CQC report explained · a residential care home
What the CQC found at Westwood Care 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
- Medicines were not always managed safely. Staff training and competency checks were not always complete or up to date, and some instructions for medicines given when needed lacked enough detail.
- Effective?
- Good
- This question was not inspected during this focused inspection. Its previous rating was used when calculating the overall rating.
- Caring?
- Good
- This question was not inspected during this focused inspection. Its previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused inspection. Its previous rating was used when calculating the overall rating.
- Well-led?
- Good
- The home had a positive and supportive culture, with improved systems and oversight. However, some staff responsible for medicines still lacked the necessary training and competency checks.
What inspectors found, October 2022
Requires Improvement; inspectors found continued medicines safety failures, although the home was well-led and some improvements had been made.
This was an unannounced, focused inspection on 16 September 2022. The inspector spoke with people, a relative, managers and staff, and reviewed medicines records, care plans, training records and audits.
The home was rated Requires Improvement overall and for Safe. Staff were not always trained or assessed as competent to give medicines. Instructions for some medicines given only when needed did not contain enough information, including for people unable to communicate their needs.
The home was rated Good for Well-led. Inspectors found enough staff, safe recruitment, regular safety checks and a positive culture. The electronic medicines recording system and care records had improved, but the continued medicines breach meant further action was required.
The inspection only covered Safe and Well-led. Ratings for the other three questions were carried over from the previous inspection when calculating the overall rating.
Enough staff
Inspectors found enough staff to meet people's needs and keep them safe. Recruitment checks were also carried out.
“People and staff told us there were enough staff to meet people's needs and keep them safe.” from the report
Positive leadership
Staff felt supported and confident in the management team. Leaders had introduced new systems and showed a commitment to improvement.
“There was a clear direction for improvement within the service and leaders and staff were committed to continuous learning and improvement.” from the report
Improved care records
A new electronic care-record system was in place. Inspectors found the records were detailed and focused on people's individual needs.
“Records were robust and person-centred and evidenced how people's needs were met.” from the report
People felt safe
People told inspectors they felt safe and well looked after. Staff understood how to raise concerns and respond when things went wrong.
“People told us they felt safe and well looked after.” from the report
Medicines training
seriousNot all staff who gave medicines had suitable training or up-to-date competency checks. This was a continued breach of the medicines safety regulation.
“Competency checks to ensure staff had the knowledge and skills to safely administer medications were not always completed or up to date.” from the report
Instructions for some medicines
seriousInstructions for medicines given only when needed did not always explain clearly when to give them, especially for people unable to communicate their needs or where doses varied.
“Protocols to guide staff on when to administer 'as and when required medication' did not always include enough information.” from the report
Relative feedback
minorThe home needed to do more to collect and use formal feedback from relatives to improve the service.
“Further work was required to ensure formal feedback from relatives was collected and used to improve the quality of the service.” from the report
- 01Which staff currently give medicines, and how do you check that each person is trained and competent?
- 02What action has been taken since the inspection to complete or update medicines competency checks?
- 03How do you decide when to give medicines prescribed to be used only when needed, especially if a resident cannot communicate their needs?
- 04When will the ground-floor carpet be replaced, and what temporary steps are in place to reduce the risk?
- 05How are relatives' views now collected and used to improve the service?
This was an unannounced focused inspection of Safe and Well-led only; the other ratings were carried over from the previous inspection. This explanation was written from the published report of 15 October 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, May 2021
Rated Requires Improvement; inspectors found risks in safety checks, medicines and management systems, although people were happy and well cared for.
This was an unannounced focused inspection on 30 March 2021. Two inspectors spoke with one person, one relative and seven staff. They reviewed care records, medicines records, staff files and management records.
The home was clean and homely, and people were described as happy and well cared for. Staff knew people well and appeared to meet their care needs. Infection control arrangements were mostly satisfactory, although some checks and risk assessments were incomplete.
Inspectors found that fire safety, water safety, staffing, medicines and quality checks were not managed reliably. The overall rating fell from Good to Requires Improvement. Safe was rated Requires Improvement, while Well-led remained Requires Improvement.
The inspection only assessed Safe and Well-led. Ratings for Effective, Caring and Responsive were carried forward from the previous comprehensive inspection and were not inspected this time.
People were cared for well
People were happy and well cared for. Staff knew people well and understood how to support them.
“People were happy and well cared for. The registered manager and staff knew people well and how to support them.” from the report
Positive staff culture
Inspectors observed a person-centred approach. Staff said they felt able to report concerns and trusted the manager to respond.
“The culture of the service was positive. Staff demonstrated they put the people they supported first and were caring in their approach.” from the report
Infection control arrangements
Inspectors were assured about several infection prevention measures, including visitors, admissions, protective equipment, testing, cleanliness and the infection control policy.
“We were assured that the provider was using PPE effectively and safely.” from the report
Health care links
Staff worked with community district nurses to help meet people's health needs.
“Staff worked closely with the community district nurses to ensure people's health needs were met.” from the report
Incomplete safety checks
seriousSome essential safety monitoring and environmental risk assessments were not completed or reviewed. Fire assessment actions and water safety checks were outstanding.
“Some essential safety monitoring checks had not been completed and environmental risk assessments had not been regularly reviewed.” from the report
Medicines were not always managed safely
seriousSome medicines lacked clear instructions. Training and competency checks were not always current, and missed medicines were not always followed up clearly.
“The provider had failed to ensure the proper and safe management of medication.” from the report
Weak oversight and follow-up
seriousAudits did not reliably find problems or ensure actions were completed. Record-keeping issues and earlier concerns remained unresolved.
“Governance systems and processes were not in place or effective. There was a lack of service oversight from the provider.” from the report
Recruitment and staffing evidence
needs fixingThe home could not show a robust recruitment process or a system for deciding safe staffing levels. Staff said more staff would sometimes help them respond to changing needs.
“The provider could not evidence robust recruitment process were in place and staffing levels were not regularly reviewed.” from the report
Limited ways to raise concerns
needs fixingStaff and families did not always know how to contact the provider about concerns. Resident and staff meetings had also been limited during the previous year.
“Staff and family members were not always aware of how to contact the provider if they had concerns about the service.” from the report
- 01What action has been completed to address the fire risk assessment and water safety checks?
- 02How are medicines errors, missed medicines and staff competency checks now monitored?
- 03What system do you use to decide safe staffing levels when people's needs change?
- 04How do your audits identify problems, and how do you make sure agreed actions are completed?
- 05How can families and staff now raise concerns directly with the provider?
This was a focused inspection of Safe and Well-led only; Effective, Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 12 May 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 Westwood Care Home
5 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- October 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- October 2019Goodstayed GoodSafe: GoodWell-led: Requires improvement
- March 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 7 January 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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