West Cotes Residential Care Home

Care plans did not always provide clear guidance for safe medicines use, and information for some high-risk, PRN and variable dose medicines was missing. While medicines were generally managed safely, staff did not always record or follow up missed or refused medicines as required.

People were supported by staff who demonstrated kindness and a caring approach. Positive interactions were observed, and staff responded promptly to people’s needs, which supported their comfort and day-to-day wellbeing.

However, systems to monitor, assess, and improve the quality and safety of the service were not consistently effective. There were ongoing gaps in governance, auditing, and leadership oversight, which had resulted in repeated issues across areas such as care planning, training compliance, and risk management. These issues had also been identified at previous inspections and had not been fully addressed, reducing assurance that improvements were sustained.

Leadership arrangements did not consistently provide the level of oversight required to ensure safe and effective care. Whilst management were responsive to external guidance and there was a regular management presence within the home, this had not translated into consistent monitoring or proactive service improvement.

We have asked the provider for an action plan in response to the concerns found at this assessment.