We found adequate records were in place to record food and fluid intake for people who were at risk of malnutrition and dehydration to help ensure appropriate action could be taken if people refused food and drinks.
Is the service safe?
Is the service effective?
Is the service caring?
Is the service responsive?
Is the service well led?
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, their relatives, staff supporting them and from looking at records.
If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
Care records contained risk assessments and instructions on how these risks should be managed. For example, moving and handling and preventing falls.
Systems were in place to make sure that managers and staff learnt from events such as accidents, complaints, concerns and investigations. This reduced the risks to people and helped the service continually improve.
There was a system in place to manage medications but some recording was inaccurate which did not protect people from the risks of unsafe management of medications. We have set a compliance action and asked the provider to tell us what they are going to do to meet the requirements of the law in relation to the management of medicines.
The CQC monitors the application of the Mental Capacity Act 2005 and operation of the Deprivation of Liberty Safeguards (DoLS) which apply to care homes. DoLS is a legal process used to ensure that no one has their freedom restricted without good cause or proper assessment. There was a policy in place related to people's mental capacity and deprivation of liberty safeguards. Records showed, and staff told us, they had received training on this. There was evidence to show that mental capacity assessments and deprivation of liberty checklists had been completed.
Is the service effective?
The staff we spoke with were able to describe the individual needs of the people they cared for and how these needs were met.
The service worked well with other agencies and prompt referrals were made to health care professionals which helped ensure people's health care needs were addressed.
People's health and care needs were assessed and the care plans provided staff with information about how each person's care needs should be met. Guidelines were in place to inform staff of the actions to be taken in certain situations, for example, if people exhibited behaviour that was challenging.
People were provided with a choice of suitable and nutritious food and drinks to meet their needs. People told us they enjoyed the food served to them.
We found that some records were not accurate and up to date which could place people at risk. For example staff did not always record when people were given drinks during the night and early morning. We have set a compliance action and asked the provider to tell us what they are going to do to meet the regulations in relation to records.
Is the service caring?
We spoke with six people who used the service and their comments included, "Everything is fine here. I tell them if it isn't. There are things going on but I prefer to stay in my room," "They look after me and if I have a problem I go straight to the manager and it's put right," "It's pleasant here, nice and pleasant. The staff are marvellous, they help with everything" and "The staff sit and chat."
Visitors told us they were satisfied with the care provided. Their comments included, "I would give them ten out of ten. If there are problems we meet with the manager and find solutions. Mother has a good relationship with the staff" and "Everything is good, the staff are pleasant. The manager listens so there are no problems."
A healthcare professional who was visiting the home during our inspection said, "I haven't seen anything with care practices that worries me. The staff have always been lovely with the residents."
We observed the interactions between staff and the people they cared for. We saw staff interacted well with people and were attentive and sensitive to their individual needs.
Is the service responsive?
There was a complaints procedure displayed in the home and each person was provided with a copy of this. A complaints book was maintained to record any complaints received in the home and the outcome of the investigation.
We saw prompt referrals were made to health care professionals when required and appropriate training was provided for the staff to help meet individual needs.
Monthly meetings were held for the people who lived in the home to discuss day to day issues and ask people their opinions of the service provided.
Is the service well-led?
The provider had systems in place to monitor the quality of the service people received. People were asked their opinion of the service and meetings were held every month to discuss day to day issues in the home, for example, menus and activities.
We saw records to show the manager was responsible for monitoring care records, incidents, risk assessments, complaints and health and safety.
The people who lived in the home, visitors and staff told us the manager was very approachable if they wished to raise concerns or suggest new ideas. Comments included, "I tell the manager if I have any issues and things are put right," "I tell the manager if I'm not happy about anything, such as food or the staff and she always listens" and "We meet with the manager and staff and find solutions. I would definitely speak up if I wasn't happy about anything." One visitor felt communication with the staff could be improved as they had been given incorrect information regarding their relative's recent fall.
People told us they were asked if they were happy with the service they received and they confirmed that they were. We found the provider had effective systems in place to measure the quality of the service that people received.
The records held in relation to people's care and treatment were suitably maintained in order to ensure that their care needs were met and their health and welfare promoted.
However, we found that the management of medicines was not appropriate and people were not protected against the risks associated with this.
People told us they were happy with the care and support they received at West Farm Care Centre. One person told us, "It's quite comfortable in here. The food's quite good and the staff are good and that makes a big difference if the staff are good." Other comments included, "If you are not very well they see to it you know" and "I like living here".
We found that people were cared for in a manner which ensured their safety and welfare. We witnessed positive interactions between people and staff, and we saw that people's care needs were met.
People said they were treated with dignity and respect and we found that they were. In addition, we found that staff received appropriate professional development and felt supported by management.
However, we identified shortfalls in respect of people's care delivery, medicine management, records management and the systems in place designed to monitor the quality of the service provided.
We found that people's care and support needs were not always appropriately assessed and their care was not always planned. Some people did not receive appropriate standards of care.
We saw that medication was not managed appropriately and this meant people's health and welfare was put at risk.
We found that the systems in place to assess and monitor the quality of the service provided were not effective.
The records held in relation to people's care and treatment were not suitably maintained in order to ensure that people's care needs were met and their health and welfare maintained.