CQC report explained · a residential care home
What the CQC found at Westholme Care Home Limited
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, June 2023
Westholme Care Home Limited is rated Good; inspectors found major improvements after an earlier Inadequate rating, but noted staffing and care-planning shortfalls.
This was an unannounced follow-up inspection on 23 May 2023. Inspectors spoke with people, relatives, staff and a health professional. They observed care, checked the home and reviewed care, medicines, recruitment and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People said they felt safe and received good, kind care. Medicines were managed safely, people's choices were respected, and staff worked with health and social care professionals.
Inspectors still made recommendations about staffing levels, person-centred language and keeping care plans up to date. They also found some areas that would have benefited from more cleaning. These issues did not result in a breach at this inspection.
The previous inspection, published on 23 March 2023, rated the home Inadequate and placed it in Special Measures. Inspectors found enough improvement for the home to be no longer Inadequate, no longer in Special Measures and no longer in breach of regulations.
Safe medicines
Inspectors observed staff administering medicines safely. Records for controlled medicines matched the stock held.
“People received their medicines safely. We observed medicines administration and found staff were trained, had their competency assessed and followed best practice.” from the report
Kind and respectful care
People said staff were caring and listened to them. Inspectors saw patient and compassionate interactions, with people included in everyday conversations.
“We observed staff being compassionate and patient when people were upset.” from the report
Choice and independence
People could make choices about when and how they were supported. The home used positive risk-taking to help people maintain or develop independence.
“The provider used positive risk taking to promote people's independence.” from the report
Improved leadership
The management team was visible and accessible. Staff, people and relatives spoke positively about the support and teamwork.
“There was a clear management structure with easily identifiable lead roles.” from the report
Improved visiting arrangements
Visitors said they could visit without making an appointment, unlike at the previous inspection.
“At this inspection visitors told us they could visit without making an appointment.” from the report
Staffing levels
needs fixingThe home did not consistently provide the individual support that one person had been assessed as needing for 24 hours a day. The provider said staffing levels were reviewed and increased after the inspection.
“The provider had not ensured appropriate staffing arrangements were in place to meet everyone's needs.” from the report
Care plans
needs fixingSome care plans did not contain all the information staff already knew about managing behaviours or supporting people who were distressed. Inspectors recommended reviewing all care plans.
“Not all the care plans reflected the knowledge staff had on how to manage people's behaviours or communicate with people when they were distressed to minimise their anxiety.” from the report
Person-centred language
needs fixingSome staff used language that did not consistently promote people’s dignity, although the conversations were not held in front of people and the care observed was respectful.
“Some staff did not consistently use person centred language.” from the report
Cleaning
minorSome areas of the home would have benefited from additional cleaning while refurbishment was taking place. The provider said the home had received a deep clean after the inspection.
“While there were dedicated housekeeping staff there were areas of the home that would have benefitted from additional cleaning.” from the report
- 01How many staff are now on each shift, and how do you make sure people receive any one-to-one support set out in their assessments?
- 02What changes have you made to care plans for people who may become distressed or whose behaviour needs specific support?
- 03How are staff being supported to use person-centred language consistently?
- 04What cleaning and refurbishment work has been completed since the inspection, and how is it checked?
- 05How will you show that the improvements found at this inspection are being sustained?
This was an unannounced follow-up inspection that checked action from the previous inspection and infection prevention and control, while reporting ratings for all five key questions. This explanation was written from the published report of 16 June 2023 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 2023
Westholme Care Home Limited rated Inadequate and placed in special measures; inspectors found serious gaps in safety, medicines, consent, staffing and management.
This was an unannounced, comprehensive inspection over three days. Three inspectors spoke with people, relatives and staff, reviewed care plans, medicine records, recruitment files and management records, and observed care and the building.
The home was rated Inadequate overall. Safe and Effective were rated Inadequate. Caring, Responsive and Well-led were rated Requires Improvement. Inspectors found risks were not always assessed, medicines records were not reliable, infection control was not effective and some staff recruitment and training checks were incomplete.
Inspectors also found that consent and best-interest decisions were not routinely recorded. People's dignity, personalised care, activities and end-of-life preferences needed improvement. The home had recently changed provider and was undergoing major renovations, which affected some safety and infection control arrangements.
