CQC report explained · a residential care home
What the CQC found at Westwood
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- There were not always enough staff in the afternoons, evenings and at night. Inspectors also found concerns about supporting people safely during a night-time fire evacuation, although staffing was increased after the inspection.
- Effective?
- Good
- People's needs and choices were assessed and reviewed. Staff received relevant training, people were supported with food and drink, and health referrals were made when needed.
- Caring?
- Good
- This question was not inspected at this visit, so no current rating was given in this report.
- Responsive?
- Requires improvement
- This question was not inspected at this visit, so no current rating was given in this report.
- Well-led?
- Requires improvement
- The manager and staff were described as supportive, but governance systems had not identified staffing problems. Records did not always show that people's wishes and goals had been acted on.
What inspectors found, December 2022
Rated Requires Improvement; inspectors found kind and effective care, but staffing and management checks were not reliable enough.
This was an unannounced follow-up inspection on 23 and 24 November 2022. The inspector spoke with people, staff, the manager, relatives and professionals. Records, care plans, medicines, staff rotas, training and safety checks were also reviewed.
The home provided care for nine people with needs including learning disability, dementia, autism and mental health needs. People and relatives generally said they felt safe and were happy with the care. Medicines were managed safely, staff were trained, and people's health needs were assessed and reviewed.
The main problem was staffing in the afternoons, evenings and at night. There were concerns about whether one night worker could safely support everyone, especially in a fire. The home increased staffing after the inspection and removed a kitchen cupboard lock.
The overall rating remained Requires Improvement. Safe and Well-led were Requires Improvement, while Effective improved from Requires Improvement to Good. The report says the home was still in breach of good governance and had a new breach relating to staffing.
Kind care and positive feedback
People said they felt safe, and relatives gave very positive feedback about the care and support. Staff were described as kind and caring.
“Overall, we received very positive feedback from relatives we contacted, and they spoke very warmly of the care and support provided at Westwood.” from the report
Safe medicines
Medicines were stored, given and reviewed safely. Staff were checked as competent before giving medicines, and one person was supported to manage their own medicines.
“There were safe procedures to ensure medicines were correctly ordered, stored and given appropriately.” from the report
Trained and supported staff
Staff had training in essential and specialist areas. They received supervision, could shadow experienced colleagues and said they felt supported.
“Staff received a programme of training to ensure they could meet people's needs effectively.” from the report
Personalised support
People's rooms reflected their personalities and the home used equipment and information to support communication, mobility and individual routines.
“Each room looked different and reflected people's personalities.” from the report
Good health and decision support
The home made health referrals and used best-interest meetings when people needed help with important decisions. Easy-read information was used where possible.
“Easy read information was always used as far as possible to explain medical procedures to people to enable them to make an informed choice.” from the report
Not enough staff at key times
seriousStaffing was too low in the afternoons, evenings and at night. This limited activities and could leave one staff member supporting eight people while another task was being completed.
“There were not always enough staff to support people in the afternoons and evenings.” from the report
Night-time fire safety
seriousInspectors could not be assured that one night worker could safely support everyone if there was a fire. The fire risk assessment and staffing arrangements were reviewed after the inspection.
“Given people's varying needs, we could not be assured that people could be supported appropriately by one person safely at night in the event of a fire.” from the report
Weak management checks
seriousThe provider's oversight had not found the staffing problems or fully resolved earlier concerns about restrictions and records. This led to a continuing breach of good governance.
“The governance was not robust enough to identify the problems with staffing.” from the report
Incomplete fire drill records
needs fixingFire drill records did not clearly show what staff did, how long drills took or what improvements were needed.
“Records of fire drills continued to lack detail and did not demonstrate that staff knew what to do in the event of a fire.” from the report
- 01How many staff are now on duty in the afternoons, evenings and overnight, and has this staffing level been maintained?
- 02How would each person be supported to leave the building safely during a night-time fire?
- 03What changes have been made to fire drills, and do the records now show staff actions and evacuation times?
- 04How do you record and check that people's requests, activities and personal goals have been followed through?
