CQC report explained · a nursing home
What the CQC found at Westcroft Nursing Home Ltd
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Medicines, staffing, equipment, infection control and emergency plans were managed safely, although care files lacked time-specific repositioning guidance.
- Effective?
- Good
- Staff had training, induction, supervision and appraisals. People received suitable support with food, drink, healthcare, their individual needs and decisions about their care.
- Caring?
- Good
- People and relatives said staff were caring and respectful. Inspectors saw positive interactions and found that people were involved in care planning and supported to maintain privacy, dignity and independence.
- Responsive?
- Good
- Care was personalised around people's preferences, communication needs and interests. The home provided activities, supported relationships, responded to complaints and recorded end-of-life preferences.
- Well-led?
- Good
- The home had a positive culture, clear management arrangements and regular quality audits. This rating improved from Requires Improvement at the previous inspection.
What inspectors found, March 2020
Westcroft Nursing Home Ltd was rated Good; inspectors found safe, kind and personalised care, with a small gap in pressure-ulcer guidance.
This was an unannounced inspection on 12 February 2020. One inspector spoke with people, relatives and staff, observed care, and checked care records, medicines, complaints, recruitment records, training, rotas and audits. The home cared for 25 people at the time, with space for up to 28.
Inspectors found that people were safe and that medicines, staffing, safeguarding and infection control were managed well. Staff followed risk assessments and used safe moving and handling techniques. One small record-keeping gap was found because care files did not say exactly when repositioning should happen, although staff repositioned people every four hours and monitored their skin well.
People were treated with dignity and respect. Care was tailored to people's needs, choices, communication and interests. The home supported healthcare, food and drink, activities and relationships, and was continuing refurbishment, including a new sensory room.
All five areas were rated Good. The overall rating remained Good from the previous inspection in 2017. The well-led rating improved from Requires Improvement to Good.
Safe staffing
People and relatives said there were enough staff. Inspectors saw staff meeting people's needs promptly, with the manager helping when extra support was needed.
“People were supported by a sufficient number of staff to meet their needs in a timely manner.” from the report
Kind and respectful care
People said staff treated them with dignity and respect. Inspectors also saw positive, gentle interactions during meals and throughout the day.
“All people spoken with felt that staff were caring and treated them with dignity and respect.” from the report
Personalised support
Care plans recorded people's histories, preferences, interests and communication needs. Staff used this information to provide individual support.
“The registered manager ensured people's care was person centred and individual to meet their specific needs and preferences.” from the report
Activities and relationships
People had access to individual and group activities, including events involving families. The home worked to reduce social isolation.
“People had access to individualised and group activities and received the necessary support to follow their interests.” from the report
Quality monitoring
The home used regular audits covering areas such as medicines, accidents, complaints, weight loss and pressure sores. The manager used these processes to identify improvements.
“The quality of the service was monitored through robust governance processes.” from the report
Repositioning records
minorCare files did not give time-specific instructions for repositioning people at risk of pressure ulcers. Inspectors found that people were repositioned every four hours and their skin was well monitored, so no harm or risk to skin integrity was found at the inspection.
“We found that people had been consistently repositioned every four hours, but there was no time specific guidance in care files.” from the report
Signage still planned
minorThe refurbishment was continuing, and further signage improvements were planned to help people living with dementia find their way around the home.
“Further improvements were planned for example, signage on bathroom doors.” from the report
- 01How do you now record the exact times when each person needs to be repositioned?
- 02Which signage improvements for people living with dementia have been completed, and what is still planned?
- 03How will you make sure care plans continue to reflect changes in people's needs and preferences?
- 04What activities and family events are available for someone with my relative's interests and communication needs?
- 05How are relatives told about incidents, complaints and any changes in their relative's care?
This was a planned, unannounced inspection that looked at the home, the care provided and all five CQC questions; the inspector also used observations when some people could not describe their experiences. This explanation was written from the published report of 18 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, October 2017
Westcroft Nursing Home Ltd rated Good; inspectors found safe, kind and personalised care, but the service was not always well-led.
This was an unannounced inspection on 18 September 2017. Inspectors spoke with people living there, relatives, staff and managers. They observed care and checked care plans, medicines records, staff files, accident records and quality checks.
The home was rated Good overall. Safe, Effective, Caring and Responsive were all rated Good. People were described as safe, well supported, treated with dignity and given choices about their care, food and activities.
Well-led was rated Requires Improvement. The home had quality checks, but these did not always find problems with record keeping. Inspectors also found some records about medicines, legal safeguards, health support and accidents needed more detail or clearer recording.
The home had improved since the previous inspection in August 2016. Medicines were being managed more safely and the Mental Capacity Act principles were being followed better. Further improvements were still needed, and the provider said it would act immediately on several recording issues.
Kind and respectful care
Staff took time to talk with people and built caring relationships. Inspectors saw people being treated respectfully and their privacy being protected.
“This showed people received care and support from caring staff who took time to build relationships with them.” from the report
Choice and independence
People could choose when to get up, what to wear, what to eat and where to spend their time. Staff encouraged people to do what they could for themselves.
“This meant people's independence was promoted.” from the report
Activities and personal interests
People could take part in varied activities and follow their own interests. Records included activities people had enjoyed.
“This showed people were supported to follow their interests and had access to a varied activities programme.” from the report
Improvements since the last inspection
The provider had improved medicines management and followed the Mental Capacity Act principles more closely than at the previous inspection.
“At this inspection we found the provider had made the required improvements.” from the report
Care records were not always clear
needs fixingSome records contained out-of-date information, were difficult to cross-reference or did not include enough person-centred detail. This could make it harder for staff to find the right information.
“However information that was out of date had not been archived which was sometimes confusing and the records were sometimes difficult to cross reference due to how they were stored.” from the report
Legal safeguard records needed more detail
needs fixingRecords did not always clearly show how conditions attached to some Deprivation of Liberty Safeguards were being met. Some records of refusals and behaviour monitoring were not detailed enough.
“However records of how the conditions were being met were not always clear and easy to find.” from the report
Some medicines records needed improvement
needs fixingThere was not one agreed system for recording as-required medicines. Daily checks for a patch-based pain medicine were also not documented.
“However there were some differences in how as required medicines were recorded there did not seem to be one agreed system in place which could lead to confusion.” from the report
Quality checks did not find every problem
needs fixingThe provider had audits and action plans, but they did not always identify concerns with record keeping. Accident reviews were also not recorded clearly enough to show what analysis and action had taken place.
“However there was no record of the analysis they carried out and any actions they had taken which meant we could not be assured this was effective in driving improvements.” from the report
- 01What changes have been made to ensure as-required medicines are recorded in one consistent way?
- 02How do you now record daily checks for patch-based medicines?
- 03How are Deprivation of Liberty Safeguards conditions, refusals and behaviour monitoring recorded and checked?
- 04Have all out-of-date care plan records been archived, and can staff quickly find the current information?
- 05How are accident reviews and any resulting actions now recorded and monitored?
This was an unannounced inspection covering all five CQC questions, including observations, discussions and checks of care, medicines, staffing and management records. This explanation was written from the published report of 25 October 2017 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 Westcroft Nursing Home Ltd
3 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- March 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2013
Report published without a new overall rating.
- August 2012
Registered with the Care Quality Commission on 16 August 2012.
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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