CQC report explained · a nursing home
What the CQC found at Westmorland Court Nursing and Residential Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, March 2023
Westmorland Court Nursing and Residential Home is rated Requires Improvement; medicines were not always managed safely and oversight needed strengthening.
This was an unannounced focused inspection on 8 and 10 February 2023. Inspectors spoke with people, relatives and staff, and reviewed care records, medicines records, recruitment files and management information.
The home had enough staff and recruitment checks had improved. People described staff as kind and respectful. Infection prevention arrangements were satisfactory, and the home was working within the principles of the Mental Capacity Act.
However, medicines were not always managed safely. Some required medicines were given too soon, records for creams and thickened fluids were incomplete, and some written instructions were missing. Risk records were also incomplete, and some incidents had not been notified to the CQC as required.
The overall rating remains Requires Improvement. Safe and Well-led were both rated Requires Improvement. This inspection only assessed those two areas, so the other ratings were carried forward from the previous inspection.
Kind and respectful care
People spoke positively about the care and said staff treated them with respect and dignity.
“People told us they thought the care they received was very good and spoke positively about the staff who supported them.” from the report
Staffing and recruitment
Inspectors found enough staff to support people. Recruitment checks had improved, including checks for staff employed from overseas.
“Staff employed had been checked to ensure they were suitable for their role.” from the report
Infection control
Inspectors were assured that the home had arrangements to prevent and manage infections, including using protective equipment safely.
“We were assured that the provider was using PPE effectively and safely.” from the report
Support with decisions
The home was working within the principles of the Mental Capacity Act. Where needed, legal authorisations were in place and their conditions were being met.
“We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place” from the report
Medicines were not always safe
seriousSome medicines prescribed for use when needed did not have written protocols available. Some paracetamol doses were given before the required four-hour gap, and records for creams and thickened fluids were not always complete.
“We found for 2 people prescribed paracetamol the required safe 4 hour gap between doses had not always been observed by staff” from the report
Incomplete risk records
needs fixingSome risks relating to people's needs had not been identified or did not have detailed management plans. The manager took immediate action to update the records.
“Not all risks relating to people's needs had been identified.” from the report
Checks did not find all problems
needs fixingThe home's medicines audits were not effective enough to identify the concerns found by inspectors. The provider was asked to improve its systems for overseeing safety and quality.
“Various audits had been undertaken. However, we found those related to the management of medicines had not been effective in identifying the concerns we found.” from the report
Missing statutory notifications
needs fixingTwo incidents had been shared with the local authority but had not been notified to the CQC as required. Inspectors recommended stronger systems for identifying when notifications must be sent.
“However, we found 2 incidents that had been appropriately shared with the local authority safeguarding team but not with us.” from the report
- 01What has changed to stop medicines being given before the required four-hour gap?
- 02How are you checking that written protocols for medicines used when needed are available to staff at the point of administration?
- 03How do you now record thickened fluids and topical creams, and who checks these records?
- 04How have you improved your medicines audits so they identify problems before they affect people?
- 05Have all outstanding risk assessments and statutory notifications now been completed?
This was a focused inspection of Safe and Well-led only; the other key-question ratings were carried forward from the previous inspection. This explanation was written from the published report of 21 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.
What inspectors found, November 2022
Inspected but not rated; inspectors found risks around delayed emergency referrals and checks on agency staff.
This was an unannounced targeted inspection on 13 and 14 October 2022. Inspectors looked at concerns about recognising when people became seriously unwell and about the safe use of agency staff. They spoke with managers and reviewed six staff employment records.
Inspectors found one case where a person's worsening health was not referred to specialist healthcare professionals quickly enough. This could have increased the risk of harm. The home took immediate action and started an internal review. In two other cases, inspectors were satisfied that concerns had been referred appropriately.
Checks on three agency staff were not complete. Records such as right-to-work, experience and training documents were not always available. The home obtained the missing documents during the inspection and said it would introduce a stronger checking system.
The service was inspected but not rated. This was because the inspection was targeted and did not assess the whole Safe question or the other four questions. The previous overall rating was Requires Improvement, published on 29 August 2019.
Appropriate referrals in other cases
In two other cases reviewed, the home had referred concerns to healthcare professionals appropriately.
“In the 2 other cases we reviewed, we were assured the service had appropriately elevated concerns to the relevant healthcare professionals.” from the report
Action taken during inspection
The home acted on the concerns, obtained missing agency staff documents and retrained one agency worker.
“The registered manager obtained relevant documentation during the inspection.” from the report
Direct recruitment processes
Inspectors found that the recruitment processes for staff employed directly by the provider were appropriate and followed.
“Appropriate processes were in place and followed when staff had been directly employed by the provider.” from the report
Delay in emergency referral
seriousIn one case, staff recorded signs that a person's health was deteriorating but did not refer them to specialist healthcare professionals quickly enough. Inspectors said this could have increased the risk of harm.
“There was a delay in referring the person to specialist healthcare professionals, such as ambulance staff.” from the report
Incomplete agency staff checks
needs fixingThe home could not initially confirm that three agency staff had the right work history, training and permission to work. Inspectors recommended a robust checking system.
“This meant the provider could not be assured they were appropriate to work with vulnerable people.” from the report
- 01What is the current process for recognising and escalating a resident's worsening health?
- 02How quickly would staff contact ambulance staff or other specialist healthcare professionals when a resident deteriorates?
- 03What checks are now completed before agency staff work with residents?
- 04How do you confirm agency staff have the required training, experience and right to work?
- 05When will the next comprehensive inspection take place, and what changes have been made since this targeted inspection?
This was a targeted inspection of concerns about escalating serious health changes and using agency staff; it did not assess the whole Safe question or the other four key questions, so the previous ratings carried over. This explanation was written from the published report of 16 November 2022 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 Westmorland Court Nursing and Residential Home
8 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- March 2023Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Westmorland Court Nursing and Residential Home →
- November 2022Inspected but not ratedSafe: Inspected but not rated
Read what inspectors found at Westmorland Court Nursing and Residential Home →
- March 2022Inspected but not ratedSafe: Inspected but not rated
- August 2019Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- August 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2018Requires improvementstayed Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- February 2017Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- December 2016Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- September 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- June 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 7 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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9 live-in carers within about an hour of Westmorland and Furness
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.
8 can care for a couple. 10 years' experience on average.
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.