CQC report explained · a nursing home
What the CQC found at The West Gate
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, March 2020
The West Gate was rated Good; inspectors found kind, responsive care, but safety checks and records still needed improvement.
This was an unannounced inspection by two inspectors on 19 February 2020. They spoke with people, relatives, staff and a visiting GP. They observed care and reviewed care plans, medicines records, staff files and management records.
The home was rated Good overall. Effective, caring, responsive and well-led were rated Good. Safe was rated Requires Improvement, as some risk assessments did not give enough detail, one person's medicines count was wrong and one recruitment file was incomplete.
The inspectors found no impact on people from these shortfalls. The management team had identified the problems and had action plans and extra training in place. The overall rating improved from Requires Improvement at the previous inspection, while Safe remained Requires Improvement and Well-led improved to Good.
Kind and personal care
Staff knew people well and used this knowledge to comfort them when they were distressed or confused.
“Staff took time to get to know people well and used this knowledge to reassure them when they were distressed or confused.” from the report
Activities for everyone
Dedicated activities staff supported people to take part in activities, including people who preferred to stay in their rooms.
“Dedicated activities staff ensured everyone had things to do, including those who stayed in their room by choice or due to their health.” from the report
Improved staffing
Staffing levels had increased since the previous inspection. Inspectors saw that people did not have to wait for help during the visit.
“Staffing levels had been increased since the last inspection which had had a positive impact on the care people received.” from the report
Visible management
Managers were based in the centre of the home, had an open-door policy and responded to concerns from people, relatives and staff.
“The management team worked in an office in the centre of the service and had windows overlooking the main communal area.” from the report
Risk assessments lacked detail
seriousSome care records did not explain clearly enough how staff should manage risks linked to moving people, feeding tubes and stomas. This could leave new or agency staff without all the guidance they need.
“There was no guidance about how to position the sling especially when people required specific positioning.” from the report
One medicines record was incorrect
seriousOne person's tablets were fewer than expected and staff could not explain why. The home sent an action plan after the inspection to reduce the risk of this happening again.
“One person's tablets were incorrect, the numbers were less than what they should have been.” from the report
Recruitment checks were incomplete
needs fixingOne recently recruited staff member did not have a full employment history, and a nurse's registration check had not been completed. These issues were resolved during the inspection.
“One staff member did not have a full employment history in place.” from the report
- 01Have all the missing details in risk assessments for moving people, feeding tubes and stomas now been added?
- 02What extra training has nursing staff received on the electronic medicines system?
- 03What checks are now used to make sure medicine counts are correct?
- 04How are new or agency staff shown the detailed guidance they need for people's individual risks?
- 05What changes were made after the previous inspection's concerns about staffing and management checks?
This was an unannounced inspection covering all five CQC questions, with the previous overall rating of Requires Improvement used as part of the reason for the visit. This explanation was written from the published report of 10 March 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, February 2019
Rated Requires Improvement; inspectors found kind and responsive care, but weaknesses remained in fluid records, catheter risk information and quality checks.
This was an unannounced inspection over 3, 4 and 7 December 2018. Inspectors spoke with people and relatives, observed care, checked the building and reviewed care plans, medicines, staff records, risk assessments and audits.
There had been improvements since the previous inspection in October 2017, especially in medicines management and some risk guidance. However, staff did not consistently record how much some people drank, and catheter care information was incomplete. This meant people could be at risk of not receiving care suited to their needs.
Inspectors rated Effective, Caring and Responsive as Good. Safe and Well-led were Requires Improvement because safety records and management checks were not consistently reliable. The overall rating was Requires Improvement.
Kind and dignified care
Inspectors saw many positive interactions. Staff took time to reassure people, respected their privacy and supported them in a dignified way.
“Throughout the inspection people were treated with dignity and kindness.” from the report
Suitable staffing and training
Inspectors found enough staff on duty to meet people's needs. Staff had relevant training, supervision and competency checks.
“There were enough staff on duty that had received relevant training and supervision to help them carry out their roles effectively.” from the report
Good support with health and nutrition
People's health was monitored and referrals were made when needed. Staff supported dietary needs and followed specialist advice, including for thickened fluids.
“People were provided with a suitable range of nutritious food and drink.” from the report
Personalised care and activities
Care plans included individual choices and preferences. People were offered group and one-to-one activities, including music, crafts, exercises and reading.
“People were supported to take part in a wide range of activities that they chose.” from the report
Complaints were handled
People and relatives knew how to raise concerns. The complaints reviewed had been investigated, answered in a timely way and resolved.
“All the complaints we reviewed had been responded to in a timely manner and resolved.” from the report
Fluid records were incomplete
seriousStaff did not consistently record how much some people drank or what action was taken when targets were not met. This could put people at risk of poor hydration.
“There was no oversight or accurate record of the amount that people drank to make sure they remained hydrated.” from the report
Catheter care information was incomplete
seriousOne catheter risk assessment did not include the signs and symptoms staff should look for when there were problems. New or agency staff might not have had enough guidance.
“As a result, people could be at risk of not receiving care and support appropriate to their needs.” from the report
Bathrooms briefly lacked soap
minorTwo bathroom soap dispensers were empty when inspected. This was corrected immediately, with more frequent checks planned.
“However, two bathrooms had no soap in the dispensers provided.” from the report
- 01How do you now make sure every drink is recorded accurately and that staff act when a person's fluid target is not met?
- 02Has the catheter risk assessment been completed, and how are agency and new staff shown the signs of possible complications?
- 03What checks now confirm that care records are complete and accurate?
- 04How do you review whether fluid targets are realistic for people with ongoing health conditions?
- 05How do you monitor whether improvements from the previous inspection have been sustained?
This was an unannounced inspection covering all five CQC questions and checking whether action had been taken after breaches found in October 2017. This explanation was written from the published report of 21 February 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of The West Gate
6 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- March 2020Goodcurrent ratingup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2016Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2016Inadequatedown from Requires improvementSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- December 2015Requires improvementSafe: Requires improvementEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- April 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 26 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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