CQC report explained · a residential care home
What the CQC found at West Cliff Hall
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, January 2021
Requires Improvement; inspectors found people were generally cared for kindly and felt safe, but medicines and management systems were not reliable enough.
This was an unannounced focused inspection on 30 September 2020. Inspectors looked only at Safe and Well-led, following concerns about medicines, person-centred care and infection control. They spoke with people, relatives, managers and staff, and checked medicine records, care plans, training records, audits and other documents.
The home had systems for medicines and infection control, but staff did not always follow them. Inspectors found problems with medicine records, allergy information, controlled drugs and guidance for some medicines. Infection control checks and the use of protective equipment were not always consistent. Views about staffing levels were mixed.
People generally said they felt safe and well cared for. Staff were positive about their work and understood safeguarding responsibilities. However, audits had identified problems that were not always fixed, and records did not always show that staff had been trained and assessed to give medicines safely.
The overall rating fell from Good to Requires Improvement. Safe and Well-led were both rated Requires Improvement. The other three areas were not inspected at this visit, so their previous ratings were used in the overall rating.
People generally felt safe
People and relatives were mostly positive about the care. People told inspectors they felt safe and looked after.
“One person said "I feel very safe here because staff are very good and check on me and will talk to me.” from the report
Safeguarding awareness
Staff understood their safeguarding duties and said senior staff were approachable when concerns needed to be raised.
“Staff were clear about their responsibilities in relation to safeguarding procedures.” from the report
Medicine ordering
The ordering of medicines was described as effective and well managed between the home, the GP practice and the pharmacy.
“Senior care staff followed processes and systems for ordering medicines which were effective and well managed between the service, GP practice and community pharmacy.” from the report
Person-centred care plans
Care plans were generally person-centred. Staff used detailed plans and communication tools to support people with dementia or behaviours that challenged the service.
“Care plans overall were person-centred.” from the report
Staff communication
Staff meetings covered safeguarding, incidents, call bell responses, social distancing and recent audits.
“Staff meetings for all roles took place and were recorded.” from the report
Medicine safety
seriousMedicine changes were not always copied correctly into medicine records. Allergy details, controlled drugs and guidance for as-needed medicines were also not consistently managed.
“Staff did not always follow processes for transcribing changes to medicines on people's individual Medicines Administration Records (MAR) charts in line with national guidance.” from the report
Infection control records and PPE
needs fixingThe home did not always record coronavirus test results or symptom checks consistently for new residents. Inspectors were also not fully assured that all staff knew how to use protective equipment safely.
“We were not fully assured that the provider was using PPE effectively and safely.” from the report
Audits did not lead to consistent action
needs fixingThe home carried out audits, but problems found in those audits were still present at inspection. This included gaps in medicine training, checks and protocols.
“Issues identified from internal audits were also identified upon inspection.” from the report
Staffing could be stretched
needs fixingStaff and relatives gave mixed views about staffing. Some said staffing was inconsistent, and relatives raised concerns that agency staff might not know individual residents well.
“There were some concerns that staffing levels were sometimes stretched and agency staff did not get to know the individual residents.” from the report
No registered manager
minorThe home had been without a manager registered with the CQC since March 2019. A new manager was in post and planned to apply after completing probation.
“The service had been without a registered manager since March 2019.” from the report
- 01What has been done to make sure medicine changes, allergies, controlled drugs and as-needed medicine instructions are recorded correctly?
- 02How do you now prove that every staff member giving medicines has completed training and a competency assessment?
- 03How are coronavirus tests, symptom checks and isolation arrangements for new residents recorded and checked?
- 04What has been done to make sure all staff use protective equipment safely and follow the current guidance?
- 05How are staffing levels monitored, and how do you make sure agency staff understand each resident's needs?
This was a focused inspection of Safe and Well-led only; the other three key question ratings were not inspected and previous ratings were carried forward. This explanation was written from the published report of 15 January 2021 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, January 2018
Rated Good overall; inspectors found safe, kind and responsive care, but well-led was rated Requires Improvement.
Inspectors carried out an unannounced comprehensive inspection on 18 December 2017. It followed concerns about clinical oversight and nursing care. They spoke with people, relatives, staff and health professionals, observed care, and checked care plans, medicines and management records.
The home was rated Good overall. Safe, effective, caring and responsive were all rated Good. Inspectors found enough staff, safe medicines arrangements, kind care, suitable activities and care plans that generally reflected people's needs.
Well-led was rated Requires Improvement. There was no registered manager in post, and the new management and clinical leadership arrangements needed time to become established. Inspectors also found that some daily records were task-focused rather than person-centred, and one person's pureed meal was not prepared sufficiently.
Staffing improved
Inspectors found enough staff deployed to meet people's needs safely. Staff had time to interact with people in a calm and unhurried way.
“During our inspection there were sufficient numbers of staff deployed to support people and meet their needs safely.” from the report
Safe medicines
Medicines were stored and given safely by trained staff. The home also audited medicines and monitored medicines prescribed when needed.
“People received their medicines in a safe and effective way from staff who had received appropriate training.” from the report
Kind and respectful care
Staff knew people's preferences and histories. Inspectors saw staff protect privacy, ask permission and support independence.
“People were supported in a kind and caring manner.” from the report
Activities and engagement
People could choose from activities, outings and individual interests. Inspectors saw people taking part in exercises, puzzles, reading and knitting.
“A weekly activities programme was displayed in the home and offered the opportunity for people to participate in a wide range of games, entertainment, trips and individual activities in the home.” from the report
Clinical incident oversight
seriousInspectors said the provider needed more time to show that the new clinical leadership arrangements were effective when managing clinical incidents. A further clinical matter was being investigated by the local authority after the inspection.
“Whilst steps had been taken to address the clinical leadership in the home, the registered provider required time to ensure these roles were effective in the management of clinical incidents.” from the report
Daily records
needs fixingSome daily care records described tasks rather than the person's experience and needs. The new manager had identified this and was working to improve the records.
“Whilst some daily care records gave an insight into people's daily lives, others were staff focused or task orientated and not person centred.” from the report
Pureed food
needs fixingOne person who needed soft food did not receive a meal pureed enough for them to eat as requested. Managers said they would look into this.
“For a fourth person who preferred soft foods, we saw they had not been provided with a meal which had been pureed sufficiently for them to eat as they had requested.” from the report
- 01Has a registered manager now been appointed and registered, and how has this improved stability in the home?
- 02What process is now used to review and learn from clinical incidents?
- 03How do managers check that daily care records are person-centred and accurately describe the care given?
- 04How are soft and pureed meals checked before they are served to people who need them?
- 05How are complaints reviewed for patterns, and how are families involved when concerns are raised?
This was an unannounced comprehensive inspection covering all five key questions, prompted by concerns about clinical oversight and nursing care. This explanation was written from the published report of 25 January 2018 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 West Cliff Hall
3 rated inspections over 4 years: the service has held its Requires improvement rating throughout.
- January 2021Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2018Goodup from Requires improvementSafe: GoodWell-led: Requires improvement
- June 2017Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2016
Registered with the Care Quality Commission on 11 January 2016.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
26 live-in carers within about an hour of Hampshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,260 a week. 23 can care for a couple. 14 years' experience on average.
“I cannot recommend Prisca highly enough, she is one in a million.”
“He stayed with her throughout the pandemic, refusing to visit his own family, who lived nearby, to reduce the risk of infection.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.