CQC report explained · a nursing home
What the CQC found at Westgate House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safer recruitment, detailed and regularly reviewed risk assessments, safe medicines systems and suitable infection control arrangements.
- Effective?
- Good
- No new rating was given for this question during the focused inspection.
- Caring?
- Good
- No new rating was given for this question during the focused inspection. Inspectors did observe that staff treated people with dignity and respected their individual needs and preferences.
- Responsive?
- Good
- People had personalised care plans, access to activities and support to maintain relationships. Complaints were handled and recorded appropriately, although written communication in alternative languages was not always explored.
- Well-led?
- Good
- Inspectors found regular audits, visible management and positive feedback from staff, people and relatives. The new manager had started recently and was going through CQC registration.
What inspectors found, October 2021
Westgate House was rated Good; inspectors found safe, personalised care and better management, with a recommendation about communication in other languages.
This was an unannounced focused inspection on 12 and 13 October 2021. Inspectors spoke with people, relatives and staff, observed care, and checked care plans, medicines records, recruitment files and management records.
The home was rated Good overall, with Good ratings for Safe, Responsive and Well-led. Inspectors found enough staff, safe recruitment, suitable risk assessments, safe medicines systems and good infection control. People were treated with kindness and had personalised care plans, activities and support with relationships.
The home had improved from Requires Improvement at the previous inspection in 2019. Earlier problems with recruitment and complaints had been addressed, and the home was no longer in breach of those regulations.
Inspectors recommended that the home seek advice about providing written information in alternative languages for people whose first language is not English. New ratings were not given for Effective or Caring because this was a focused inspection.
Safer staffing
Recruitment checks had improved and records showed the required checks were completed before staff worked unsupervised. Inspectors also found enough staff on duty.
“Improvements had been made and recruitment procedures were robust.” from the report
Safe medicines
Medicines were ordered, stored, given and disposed of through clear systems. Staff had training and competency checks, and audits showed problems were acted on promptly.
“Medicines were managed safely. The home has robust procedures in place to ensure the safe ordering, storage, administration and disposal of medicines.” from the report
Personalised support
Care records covered people's needs, preferences and personalities. People and relatives said staff provided kind and individual care.
“Care records were individualised, covered people's specific needs and held information about people's preferences and personalities.” from the report
Activities and relationships
People were supported to keep in touch with relatives and take part in one-to-one or group activities based on their preferences.
“There was a programme of activities arranged based on people's known preferences and choices” from the report
Improved complaints handling
The home had acted on the previous inspection's concerns. Complaints were now dealt with in a timely way, recorded properly and used for learning.
“We found that complaints were now dealt with in a timely manner and were recorded appropriately with lessons learnt documented.” from the report
Inspectors raised no specific concerns in this report.
- 01What written information can you provide in my relative's first language if it is not English?
- 02How will you make sure my relative's communication needs are followed in day-to-day care?
- 03How is the new manager's CQC registration process progressing?
- 04How do you check that staffing levels remain sufficient when staff are absent?
- 05How are complaints reviewed and lessons from them shared with staff?
This was a focused inspection to check improvements after the previous inspection; Safe, Responsive and Well-led were assessed, while ratings for the other key questions were carried over. This explanation was written from the published report of 29 October 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, March 2019
Rated Requires Improvement; inspectors found kind, effective care, but concerns about recruitment, complaints and quality checks.
Inspectors visited without notice on 19 February 2019. They spoke with six people, two relatives and staff. They also reviewed care records, staff files, training documents and management records.
The home was rated Good for Effective and Caring. People were protected from abuse, risks were assessed, medicines were managed safely, and staff generally treated people with kindness, dignity and respect.
The home was rated Requires Improvement for Safe, Responsive and Well-led. Recruitment checks were not always complete, some complaints were not investigated or answered promptly, and quality checks did not always lead to timely action.
This was the home's third consecutive Requires Improvement rating. The provider was told to send an action plan because inspectors found two legal breaches.
Individual risk planning
Risk assessments covered areas such as falls, choking, medicines, nutrition and moving and handling. They were reviewed at least monthly or when people's needs changed.
“The provider carried out detailed risk assessments to ensure the risks to people were identified, assessed and mitigated.” from the report
Kind and respectful care
People and relatives described staff as caring. Inspectors saw staff speaking warmly, respecting privacy and helping people maintain their independence.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Personalised support
Care plans recorded people's preferences, routines, communication needs and choices. People and relatives were involved in care planning and reviews.
“People's care was person-centred. The care was designed to ensure people's independence was encouraged and maintained.” from the report
Safe medicines systems
Medicines were stored securely and records and fridge temperatures were checked. Staff had medicines training and annual competency checks.
“During the inspection we checked medicines storage, medicines administration records, and medicine supplies.” from the report
Incomplete recruitment checks
seriousThe provider did not always complete or fully assess recruitment checks before employing staff. This created an increased risk that people could be harmed.
“The provider did not always follow safe recruitment practices however some improvements had been made since the last inspection.” from the report
Complaints not dealt with promptly
seriousSome complaints from relatives and professionals had no recorded response or investigation. One relative had waited from November and December until January without receiving replies.
“The service did not have an effective system in place to make sure all complaints were investigated, analysed and recorded.” from the report
Quality checks did not drive action
needs fixingThe home carried out audits, but these did not always address identified problems effectively or quickly. Inspectors said further improvement was needed in quality monitoring.
“Although some of the areas we checked had been identified through the provider's audit processes, these did not always address and action the concerns in an effective and timely manner.” from the report
Temporary management
needs fixingThe registered manager had left shortly before the inspection. An interim manager was covering the role for three months while the provider recruited a replacement.
“The registered manager had recently left the service. The provider had replaced them with a temporary manager for a three-month period until a new registered manager was appointed.” from the report
Dementia-friendly areas
minorThe dementia unit had sensory objects, but other areas used by people with dementia lacked suitable signage and were less dementia-friendly. Inspectors made a recommendation for improvement.
“The other units had people with dementia however they were not as dementia friendly.” from the report
Strong smell on ground floor
minorInspectors found a strong smell throughout the ground floor during the inspection. The manager had ordered a product and the provider later said new carpets had been approved.
“However, the ground floor had a strong malodour throughout the day of the inspection.” from the report
- 01What recruitment checks are now completed and signed off before a staff member starts work?
- 02How are complaints now logged, investigated and answered within a clear timescale?
- 03Who is the registered manager now, and how has management changed since the interim manager was in post?
- 04What action has been taken to improve quality audits and make sure identified problems are fixed promptly?
- 05Have the dementia-friendly signage and the ground-floor smell been improved, and when were these changes completed?
This was an unannounced inspection of the whole care home, including accommodation and care, and it assessed all five CQC questions. This explanation was written from the published report of 29 March 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 Westgate House
6 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- October 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2019Requires improvementstayed Requires improvementSafe: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- October 2016Requires improvementstayed Requires improvementSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Good
- December 2014Inspected but not rated
- January 2014
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 15 February 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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