West Ridings Care Home

Updated 22 September 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 4 inspectors, including a member of the CQC medicines team and 2 Experts 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. The inspection team was also accompanied by 2 members of the CQC management team.

Service and service type

West Ridings Care Home is a ‘care home’. People in care homes receive accommodation and nursing and personal care as a single package under 1 contractual agreement dependent on their registration with us. West Ridings Care Home 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

A new manager had been recruited and had been in post for 2 months at the time of our inspection.

Notice of inspection

The inspection was unannounced. We visited the service on 5 July 2023.

What we did before the 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 also contacted Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. 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 15 people who used the service and 8 relatives. We spoke with staff including the manager, clinical deputy, nurses, care staff, activities coordinator, administrator, laundry and domestic staff and a member of the provider’s management team. We reviewed records relating to medicines management. We looked at 10 people’s records relating to their care, and a range of records relating the management of the service.

After the inspection visit the manager sent further records to us for review, in relation to the management of quality and safety of the service, medicines, Deprivation of Liberty Safeguards, staffing, staff training and support, and engagement with people using the service, their relatives and the staff.

Updated 22 September 2023

About the service

West Ridings Care Home is a nursing home which provides nursing and personal care for up to 180 people with various health conditions, including people living with dementia. Accommodation is provided in 4 purpose-built, single storey buildings with disabled access. These were known as Wensleydale, Calderdale, Swaledale and Wharfedale. There were 94 people using the service at the time of our inspection.

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

There was a system in place to manage medicines. However, we identified some shortfalls in relation to the storage and management of people’s medicines. The service was clean overall, although there was a need for more thorough monitoring of equipment in the kitchenettes in each unit.

People were supported to have maximum choice and control of their lives and staff supported them in them in the least restrictive way possible and in their best interests. The management team was working to ensure the records, policies and systems in the service always supported this practice. The management team were aware of the need for improvement in some areas of people’s care planning and records, including records about the Deprivation of Liberty Safeguards (DoLS). The manager had created an improvement plan and was working to this, to ensure shortfalls were addressed.

The manager was working to ensure the system to monitor and manage the quality and safety of the service was effective. However, there was further work to do to achieve this and some audits and checks needed to be strengthened.

Some areas of the home had been redecorated and further redecoration was needed, as not all units were of a similar standard. We received mixed feedback about the food and the staffing levels, although overall, we found people were supported to eat and drink enough and there were enough staff to keep people safe.

Staff received the training and support needed to help them to meet people’s needs. People said staff were proactive in supporting their health needs and arranged any health care they needed promptly. We received a lot of very positive feedback about the care staff from people and relatives. One person said, “I would know who to complain to. It is lovely and well run here. Just being here is the nicest thing. Nothing to improve. They [staff] are all nice and I love them all.”

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 21 December 2022).

Why we inspected

We received concerns in relation to nutrition, unexplained injuries, and the standard and culture of nursing care. As a result, we undertook a focused inspection to review the key questions of safe and well-led. During our inspection visit, issues were identified, and the inspection was expanded to include the effective key question.

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.

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

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

Enforcement and Recommendations

We have identified breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 related to safe care and treatment, and good governance during this inspection.

We have made recommendations regarding staff deployment and internet access in relation to people’s electronic care records.

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 how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.