CQC report explained · a residential care home
What the CQC found at Westholme
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe, risks were assessed and staff knew how to respond to safeguarding concerns and emergencies. Medicines, staffing, recruitment and infection control were also found to be managed safely.
- Effective?
- Good
- People's needs were assessed and care plans were updated when needs changed. Staff had relevant training, people had choices about food and drink, and healthcare support was arranged when needed.
- Caring?
- Good
- People described staff as kind, caring and respectful. Inspectors saw positive relationships, support for independence and people being involved in decisions about their daily lives.
- Responsive?
- Good
- Care was personalised and staff knew people well. People could take part in activities and holidays, and complaints were investigated and resolved. End-of-life wishes had not been recorded for everyone.
- Well-led?
- Good
- People and staff felt the home was well led. Quality checks were in place, action was taken when improvements were found, and people were asked for feedback.
What inspectors found, January 2020
Rated Good; inspectors found safe, kind and personalised care, with one gap in recording everyone's end-of-life wishes.
The home provides residential personal care for up to 14 people who have acquired brain injuries or mental health conditions. At the inspection, 13 people lived there.
Two inspectors made an unannounced visit on 10 December 2019. They spoke with people, a relative, staff and a health professional. They also checked care records, medicines records, recruitment information and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines practice, kind relationships, personalised support and systems to monitor quality.
The previous inspection, published in June 2017, also rated the home Good. Inspectors noted that some people's end-of-life wishes had been recorded, but this had not been done for everyone. The manager said this would be addressed.
Enough staff
People said there were enough staff, and inspectors saw staff available and responding promptly when support was needed.
“We observed that staff were visible and available for people throughout the home.” from the report
Kind relationships
People described staff as kind and respectful. Inspectors saw friendly and compassionate interactions throughout the day.
“It was clear that friendly, compassionate relationships had been formed with people and their staff team.” from the report
Personalised support
Staff knew people's backgrounds, preferences and care needs. People were involved in care planning and had choices about their routines.
“People told us that staff knew them well and staff demonstrated that they had taken time to get to know about people, their lives and their care needs.” from the report
Supporting independence
The home supported people to go out independently where possible and acted to reduce risks that could prevent this.
“People were supported and encouraged to go out independently where possible and the provider had taken steps to enable people to do this.” from the report
Learning from concerns
The manager acted on concerns and complaints to improve the service, including improving access to the outdoor area.
“We saw that action was taken where people had concerns to ensure that improvements were made to the service.” from the report
End-of-life wishes not recorded for everyone
needs fixingSome people's wishes had been recorded, including decisions about resuscitation, but this was not complete for all people. The manager said discussions would be recorded for everyone.
“However, this was not the case for all people.” from the report
- 01How will you make sure my relative's end-of-life wishes are discussed, recorded and kept up to date?
- 02How do you assess and review risks linked to my relative's specific health conditions or equipment?
- 03What choices will my relative have about daily routines, meals, activities and going out?
- 04How will you involve our family in reviews and tell us about changes in my relative's needs?
- 05How do you use complaints, surveys and audits to make improvements?
This was an unannounced planned inspection covering the home and care provided, with all five CQC questions rated. This explanation was written from the published report of 14 January 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, June 2017
Rated Good; inspectors found kind, safe and personalised care, but staffing shortages sometimes limited activities and repairs were delayed.
This was an unannounced comprehensive inspection on 02 May 2017. The inspector met nine of the 13 people living at the home, observed care, reviewed care plans, medicines, staff recruitment and quality checks, and spoke with relatives, staff and a health professional.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people received support suited to their needs, had trusting relationships with staff, and were supported with health care, medicines, food, activities and daily living skills.
There was a temporary shortage of permanent staff. Safety was maintained, but there were not always enough staff to support all planned activities. The home also needed improvements to its premises, and repairs to two showers were not completed promptly. The overall rating remained Good, as it had been at the previous inspection in June 2015.
Kind relationships
People appeared relaxed with staff and had built trusting relationships. Care was delivered with patience, kindness and compassion.
“All the care and support we observed was offered with kindness and compassion.” from the report
Personalised support
Staff knew people's needs, preferences and goals. People were supported to make choices, build daily living skills and stay connected with important people and activities.
“Our observations and people's care records showed that each person had been provided with care and support that was tailored to meet their individual needs and wishes.” from the report
Health and medicines
Staff were trained to manage medicines and supported people to access relevant health professionals. Checks were in place to monitor medicines safely.
“People could be confident that their medicines were well managed.” from the report
Staffing affected activities
needs fixingThere was a temporary shortage of permanent staff. Although there were enough staff to maintain safety, there were not always enough to support activities that mattered to people.
“there were not always sufficient staff to support people in undertaking activities that were important to them.” from the report
Delayed shower repairs
needs fixingTwo broken showers took too long to repair. This reduced people's choice about where to meet their personal hygiene needs.
“the registered providers arrangements had not been effective at ensuring these repairs were undertaken promptly” from the report
- 01How many permanent staff vacancies are there now, and has the temporary reliance on additional hours and agency staff ended?
- 02How do you make sure planned community activities still take place when staffing levels are lower?
- 03Have the two broken showers been repaired, and have the other planned premises improvements been completed?
- 04How are people supported to manage their own medicines where they have been assessed as able to do so?
- 05How are families involved in care plan reviews and decisions when a person cannot take part themselves?
This was an unannounced comprehensive inspection covering all five questions and the overall rating. This explanation was written from the published report of 10 June 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 Westholme
3 rated inspections over 4 years: the service has held its Good rating throughout.
- January 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 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.
- October 2012
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 24 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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