CQC report explained · a nursing home
What the CQC found at Westvale House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found problems with risk management, response to call bells, repositioning, hydration records, staffing deployment and medicines. This was a breach of Regulation 12.
- Effective?
- Good
- This question was not inspected during this focused inspection. Its previous rating was carried over.
- Caring?
- Good
- This question was not inspected during this focused inspection. Its previous rating was carried over.
- Responsive?
- Good
- This question was not inspected during this focused inspection. Its previous rating was carried over.
- Well-led?
- Requires improvement
- Audits and care records did not reliably identify or show that people's needs were being met. Communication about care was not always effective, and this was a breach of Regulation 17.
What inspectors found, February 2024
Westvale House was rated Requires Improvement; inspectors found risks with medicines, care records, staffing and monitoring.
This was an unannounced focused inspection. Inspectors looked at Safe and Well-led, spoke with people, relatives and staff, observed care, and checked records, medicines, recruitment files and the home.
The home was not always safe. Inspectors found that call bells were not always answered quickly, people were not always repositioned as required, fluid records were unreliable, and medicines records and checks were not always safe. Staff were also not always deployed where they were needed.
The home was not always well-led. Audits had failed to find important problems, and daily care records and communication about people's needs were incomplete. The provider had recruited staff and made management changes, which appeared to be helping, but improvements had not yet been fully established.
The overall rating changed from Good at the previous inspection in 2018 to Requires Improvement. The report says the provider must send an action plan, and CQC will monitor progress with the provider and local authority.
People felt safe
People told inspectors they felt safe, and staff understood their safeguarding responsibilities.
“I feel safe and if I had any problems I would talk to staff.” from the report
Kind interactions
Inspectors saw positive interactions, and staff knew the people they supported well.
“We observed positive interactions between staff and people who lived at the service.” from the report
Action on feedback
The registered manager was open to feedback and took some immediate steps to address concerns during the inspection.
“The provider was responsive to feedback and took immediate action to address some of the concerns raised.” from the report
Infection control
Inspectors found that staff followed safe infection prevention and control practices.
“People were protected from the risk of infection as staff were following safe infection prevention” from the report
Risks were not managed reliably
seriousCall bells were not always accessible or answered quickly. Records and practice did not always show that people received the repositioning, fluids and dietary support they needed.
“Systems had not been effective to assess, monitor and mitigate risks to the health, safety and welfare of people using the service.” from the report
Medicine checks were not safe enough
seriousMedicine records did not always show the correct creams or doses given. Inspectors also found expired equipment and medicines that had not been destroyed when no longer needed.
“The oversight of medicine was not robust enough to ensure people where safely given their medicines.” from the report
Staffing deployment
needs fixingStaff were not always easy to find on the unit, and people were sometimes left without their assessed level of support. CQC recommended reviewing how staff are deployed.
“Staff were not always effectively deployed, and we found occasions where staff could not be located on the unit for periods of time.” from the report
Weak monitoring and records
seriousAudits did not identify all the problems found by inspectors. Daily records had gaps, so the home could not be certain they accurately showed the care people received.
“We therefore could not be certain of the accuracy of any records held regarding people's daily care.” from the report
Communication gaps
needs fixingInformation from outside professionals and changes in people's care were not always recorded or shared clearly with staff.
“Systems to ensure communication of relevant information relating to people's care needs was not always effective.” from the report
- 01What has been changed to make sure medicines, including creams and variable doses, are recorded and checked correctly?
- 02How do you make sure call bells are answered promptly and people are repositioned, hydrated and supported according to their care plans?
- 03How do you check that enough staff are available on each unit, including when staff are absent?
- 04How are gaps in daily care records and communication from health professionals being prevented?
- 05What actions are in your improvement plan, and how will you show families that they have been completed?
This was a focused inspection of Safe and Well-led only; the other ratings were carried over from the previous inspection in 2018. This explanation was written from the published report of 1 February 2024 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 2021
Westvale House was inspected but not rated; inspectors were assured that infection risks during the COVID-19 pandemic were being managed.
This was an unannounced, targeted inspection on 22 January 2021. Inspectors looked at infection prevention and control measures during the COVID-19 pandemic.
Inspectors were assured that the home was using testing, symptom checks, personal protective equipment and cleaning to reduce infection risks. Staff were tested regularly, and people living there had temperature and symptom checks twice a day.
The home changed its layout and working arrangements to reduce spread. Staff were assigned to floors, had separate changing areas and staff rooms, and visitors used a heated visiting pod. The overall service and Safe question were both recorded as inspected but not rated.
Regular testing and checks
Staff received regular COVID-19 testing and symptom checks. People living at the home had their temperature and main symptoms checked twice a day.
“Staff were also tested staff using rapid testing twice a week in addition to the weekly testing programme.” from the report
PPE and hygiene
Inspectors found supplies of PPE and hand gel, trained staff, and extra housekeeping resources to support cleanliness.
“Senior staff ensured that there was always a good supply of PPE and hand gel at convenient locations throughout the home.” from the report
Safer visiting arrangements
Visits inside the main building were restricted, but families could book a heated visiting pod. The pod was cleaned between visits.
“There was a purpose built, heated visiting pod in the grounds of the building that people's friends and family could book for a socially distanced visit.” from the report
Support for contact and wellbeing
People had access to Wi-Fi and were supported with video and phone calls. Staff also spent time talking with people and organised activities.
“There was wi-fi and internet access available throughout the home and people had been supported to make video and phone calls to friends and family.” from the report
Pandemic leadership
Inspectors found that the management team had introduced changes, audits, training and extra support during the pandemic.
“The service had been well-led during the period of the COVID-19 pandemic.” from the report
Inspectors raised no specific concerns in this report.
- 01What infection prevention and control arrangements are in place now, and how often are staff tested?
- 02How are staff trained and checked to make sure PPE is used safely?
- 03How can relatives visit now, and what happens if visiting restrictions are needed again?
- 04How are people supported to keep in touch with family if visits are restricted?
- 05How are new residents admitted safely and supported during any initial period in their room?
This was an unannounced targeted inspection of infection prevention and control measures during the COVID-19 pandemic; the service was inspected but not rated. This explanation was written from the published report of 4 March 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 Westvale House
4 rated inspections over 9 years: the service has slipped, from Good to Requires improvement.
- February 2024Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2021Inspected but not ratedSafe: Inspected but not rated
- December 2018Goodup from Requires improvementSafe: GoodWell-led: Good
- June 2017Requires improvementdown from GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- December 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 15 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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