CQC report explained · a residential care home
What the CQC found at Westlands Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found comprehensive risk assessments, safe medicines systems, effective recruitment and enough staff to meet people's needs. The home was clean and had systems for learning from incidents.
- Effective?
- Good
- Staff supported people in line with the Mental Capacity Act and received training, induction, supervision and appraisals. People were supported with food, drink and access to health professionals.
- Caring?
- Good
- Staff were observed treating people with kindness, compassion, dignity and respect. People were involved in their care and encouraged to remain as independent as possible.
- Responsive?
- Good
- Care plans were personalised, up to date and reflected people's needs, preferences and communication methods. People took part in activities and were supported to keep in touch with family and friends.
- Well-led?
- Good
- The home had introduced audits covering care plans, risks, incidents, staffing, safety and cleanliness. People, relatives and staff were asked for their views, and the manager notified CQC about significant events.
What inspectors found, August 2019
Rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
This was an unannounced inspection on 30 July and 2 August 2019. Inspectors spoke with nine people, three relatives and ten staff. They observed care and reviewed care files, staff records, training records and other documents.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people were safe, treated with kindness and supported by staff who understood their needs. Medicines, risk assessments, recruitment and training had improved.
The previous inspection, published in August 2018, rated the home Requires Improvement and found seven breaches of regulations. This inspection found enough improvement and said the home was no longer in breach of those regulations.
Risk and medicines
Risk assessments were comprehensive and regularly reviewed. Medicines were stored, administered and checked safely, with staff training and competency checks.
“Comprehensive risk assessments were in place. People's individual risks were identified, and the necessary risk assessment reviews were carried out to keep people safe.” from the report
Kind and respectful care
Inspectors saw staff offering reassurance, encouragement and respectful personal care. Staff knew people's routines, likes and dislikes.
“Staff were kind and compassionate and treated people with respect.” from the report
Personalised care plans
Care plans were clearly organised and included people's history, preferences, health needs and communication methods.
“Care plans were up-to-date and were clearly laid out.” from the report
Improved leadership
The home had put stronger checks in place and followed up actions such as updating care plans and completing maintenance work.
“Robust audits had been implemented following guidance from the Quality Assurance Improvement Team (QAIT) of the local authority.” from the report
Refurbishment was still under way
minorThe home was still being refurbished to make it more homely and dementia friendly. Signage was planned after structural work, and completion was expected in December 2019.
“An internal refurbishment programme was currently in place to make the environment homelier and dementia friendly.” from the report
- 01Has the refurbishment to make the home more dementia friendly been completed, including the planned signage?
- 02Did the activities coordinator start, and what activities are now available each week?
- 03How are risk assessments and care plans reviewed when a person's needs or health changes?
- 04How are medicines audits and staff competency checks kept up to date?
- 05How are people's views, relatives' views and complaints used to make further improvements?
This was an unannounced planned inspection looking at all five key questions, including the premises and care provided; the inspection followed the previous Requires Improvement rating. This explanation was written from the published report of 20 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
Westlands Retirement Home was rated Requires Improvement; inspectors found kind care but serious gaps in safety, records, staffing and management.
This was an unannounced, comprehensive inspection on 14 and 15 June 2018. Inspectors spoke with people, relatives, staff and a healthcare professional. They reviewed six care records, medicines, recruitment files, training records and the home's management checks.
People were generally treated kindly and with respect. They received their medicines on time, were supported with healthcare and had food choices. However, inspectors found risks were not always managed safely. These included incorrectly set pressure-relieving mattresses, unsecured doors and gates, unsafe medicines storage, unrestricted windows and overdue safety checks.
The home was rated Requires Improvement overall. Caring was rated Good. Safe, Effective, Responsive and Well-led were all rated Requires Improvement. The report found several legal breaches and said the provider had to send CQC a plan showing what action would be taken.
Kind and respectful care
People and relatives spoke positively about staff. Inspectors saw staff treating people with patience, dignity and compassion.
“People were positive about the care and support they received and felt staff were kind, caring and treated them with respect.” from the report
Healthcare support
Staff monitored people's health and made referrals when needs changed. A visiting healthcare professional said referrals were made quickly and advice was followed.
“People's health care needs were monitored and referrals made when necessary.” from the report
Medicines given on time
Inspectors found that prescribed medicines were given on time and in a safe way, although storage arrangements were not secure.
“People received their prescribed medicines on time and in a safe way.” from the report
Privacy and independence
People were involved in everyday decisions and encouraged to do things for themselves. Staff respected privacy and personal dignity.
“People's privacy and dignity were respected and their independence was promoted.” from the report
Food choices
Most people enjoyed the food. The chef knew people's likes and dislikes, and information about allergies and special diets was available.
“Details of people's food allergies or special dietary requirements were available in the kitchen and regularly reviewed” from the report
Risks were not controlled
seriousFour of six pressure-relieving mattresses were set incorrectly, placing people at avoidable risk. Other risks included an unlocked gate, unrestricted windows and inadequate checks during building work.
“This meant that people had been placed at avoidable risk of developing pressure ulcers.” from the report
Medicines and safety checks
seriousMedicines could be accessed because keys and cupboards were not kept securely. Fire alarm and emergency lighting checks were also overdue.
“This meant the home did not have a robust system in place to ensure people or unauthorised staff could not access medicines.” from the report
Recruitment and staff support
seriousSome references and required checks were completed after staff started work. Staff training, induction, supervision and appraisal records were not sufficient.
“The failure to complete necessary employment checks before allowing staff to provide care had exposed people to unnecessary risk.” from the report
Outdated care plans
seriousSome records did not reflect current mobility, dietary or health needs. This meant staff might not have reliable information about how to support people.
“People were at risk of receiving care that did not meet their needs.” from the report
Mental Capacity Act records
seriousRecords did not consistently show that capacity had been assessed or that best-interests decisions had been properly recorded. This included arrangements that restricted access to doors or the garden.
“There were no records to show the rationale for this decision, no mental capacity assessment to show that people did not have capacity to consent to these arrangements” from the report
Weak oversight
seriousThe home's checks had not identified several of the problems found. Significant incidents had also not always been reported to CQC as required.
“Although quality assurance systems were in place, they were not being used effectively or undertaken robustly enough to identify the issues seen during the inspection.” from the report
- 01Have all care plans been reviewed and corrected so they match each person's current mobility, diet, health needs and preferences?
- 02What system now decides staffing levels for evenings and nights, based on people's needs?
- 03How are medicines, keys, windows, doors and gates kept secure, and when were the latest fire and premises checks completed?
- 04What checks are completed before staff start work, and how are induction, training, supervision and competence recorded?
- 05How are Mental Capacity Act assessments and best-interests decisions recorded when doors, garden access or other arrangements restrict a person's freedom?
This was a comprehensive inspection covering all five CQC questions, including the premises and care provided. This explanation was written from the published report of 30 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 Westlands Care Home
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- August 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2018Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2017
Registered with the Care Quality Commission on 6 February 2017.
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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