The home was placed in special measures. The provider must send an action plan, and CQC said it would work with the provider and local authority to monitor progress. The previous rating under the former provider was Good, published in June 2019.
Safeguarding awareness
The home had safeguarding procedures. Staff understood when concerns should be reported, and the provider made referrals to the local authority when required.
“The provider had a procedure in place to safeguard people from abuse and staff we spoke with were knowledgeable about when to report concerns.” from the report
Positive relationships
People generally spoke positively about staff. Inspectors saw friendly relationships, laughter and staff helping some people living with dementia to feel less anxious.
“We saw staff and people in the home had good relationships and often heard laughter and banter between people and staff.” from the report
Food and drink support
People's dietary needs were assessed. The chef knew about these needs, and additional monitoring was used when people needed help to maintain nutrition and hydration.
“People's dietary needs were assessed, and the chef was aware of those needs.” from the report
Links with health services
The home referred people to specialist services when their needs increased. District nursing, occupational health and mental health teams worked with the home.
“District nursing teams, occupational health and mental health teams worked with the home to meet people's needs” from the report
Risks and medicines
seriousSome health risks were not properly assessed or reflected in care plans. Medicine records were unclear, some night staff were not trained to give medicines, and controlled drug records were not kept correctly.
“Risks to people were not always identified or if identified were not appropriately assessed and where possible mitigated.” from the report
Infection and building safety
seriousInspectors were not assured about PPE, infection prevention, hygiene, the dedicated sluice arrangements or fire safety during renovation works. Referrals were made to infection control, health and safety and fire services.
“We were not assured that the provider was supporting people living at the service to minimise the spread of infection.” from the report
Consent and legal safeguards
seriousRecords did not consistently show that people lacking capacity had proper best-interest decisions or lawful consent. Some Deprivation of Liberty Safeguards applications and authorisations were not in place.
“When the principles of the Mental Capacity Act are not followed people may not be protected and decisions around their care may not be in their best interest.” from the report
Staff checks and training
seriousSome recruitment records were incomplete, including missing employment history and an enhanced DBS check. Induction, supervision, training records and competency checks were not consistently available.
“Staff were not always safely recruited. Schedule 3 information, used to support safe recruitment practices, was not always available.” from the report
Dignity and privacy
seriousCommunal toilets did not have dignity locks during the inspection. Inspectors also found an unnamed container of underwear being kept for emergencies, although it was removed after this was raised.
“When procedures are not in place to maintain people's dignity and respect their independence this is a breach of regulation 10(1) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Records, activities and future wishes
needs fixingCare records were sometimes contradictory or not up to date, and audits did not identify these problems. End-of-life preferences were often missing, and inspectors saw little meaningful activity or conversation during their observation.
“There was not any meaningful engagement or conversation that took place.” from the report
- 01How are you now checking that medicines are given as prescribed, and have all staff giving medicines had their competency checked?
- 02How have you updated risk assessments and care plans so they accurately reflect each person's current health needs?
- 03Which people now have Mental Capacity Act assessments, best-interest decisions and the required Deprivation of Liberty Safeguards applications or authorisations?
- 04What has been done to make the building safe during and after renovation works, including fire doors, fire signage, storage and the sluice room?
- 05How are you now recording people's end-of-life wishes, involvement in care planning and access to meaningful activities?
This was an unannounced comprehensive inspection of the newly registered service, covering all five key questions, the care provided and the whole environment. This explanation was written from the published report of 23 March 2023 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 Care Home Limited
6 rated inspections over 8 years: the service has held its Good rating throughout.
- June 2023Goodcurrent ratingup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2023Inadequatedown from GoodSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2018Goodstayed GoodResponsive: GoodWell-led: Good
- January 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2022
Registered with the Care Quality Commission on 18 January 2022.
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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85 live-in carers within about an hour of Lancashire
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 £980 to £1,260 a week. 78 can care for a couple. 11 years' experience on average.
“She understands the needs of an elderly person in the early stages of dementia and has treated my mother with great kindness and skill.”
“Thanks to Tracy, Dad was always immaculately dressed and clean, his meals were all home cooked and nutritionally well balanced and his home was always kept really clean and tidy.”
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.