Westin Care Home

Westin Care Home is a nursing home providing regulated activities (personal and nursing care) to up to 52 people. The service provides support to older people, people with dementia and mental health needs, and people with physical disabilities and sensory impairments. At the time of our inspection, there were 38 people using the service.

The service is laid out across two floors; the ground floor is named oak unit and the first floor is named willow unit. Both units offer communal dining, lounging, bathroom and toilet facilities. Bedrooms on both floors can be accessed by a lift, stairs or stair-lift. There is level access to the garden from the ground-floor. The manager’s office is located adjacent to the reception area.

People’s experience of using this service and what we found

The provider failed to implement a robust approach to infection prevention and control (IPC) practice. This meant people were placed at increased risk from the spread of infection. We identified gaps in relation to risk assessment, management and associated guidance. This placed people at increased risk of experiencing avoidable harm. There were sufficient numbers of suitably qualified staff to meet peoples’ needs, and employment checks were in place to prevent unsuitable staff working in the service. Staff spoke confidently about how they would protect people from harm and abuse. Safeguarding processes meant actions were taken if potential safeguarding concerns were identified.

The registered manager was not involved with the day-to-day running of the service. Audits and checks had not always been used effectively and had failed to identify the concerns, errors and omissions we found during our inspection. Staff spoke about people in a person-centred way, we observed kind and caring interactions between people and staff. The manager was introducing new ways of working to improve continuity of care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published January 2022).

Why we inspected

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The inspection was prompted in part due to concerns received about pressure ulcer management. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

After our inspection, the manager contacted us and told us about changes and improvements they had made in response to our feedback and findings at this inspection.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Westin Care Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to how the quality and safety of care provision is monitored, managed and assessed.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Westin Care Home is registered to provide accommodation and personal or nursing care for up to 52 predominately older people. At the time of this inspection there were 33 people in residence. They were supported by a team of qualified nurses, care assistants and ancillary staff.

People’s experience of using this service

We have made a recommendation that the provider reviews the use of television and music during meal times in the main dining rooms.

People were looked after by staff who ensured their safety was maintained. Staff received safeguarding training and knew what to do if they witnessed or suspected that a person was being abused. Safeguarding concerns have been raised by family members and healthcare professionals and the service has worked with the local authorities to address concerns around standards of care and staff actions.

Medicines were administered safely by qualified nurses and there were safe infection control measures in place.

Each person’s care and support needs were assessed before moving into Westin Care Home. The assessment took account of any risks that could affect the person’s health and welfare. Management plans were put in place to mitigate the risk.

The staff team received the training they needed to do their job well and were well supported by the manager and the regional manager. There was an induction training programme for new staff and ongoing refresher training for all other staff. Staff received regular supervision.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People said the staff were kind and caring and looked after them well. We observed positive interactions between staff and people. We received the following comments, “They are all really nice” and “I am very well looked after.”

People received personalised care and support based upon their specific needs. Each person had a care plan, and this was amended if there was any change in their health status or care needs. The plan was regularly reviewed. This ensured each person received the level of care and support they needed and any changes in need were identified and acted upon.

The manager was supported by the regional manager and a clinical lead nurse and the provider visited the service regularly. The provider held regularly managers meetings, and this enabled them to share information and intelligence and make any changes as necessary. Staff said they felt they were valued and supported by the manager.

The service monitored the quality and safety of the service. There was a regular programme of auditing in place. Care plan reviews ensured people received the care and support they needed and were happy with the way they were looked after. People were encouraged to provide feedback regarding their views and opinions of the service.

For more details, please see the full report which is on CQC website at www.cqc.org.uk

Rating at last inspection

This is the first inspection of this service since it was registered by the Care Quality Commission in October 2020. The service has been rated Good.

Why we inspected

This was a planned inspection however has also been prompted in part due to concerns received about safeguarding events around the delivery of personal care and management of medicines. A decision was made for us to inspect and examine those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor the service through the information we receive. We will inspect in line with our inspection programme or sooner if required.