The Westbourne Care Home

Updated 22 July 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors, a nurse specialist advisor and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

The Westbourne is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Westbourne is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 12 people about their experience of the care provided, along with 6 visiting relatives. We spoke with 14 members of staff including the registered and deputy manager. We reviewed a range of records, this included 13 people's care records and numerous medication records. We looked at 3 staff files in relation to recruitment and training. A variety of records relating to the management of the service, including policies and procedures were reviewed. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 22 July 2023

About the service

The Westbourne is a care home providing personal and nursing care to 45 people at the time of the inspection. The service can support up to 50 people across two separate floors, each of which has separate adapted facilities.

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

The management of risk to people was not always sufficiently robust. Where risks had been assessed, staff had not always followed the identified guidance to manage the risk safely. Aspects of training and induction was not sufficiently effective to support staff knowledge and understanding. Systems and processes to maintain oversight of the quality and safety of care were not always effective.

Staff worked within the principles of the MCA. Appropriate Deprivation of Liberty Safeguards (DoLS) authorisations were in place where required. However, the service had not ensured all conditions attached to 1 person’s DoLS authorisation were being met. We have made a recommendation about this.

New staff had been recruited, which meant the home was fully staffed. Overall, staff had been safely recruited, the provider and was in the process of reviewing current policy and procedures. The current registered manager had focused upon supporting and building an effective staff team. People told us they felt safe living at The Westbourne and staff understood their role in safeguarding people.

Overall medicines were managed safely. On the first day of the inspection aspects of the building needed cleaning, this was addressed along with some redecoration during the inspection. A planned refurbishment programme was due to commence at the home. There were no visiting restrictions in place, and we saw various visitors in the home.

Care plans were developed from assessments. However, the level of detail varied and some contained contradictory information, including some around nutritional needs. They did not always contain enough person-centred information about people’s individual needs and requirements to guide staff. Managers had already identified this was an area for improvement and actions were underway to amend aspects of the electronic care planning system and to improve regular communication with relatives.

Feedback indicated that due to recent recruitment, overall staffing was more consistent, which was helping to ensure staff knew people well and understood any changes to their needs . Staff worked in partnership with health and social care professionals.

The provider had a lifestyle manager who was supporting the team to review and develop activities, especially for people who were living with dementia. The provider had a feedback policy in place, overall feedback indicated the registered manager was responsive and acted to address any issues or concerns raised.

Records were not always complete and/or up to date with person centred information and some were contradictory.

The registered manager understood their role and responsibility under the duty of candour. They were open and honest about shortfalls found during the inspection and acknowledged there was ongoing work to build on learning and improvements which had already been made. Staff told us they were well supported and there were some positive examples and compliments about the care provided.

The provider’s quality team were supporting the service and were responsive to feedback for ongoing improvement.

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

Rating at last inspection

The last rating for this service was good (published 26 May 2021).

Why we inspected

This inspection was prompted by a complaint about the service.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We have identified breaches in relation to risk management, staff training and good governance. We have also made recommendations in relation to The Deprivation of Liberty Safeguards (DoLS)

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

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.