CQC report explained · a nursing home
What the CQC found at Weston House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found people were safe, with enough staff, safe recruitment and trained staff. They identified some medicines improvements and one missing oxygen risk assessment, which was put in place during the inspection.
- Effective?
- Good
- This area was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Caring?
- Good
- This area was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This area was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Well-led?
- Requires improvement
- Quality assurance checks were not always completed effectively or on time. Some care plans did not contain enough safe moving guidance, and people and relatives were not always aware of the management team.
What inspectors found, July 2022
Weston House was rated Good overall; inspectors found safe care, but management oversight and care-plan checks needed improvement.
This was an unannounced focused inspection on 31 May 2022. Inspectors looked only at Safe and Well-led, following concerns about medicines, risk assessments and staff use of protective clothing.
The home was rated Good for Safe. Inspectors found enough staff, safe recruitment, trained staff, suitable infection control and safe medicines support. One missing oxygen risk assessment was added during the inspection, and some medicines improvements were already underway.
The home was rated Requires Improvement for Well-led. Quality checks were not always completed on time or effectively. Some care plans lacked safe hoist guidance, and there had been gaps in staff supervision and appraisal records.
The overall rating remained Good, the same as at the previous inspection published in January 2019. The ratings for the other areas were carried forward because they were not inspected this time.
Enough trained staff
Inspectors found enough staff to meet people's needs promptly. Recruitment checks, induction and training were in place.
“There has always been enough staff about whenever I've needed help with anything.” from the report
Infection control
Staff were seen wearing protective equipment correctly. Inspectors were assured about the home's arrangements for preventing and managing infections.
“At our inspection we saw all staff were wearing their PPE correctly.” from the report
People felt safe
People and relatives said they felt safe and could raise concerns. Safeguarding concerns were reported to the local authority when needed.
“The care is wonderful and I know [my relative] is safe here.” from the report
Learning from incidents
The management team reviewed falls and introduced checks on falls records to help reduce future risks.
“Lessons were learned when things went wrong as the management team completed an analysis of falls in the service.” from the report
Quality checks were incomplete
needs fixingQuality assurance tools had not been completed from March to May 2022. This meant managers could not be sure that all improvements had been identified and acted on promptly.
“records showed there was a gap in quality assurance tools being completed from March to May 2022.” from the report
Care plans lacked some guidance
needs fixingSome care plans did not explain clearly how to use mobility slings safely when people needed a hoist. This could make it harder for staff to follow consistent guidance.
“their care plans did not always contain information about how to use their mobility slings safely.” from the report
Management changes
minorThere had been several recent management changes, and people and relatives did not always know who the management team were. There was no registered manager in post at the inspection.
“People and their relatives were not always aware of who the management team were.” from the report
- 01What quality checks are now completed, and how do you make sure they identify and fix problems promptly?
- 02Have all care plans been reviewed to include safe instructions for using mobility slings and hoists?
- 03Who is currently managing the home, and what is the progress on appointing a registered manager?
- 04How are medicines audits being used to make sure medicines are given as prescribed?
- 05How often are residents and relatives now invited to meetings or asked for feedback?
This was a focused inspection of Safe and Well-led only; the other ratings carried over from the previous inspection. This explanation was written from the published report of 15 July 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.
What inspectors found, January 2019
Rated Good in all five areas; inspectors found kind, safe care but some medicines records and stock checks were incomplete.
The inspection was unannounced and took place on 27 November 2018. Inspectors and Experts by Experience spoke with people, relatives, staff and managers. They observed care and reviewed care records, medicines records, complaints, accidents and quality checks.
The home was rated Good overall and Good for Safe, Effective, Caring, Responsive and Well-led. People were protected from abuse, supported by enough safely recruited staff, and received their medicines as prescribed. Inspectors also found that staff were caring, knew people well and supported people's choices, activities and health needs.
There were two medicines recording shortfalls. Staff did not always record whether 'as required' medicines had worked. Some medicine stock records were incomplete, which could make it harder to identify a missed dose. The manager said these issues would be addressed.
Caring staff
Staff were attentive, respectful and knew people well. Inspectors saw people responding positively during conversations.
“We saw staff were attentive to people, they spoke to them and there was recognition from people smiling and joining in conversations.” from the report
Safe staffing
Inspectors found enough staff available to support people without unnecessary waits. Absences were managed with regular agency staff to provide consistency.
“We found staff were available to people when they needed them and they did not have to wait for support.” from the report
Personalised support
Staff understood people's needs, preferences, communication methods and life histories. Care plans included guidance to help staff provide individual support.
“People were supported by staff to meet their diverse needs and preferences.” from the report
Activities and wellbeing
People were supported to take part in activities suited to their interests and mood. The home also provided individual reflexology and music therapy.
“Staff told us they understood what people enjoyed doing and used this knowledge to support and encourage people to be active during the day.” from the report
Involvement and complaints
Relatives were involved in care planning and felt welcome. The home had a complaints process and used complaints to make changes.
“Complaints and concerns were responded to and used to improve the quality of people's care.” from the report
Incomplete medicine effectiveness records
needs fixingNurses did not consistently record whether 'as required' medicines had worked when given. The manager said staff would be spoken to about this.
“The records required nurses to record the effectiveness of the medicine when it was administered, we found this had not been consistently recorded.” from the report
Medicine stock checks
needs fixingSome medicine stock records were incomplete, including the balance carried forward and an additional weekly stock check. This could make it difficult to identify a missed dose.
“The following week, the week of the inspection, an additional stock check should have been done this also had not been completed.” from the report
- 01How do you now record whether 'as required' medicines have worked?
- 02How are medicine balances and stock checks completed and checked by a second person?
- 03What action was taken with the nurses after the incomplete medicine records were found?
- 04How has the refurbishment progressed, including the planned colour coding and memory boxes?
- 05What activities and therapies are currently available for people with dementia or anxiety?
This was an unannounced inspection covering all five CQC questions, including the premises and the care provided; all five ratings remained Good from the 18 May 2016 inspection. This explanation was written from the published report of 12 January 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 Weston House
3 rated inspections over 6 years: the service has held its Good rating throughout.
- July 2022Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2019Goodstayed GoodSafe: GoodWell-led: Good
- June 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 22 December 2010.
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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