CQC report explained · a residential care home
What the CQC found at West View Integrated Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risks were assessed and updated, staffing levels had improved, and medicines were administered by trained and competent staff. Inspectors also found the home clean and staff understood safeguarding responsibilities.
- Effective?
- Good
- People's needs were assessed before they moved in. Staff worked with health and social care professionals, supported eating and drinking, and followed the principles of consent and best-interest decision-making.
- Caring?
- Good
- People and relatives described staff as welcoming, supportive and caring. Staff supported dignity, independence and involvement in care decisions.
- Responsive?
- Good
- Care plans were detailed, personalised and regularly updated. People had activities, could receive visitors at any time and had their communication and end-of-life wishes recorded.
- Well-led?
- Good
- The manager and staff were described as approachable and open to ideas. Audits, complaints and incidents were used to identify shortfalls and make improvements.
What inspectors found, August 2019
West View Integrated Care Centre is rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
Inspectors visited without advance notice on 29 July 2019. They spoke with five people, three relatives, the manager and four staff. They reviewed six care plans, recruitment files, training records, safety checks and audits.
The home provided personal care for up to 40 older people. At the visit, 20 people were using it. Some lived there permanently, while others stayed for respite, after hospital or to regain independence.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines, personalised care plans, kind staff and good work with other professionals.
The previous inspection had rated the home Requires Improvement and found multiple breaches. Inspectors said improvements had been made and that the home was no longer in breach of regulations.
Kind and welcoming staff
People and relatives said staff were welcoming, supportive and caring. Inspectors also observed staff offering reassurance when someone became distressed.
“People and their loved ones told us that staff were welcoming, supportive and caring.” from the report
Personalised care
Care plans recorded people's preferences, including preferred names and personal routines. Plans were reviewed when people's needs changed or when they returned for another stay.
“People's care plans were now detailed, and person centred.” from the report
Safe staffing and medicines
Inspectors found enough staff to meet people's needs and said call bells were answered promptly. Medicines records were complete and medicines were given by trained staff.
“There were sufficient staff to meet people's needs and keep them safe.” from the report
Support for independence
Staff encouraged people to regain skills and confidence, including people staying for short periods who hoped to return home.
“Staff supported people to maintain and develop independent skills.” from the report
Learning from incidents
The home reviewed accidents and incidents and changed a sensor system after its sound appeared to cause some people to get up and fall.
“The system was replaced throughout the service with one which did not have the same noise.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you assess and update risks for someone who is prone to falls or whose health changes?
- 02How would you support my relative during a short stay and help plan their move back home or to another service?
- 03What staffing levels are in place on each shift, and how quickly are call bells usually answered?
- 04What activities and enablement support would be available for my relative's interests and independence goals?
- 05How do you use complaints, accidents and feedback from residents and relatives to make further improvements?
This was an unannounced inspection that considered all five CQC questions; the previous Requires Improvement rating and multiple breaches had been followed by an action plan and were no longer in place at this inspection. This explanation was written from the published report of 14 August 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.
What inspectors found, August 2018
West View Integrated Care Centre was rated Requires Improvement; inspectors found kind care but serious gaps in risk assessment, staffing and oversight.
This was an unannounced inspection in March 2018. Inspectors spoke with people, relatives and staff, observed care, and checked care plans, risk assessments, medicines records, staff files, accidents and quality checks.
People were treated kindly and with respect. Staff supported people's privacy, dignity, communication, food and drink, health appointments and relationships. The building was clean, accessible and designed to support people living with dementia.
However, risks were not always assessed before people arrived or soon enough afterwards. Some people had falls or serious injuries before safety plans were put in place. Staffing levels were not always enough, care information was split across folders, and quality checks had not found important problems.
The overall rating and four of the five question ratings were Requires Improvement. Caring was rated Good. This was the first Requires Improvement rating, following a Good rating at the May 2017 inspection.
Support with food and drink
People were offered choices and encouraged to eat and drink. Staff took extra steps when someone needed help to finish a drink or maintain their weight.
“People were supported to eat and drink sufficient amounts to maintain a balanced diet.” from the report
Health and rehabilitation support
People were referred to health professionals when needed. For short stays, staff set goals and worked with other services to support a safe return home.
“People were supported to access other health professionals such as GPs, physiotherapists, speech and language teams and occupational therapists when required.” from the report
Accessible and dementia-friendly setting
The building was wheelchair accessible and included signs and personal photographs to help people living with dementia find their way.
“The premises was designed to meet the needs of people.” from the report
Risks and staffing
seriousSome people's risks were not assessed before they arrived or soon afterwards. Inspectors found that staffing levels were not always sufficient, and the provider had not agreed extra carers more than three months after the inspection.
“Risks to people were not assessed in a timely fashion placing people at risk of harm and there were not always enough staff to keep people safe.” from the report
Learning from incidents
seriousThere had been repeated falls soon after people arrived, but the service had not identified the underlying problem soon enough. New systems were being developed but had not been tested in practice.
“Systems to recognise opportunities for learning and improvement had not been effective.” from the report
Medicines instructions
needs fixingSome units did not have protocols explaining when 'as and when' medicines should be offered, including medicines for pain, distress or agitation.
“On some units there were no PRN protocols in place.” from the report
Care information
needs fixingImportant information was kept in separate folders, and not all staff could access everything they needed. Different systems across the units increased the risk of inconsistent care.
“This led to some staff not having all the information they needed about the people they supported.” from the report
Leadership and checks
seriousThere was no registered manager, and audits were too infrequent to identify the problems found during the inspection. People who stayed longer did not have a regular opportunity to give feedback.
“The provider had failed to establish and operate systems to assess, monitor and improve the quality and safety of the services provided.” from the report
- 01What has changed since the inspection to make sure each person's risks are assessed before they arrive?
- 02How many staff are expected on each unit at different times, and what happens when staffing levels are too low?
- 03Do all staff now have access to one complete and up-to-date set of care information?
- 04Are there now written protocols for every 'as and when' medicine, including medicines for pain or distress?
- 05How are falls, injuries and near misses reviewed, and what changes have been made as a result?
This was an unannounced comprehensive inspection covering all five CQC questions; it was brought forward because of incident notifications, and it did not examine the circumstances of an incident subject to a criminal investigation. This explanation was written from the published report of 2 August 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 View Integrated Care Centre
4 rated inspections over 4 years: the service has held its Good rating throughout.
- August 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at West View Integrated Care Centre →
- August 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
Read what inspectors found at West View Integrated Care Centre →
- July 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 17 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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