charts were not always completed. People’s nutritional needs were not always clearly documented in their care plans.

Medicines were given in a safe and caring way. Medicines were stored safely and securely. There were records of medicines administered to people and where they were not given the reason for this was recorded.

People were treated with kindness and compassion in their day-today-care. They received care from staff who knew them well. People and their relatives spoke positively about the care and support they or their relative received from staff. We observed staff treating people in a dignified manner ensuring their privacy was respected at all times.

The staff had received appropriate training to develop the skills and knowledge needed to provide people with the necessary care and support. We saw safe recruitment and selection processes were in place. Appropriate checks were undertaken before new staff members’ commenced work. Whilst staff said they felt supported, formal supervision of staff had not consistently taken place.

The provider had quality assurance systems in place to audit all areas of the home to identify areas for improvement. However the audits had not identified the discrepancies noted in the safe medicines management daily checklist.

Incident and accident forms were completed where appropriate and detailed what actions and care had taken place. However, we saw in people’s daily records that incidents had been recorded but had not all been entered into the electronic system due to staff not being able to access it. This meant there wasn’t an accurate record of accidents and incidents that had occurred.

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