Westside Nursing Home

The last full ratings assessment of Westside Nursing Home was published 26 March 2022; the overall rating was Requires Improvement. At this assessment the overall rating for Westside Nursing Home has remained Requires Improvement. This is based upon the findings at this assessment.

We carried out this assessment to follow up on breaches of Regulation 12 (Safe care and treatment) and Regulation 17 (Good governance) identified at our previous assessment. A warning notice had been issued in relation to the breach of Regulation 12, and this assessment was undertaken to review the actions taken and whether sufficient improvements had been made.

At this assessment, we found the provider remained in breach of Regulation 12 (Safe care and treatment) and Regulation 17 (Good governance), as sufficient improvements had not been made to address the concerns identified at the previous assessment.

While the provider remained in breach of Regulations 12 (Safe care and treatment) and 17 (Good governance), this assessment also identified additional breaches of Regulation 9 (Person-centred care), Regulation 11 (Need for consent) and Regulation 18 (Staffing).

Systems to identify, assess and manage risks to people’s health, safety and welfare were not always effective. Care plans and risk assessments did not consistently provide staff with sufficient guidance to safely support people, environmental risks had not always been identified or mitigated, and arrangements to manage infection prevention and control and medicines were not always safe. Although some action was taken during the assessment to address immediate concerns, people were not always protected from the risk of avoidable harm. These issues demonstrated that risks were not always assessed, mitigated or monitored effectively and resulted in a breach of Regulation 12 (Safe care and treatment).

The provider did not always ensure there were sufficient numbers of suitably skilled, qualified and competent staff to meet people’s needs. People told us there were times when staffing levels were not sufficient and some people reported difficulties understanding staff. Training, supervision and competency arrangements were inconsistent, with gaps identified in mandatory training, clinical supervision for nursing staff and medicines competency assessments. These issues demonstrated that systems to determine and review staffing were not sufficiently robust and resulted in a breach of Regulation 18 (Staffing).

People’s rights were not always fully protected in accordance with the Mental Capacity Act 2005. Whilst mental capacity assessments and Deprivation of Liberty Safeguards (DoLS) processes were generally in place, we identified concerns regarding decision-making relating to people sharing bedrooms. This meant there was not always clear evidence that decisions affecting people had been made lawfully and in their best interests and resulted in a breach of Regulation 11 (Need for consent).

Care was not always planned and delivered in a fully person-centred way. Care records lacked sufficient information about some people’s preferences, life histories and what was important to them. People were not consistently involved in reviewing their care and support, and opportunities to promote meaningful occupation, social engagement and independence were limited. This resulted in a breach of Regulation 9 (Person-centred care).

Governance systems were not effective in identifying, monitoring and addressing the concerns found during this assessment. Although audits, checks and monitoring processes were in place, these had failed to identify issues relating to environmental safety, infection prevention and control, medicines management, staff training and supervision, activities provision, mental capacity processes and care documentation. This meant leaders did not always have effective oversight of the quality and safety of care being delivered. This meant risks were not always recognised or acted upon in a timely way, placing people at ongoing risk of harm, and resulted in a breach of Regulation 17 (Good governance).

Despite these concerns, people, relatives, staff and professionals described positive relationships with the registered manager and told us staff were generally kind, caring and responsive. Staff worked closely with healthcare professionals and there were examples of effective partnership working to support people’s health and wellbeing. Relatives were largely positive about the care provided and professionals described communication from the service as good. However, sustained improvements are required to ensure governance systems are effective and that people consistently receive safe, effective, person-centred care.