CQC report explained · a residential care home
What the CQC found at Westmead
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, January 2023
Rated Requires Improvement; inspectors found safety and management weaknesses, including risks from cleaning products, windows and infection control.
This was an unannounced, focused inspection prompted by concerns about staffing and unnecessary isolation. Inspectors visited over two days, including out of hours. They spoke with people, relatives, staff and professionals, and checked care records, staff files, audits and other records.
The home was rated Requires Improvement for Safe and Well-led. People were not always protected from avoidable harm. Cleaning products were not always locked away, some window restrictors were broken or missing, food was not always labelled and dated, and infection control measures were not consistently followed.
There were also weaknesses in management checks and records of meaningful activities. However, medicines were managed safely, staff knew people well, care plans were person-centred, and concerns about staffing and unnecessary isolation were not substantiated.
The overall rating changed from Good at the previous inspection, published on 14 March 2019, to Requires Improvement. The inspection only reviewed Safe and Well-led. Ratings for the other key questions were carried over from the previous inspection.
Medicines
Medicines were safely managed. The service acted when errors happened and kept accurate records.
“Where medicines errors had occurred, the service had taken appropriate action to address these, to reduce the likelihood of further incidents.” from the report
Person-centred support
Care plans were detailed, person-centred and regularly updated. Staff knew people's needs and communication preferences.
“Care plans were person centred and regularly updated to reflect people's needs and preferences.” from the report
Community activities
Some people were supported to take part in activities they chose and to be involved in their community.
“Some people were observed to be actively involved in the community.” from the report
Learning from incidents
The management team reviewed accidents and incidents and took action intended to reduce future risks.
“Accidents and incidents were reviewed by the management team and actions taken to mitigate future risks to people.” from the report
Safety measures not always followed
seriousCleaning products were not always locked away, and window restrictors were missing or broken. These issues increased the risk of avoidable harm.
“The provider did not ensure all risks to people were managed, placing people at risk of avoidable harm.” from the report
Infection control
seriousInspectors saw problems with PPE, broken clinical waste bins, exposed soiled laundry and cleaning records. One flat was visibly dirty.
“Infection, prevention and control measures did not protect people from the risk of infection.” from the report
Management checks
seriousAudits did not identify the safety and infection control problems found during the inspection. This meant leaders did not have effective oversight.
“The provider did not have effective systems in place to monitor the service and provide good outcomes for people.” from the report
Meaningful activities
needs fixingRecords did not show that everyone was offered meaningful activities, longer-term goals or chances to develop independence. Relatives said some people's activities had reduced.
“Daily records did not evidence all people were offered meaningful activities.” from the report
- 01What has been done to ensure cleaning products are locked away and window restrictors are present and working?
- 02How are infection control checks now carried out, including PPE, clinical waste, soiled laundry and cleaning schedules?
- 03How do you check that audits identify safety problems before they put people at risk?
- 04How will you provide and record meaningful activities and longer-term goals for my relative?
- 05What progress has been made since the action plan requested by the CQC?
This was an unannounced focused inspection of Safe and Well-led only; the other key question ratings were carried over from the previous inspection. This explanation was written from the published report of 5 January 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 2019
Westmead rated Good; inspectors found safe, kind and personalised care, with some records and recruitment checks needing improvement.
This was the home’s first inspection since it registered in April 2018. The unannounced visit was brought forward after the provider reported incidents that raised concerns about the management of a person’s risk of absconding.
Inspectors spoke with people living at the home, staff, relatives and health professionals. They observed care, reviewed three people’s care records, checked audits and other records, and asked for further documents after the visit.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found people received individualised support, had opportunities to build independence, and were treated with kindness and respect. They also found some records and one recruitment check needed attention, but legal requirements were met.
Personal space and independence
Each person had their own adapted flat. The home focused strongly on choice, control, positive risk-taking and building independence.
“Each person had their own individual flat including living space and kitchen which had been adapted to their individual needs and preferences.” from the report
Kind relationships
Staff knew people well and had built positive relationships. Inspectors saw staff communicating positively and treating people with dignity.
“Staff had developed good positive relationships with people.” from the report
Individualised support
Care plans and staff training were tailored to the people living at the home. Staff supported people to take part in activities and manage distress in ways that suited them.
“People received personalised care and support which met their needs, preferences and interests.” from the report
Learning from incidents
The home investigated incidents and used them to improve practice. Restrictive interventions were used as a last resort and had reduced over time.
“There was a culture of learning lessons when things went wrong.” from the report
More detail needed in one-to-one records
needs fixingInspectors found that records did not fully explain the role of one-to-one staff supporting one person, including regular welfare checks. The manager changed the protocols and risk assessments during the inspection.
“more information needed to be recorded detailing the role of one-to-one staff when supporting one person including regular checks on their welfare.” from the report
Recruitment check before shadowing
needs fixingOne staff member started shadowing shifts before their full DBS check had returned. Inspectors reminded the provider that this should only happen as a last resort and after a clear risk assessment.
“one staff member had started shadowing shifts before their full Disclosure and Barring Service (DBS) check had been returned.” from the report
Health action plans
minorNot everyone had a health action plan at the time of inspection. The manager said plans would be created with local health professionals.
“We identified people did not always have health action plans in place.” from the report
Care plans were not always dated
minorInspectors found that care plans were not always dated. This was raised with the manager for action.
“However, care plans were not always dated, we raised this with the registered manager to ensure it was addressed.” from the report
- 01How do you record the role of one-to-one staff and the regular welfare checks they must complete?
- 02Do all staff have their full DBS checks completed before they begin shadowing or working?
- 03Does each person now have a health action plan, and who helped to write it?
- 04How do you make sure care plans are dated and reviewed when people’s needs change?
- 05How are restrictive interventions monitored and reduced over time?
This was the first inspection since registration and covered all five key questions; it was brought forward to examine risks linked to reported incidents. This explanation was written from the published report of 13 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 Westmead
2 rated inspections over 4 years: the service has slipped, from Good to Requires improvement.
- January 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2019GoodSafe: GoodWell-led: Good
- April 2018
Registered with the Care Quality Commission on 12 April 2018.
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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92 live-in carers within about an hour of Wakefield
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. 79 can care for a couple. 12 years' experience on average.
“Carla has been a god send with the implementation of bringing mum back home from respite care.”
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.