- 05What action has been taken to provide the planned Makaton and Positive Behavioural Support training?
This was a focused follow-up inspection that assessed Safe, Effective and Well-led; the Caring and Responsive ratings were not inspected and were not given a new rating in this report. This explanation was written from the published report of 31 December 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, April 2020
Requires Improvement; inspectors found kind, person-centred care but concerns about weekend staffing, decision-making records and management oversight.
This was an unannounced planned inspection on 21 February and 3 March 2020. One inspector spoke with three people, staff, the registered manager and relatives. They observed people who could not easily share their views and checked care, medicines, staff recruitment and management records.
The home was caring, and people were supported by staff who knew them well. People were helped to make choices, develop independence, take part in activities and use local services. The home was clean, medicines were managed safely, and staff had relevant training.
Inspectors also found important shortfalls. There were not always enough staff at weekends. Some records were unclear, some restrictions were not supported by capacity assessments, and staff did not always have enough guidance or support. The quality checks had missed these problems. The overall rating fell from Good at the previous inspection to Requires Improvement.
Kind and respectful support
People were treated with warmth and respect. Staff understood individuals and supported them to be themselves.
“People received support from staff who knew them very well as individuals.” from the report
Choice and independence
People were encouraged to build daily living skills and take part in activities they chose, including community activities, holidays and local groups.
“People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.” from the report
Safe medicines and environment
Inspectors found safe arrangements for ordering, storing, giving and recording medicines. The home was clean and had regular safety checks.
“There were safe procedures to ensure medicines were correctly ordered, stored, given and recorded appropriately.” from the report
Relevant staff training
Staff received general training and specialist training linked to the needs of people living at the home, including autism, dementia and communication support.
“Staff received training that ensured they could meet people's needs effectively.” from the report
Weekend staffing
seriousThere were occasions when only one or two staff were on duty for eight people. Inspectors could not be assured that people's needs and planned one-to-one activity hours were always met at weekends.
“With only two staff on duty the provider could not ensure people's needs were safely met at weekends.” from the report
Incomplete management records
seriousRecords about incidents, staff assaults, pain relief and people's money did not always explain what had happened or what action was taken. The provider's checks had not found these issues.
“The provider had not ensured good governance had been maintained and records were not up to date and accurate.” from the report
Restrictions and capacity decisions
needs fixingSome food restrictions had been introduced without records showing that people's ability to make those decisions had been assessed. Inspectors said this was not the least restrictive approach.
“Without an assessment of capacity this would not be the least restrictive option.” from the report
Support for behaviours that challenge
needs fixingSome staff could not explain how they would respond to a person's hair pulling, and a support procedure for another person was no longer being used consistently. Staff also said support after incidents was inconsistent.
“One person had a behavioural support plan and there was professional guidance that was written in 2016.” from the report
Staff support and supervision
needs fixingNo supervision meetings had been completed in 2020 by the time of the inspection. Some staff found meetings negative and did not feel able to share their views.
“Although some supervision meetings had been booked, none had been carried out this year.” from the report
- 01How many staff are now scheduled at weekends, and how do you make sure people receive all their planned one-to-one activity hours?
- 02What has changed in the way incidents, staff assaults and medicines are recorded and reviewed?
- 03How do you assess whether a person has capacity before putting food or other restrictions in place?
- 04How are behavioural support plans kept up to date, and how do you make sure every staff member follows them?
- 05Have regular staff supervision and more open staff meetings been restarted?
This was an unannounced planned inspection covering all five CQC questions, with the overall rating based on the findings from the inspection visits. This explanation was written from the published report of 10 April 2020 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
4 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- December 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2020Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- February 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 9 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
19 live-in carers within about an hour of East Sussex
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.
Most charge £1,000 to £1,400 a week. 13 can care for a couple. 10 years' experience on average.
“When he point blank refused to go into hospital for a life saving blood transfusion she talked him through the situation and agreed to go in the ambulance with him and stayed until he was settled.”
“Una felt safe, secure and loved in her time with Debbie which is a gift that I am eternally grateful for.”
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.