CQC report explained · a nursing home
What the CQC found at Westside Nursing Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Some risks were not assessed or managed properly, records were not always clear, and infection control was inconsistent. Medicines, recruitment checks and safeguarding processes were found to be safe.
- Effective?
- Requires improvement
- This focused inspection did not give a rating for Effective.
- Caring?
- Good
- This focused inspection did not give a rating for Caring.
- Responsive?
- Requires improvement
- This focused inspection did not give a rating for Responsive.
- Well-led?
- Requires improvement
- Management oversight was not reliable enough. Audits had not found some problems with care plans, risk assessments and cleanliness, and there was no clear management structure.
What inspectors found, March 2022
Requires Improvement; inspectors found gaps in risk records, infection control and management oversight.
This was an unannounced focused inspection after concerns were received about infection prevention and control. Inspectors visited on 26, 27 and 31 January 2022. They spoke with people, relatives, staff and the manager, observed care and checked care, medicine, staff and management records.
The home was not consistently safe. Some health risks were not properly assessed or managed. Records were sometimes difficult to read or incomplete. Parts of the home and some equipment were not clean, and staff did not always follow infection control guidance, including correct use of masks.
Inspectors found some positive practice. Medicines were managed safely, staff understood how to report safeguarding concerns, recruitment checks were completed and people were supported to access health professionals. However, management checks had not identified or dealt with important problems.
The overall rating was Requires Improvement. Safe and well-led were both rated Requires Improvement. The home had the same overall rating at its previous inspection, published on 22 November 2019, and had been rated Requires Improvement for two consecutive inspections.
Medicines
Inspectors found that medicines were stored and given safely, including as-required medicines.
“Records showed people received their medicines as prescribed by their doctor.” from the report
Safeguarding awareness
Staff understood how to report concerns about people's safety and welfare, and all staff completed annual safeguarding training.
“Staff we spoke with demonstrated a good understanding of their responsibilities to report any concerns they may have regarding people's safety and welfare.” from the report
Health support
Staff worked with outside professionals to support people's physical and mental health.
“Staff worked closely with external professionals to ensure people received appropriate support with physical and mental health.” from the report
Recruitment
The home completed relevant checks before employing staff, including Disclosure and Barring Service checks.
“The provider followed safe recruitment practices.” from the report
Risk assessments and records
seriousSome people did not have suitable risk assessments or plans, including people with diabetes or swallowing difficulties. Some handwritten care plans were hard for staff to read, and food and fluid records were not always kept.
“Risk assessments relating to the health, safety and welfare of people using the service were not always completed and there were no plans for managing those risks.” from the report
Infection control and cleanliness
seriousBedrooms, bathrooms and other areas were not consistently clean. Some equipment was not cleaned between people, and staff did not always use the required protective masks.
“Parts of the home, including bathrooms and bedrooms were not kept clean or hygienic.” from the report
Management oversight
needs fixingAudits did not identify several problems found during the inspection. There was no registered manager and no clear management structure when the manager was not present.
“Governance of the service was not always reliable and effective and there was no clear management structure.” from the report
Staffing feedback
needs fixingSome staff said staffing levels were too low and could delay care, although inspectors and relatives did not report or observe staffing concerns during the visits.
“Some staff told us that current staffing levels were too low, impacting on staff morale and at times, delaying people's care.” from the report
- 01What has been done to complete and regularly review risk assessments for diabetes, swallowing difficulties and other health risks?
- 02How are care records checked to make sure they are complete, up to date and easy for staff to read?
- 03What daily checks now confirm that bedrooms, bathrooms and moving and handling equipment are clean?
- 04How do you make sure staff and professional visitors follow current infection control and mask requirements?
- 05Who is responsible for the home when the manager is absent, and what progress has been made with the manager's CQC registration?
This was a focused inspection of Safe and Well-led after concerns about infection prevention and control; the other key question ratings were not given in this report. This explanation was written from the published report of 26 March 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, February 2021
Westside Nursing Home: targeted inspection found good infection control practice, but the service was inspected and not rated.
This was an announced, targeted inspection of infection prevention and control during a COVID-19 outbreak. The report says the inspection visit took place on 4 February 2021, although the front page gives 04 January 2021.
Inspectors found that the home was using personal protective equipment safely, supporting social distancing and carrying out extra cleaning. People who tested positive, and people returning from hospital, were isolated. Staff were grouped to care for people who were isolating.
Families were told that the home was closed to visitors. A visitors pod had been installed, but visits there were not taking place during the outbreak. Families were offered other ways to keep in contact.
The service was inspected but not rated. This report only gives findings about infection prevention and control, not a full rating of the home.
Protective equipment
Staff had training in using protective equipment. Inspectors saw that it was available and used according to current guidance.
“Staff had received training in applying and removing personal protective equipment (PPE). We saw PPE was accessible throughout the home and staff used it in accordance with the most up to date guidance.” from the report
Managing infection risks
People with COVID-19, and people returning from hospital, were isolated. Staff were assigned to areas of the home to reduce the risk of infection spreading.
“At the outbreak people who tested positive for Covid-19 were isolated in their bedrooms. People who were discharged from hospital were also isolated to ensure there was less risk of cross contamination.” from the report
Clean environment
The home was clean, with extra cleaning and more frequent cleaning of surfaces that people often touched.
“The home was clean, extra cleaning was carried out and frequent touch points were cleaned more regularly.” from the report
Family contact
Although visitors were not allowed during the outbreak, the home used other ways for families to keep in touch with residents.
“While there were no visitors allowed in the home alternative ways for family members to keep in contact with those living at the service were used.” from the report
Inspectors raised no specific concerns in this report.
- 01What infection prevention and control arrangements are in place now, including cleaning of frequently touched surfaces?
- 02How are visitors currently allowed to meet residents, and what alternatives are available if visiting is restricted?
- 03How do you isolate residents who test positive for an infection or who return from hospital?
- 04How do you make sure staff use protective equipment correctly and receive updated training?
- 05How are residents and staff tested when there is an infection outbreak?
This was an announced, targeted inspection of infection prevention and control during a COVID-19 outbreak; it did not rate the other areas of the service. This explanation was written from the published report of 24 February 2021 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 Westside Nursing Home
4 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- March 2022Requires improvementcurrent ratingSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2021Inspected but not ratedSafe: Inspected but not rated
- November 2019Requires improvementdown from GoodSafe: GoodWell-led: Good
- May 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- June 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- September 2011
Registered with the Care Quality Commission on 22 September 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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