All inspections: West Lane - Care Quality Commission

On the 03 December 2014 we inspected West Lane. This was an unannounced inspection.

West Lane provides accommodation for persons requiring nursing and personal care to a maximum of 12 people who are living with learning disabilities. All the accommodation is in single rooms and the service is located in the residential area of Thornton, close to Bradford city centre.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At the last inspection in January 2014, we found a breach of regulation 13 (management of medicines) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. We inspected the home again on 3 December 2014 and we checked whether improvements had been made.

We found some improvements had been made to the medicine management system. Medicines were administered in a safe way. However, we saw protocols and guidance were not always followed. Some documentation for administration lacked key information. Not all medicines were stored correctly in line with best practice.

We saw the provider had a safeguarding and whistleblowing policy in place. We saw the notice boards had posters and leaflets about safeguarding and who to contact. We spoke with staff about safeguarding. Staff could describe warning signs of abuse and what action they would take.

We looked at people’s risk assessments which demonstrated how people were protected from identified risks and that measures had been put into place to reduce or remove further risk.

We saw that accidents and incidents were recorded and analysed for trends. This showed us that accidents and incidents were monitored effectively.

Staffing levels in the home were sufficient to meet people’s needs. During the inspection we saw people were not left without assistance for any significant periods of time. We found some staff needed refresher training to ensure their training was up to date. Staff understood their roles and responsibilities, as well as the values of the home. Staff had effective support and supervision.

Care plans had been completed and reviewed on a regular basis. Plans had been written in a person centred way. People’s plans of care included their choice, likes and dislikes and personal preferences. Staff completed daily records for people to record activities and people’s wellbeing.

We observed during lunch time in the home. People were served food that was suitable for their diet. Those that needed support with eating received it. People had the weight recorded on a regular basis. This record would prompt staff if someone had a significant weight loss to take action.

Staff understood the needs of people and we saw that care was provided with kindness and compassion. People spoke positively about the home and the care they received. Staff took time to talk with people or support with activities such as reading or drawing.

The Care Quality Commission (CQC) monitors the operation of the DoLS (Deprivation of Liberty Safeguards) which applies to care homes. Where people were deprived of their liberty in order to keep them safe the provider had applied for authorisation. This meant they were acting lawfully and were meeting the requirements of the DoLS.

A complaints system was in place and staff we spoke with had confidence any concerns and complaints would be appropriately dealt with. We saw action had been taken to resolve one current complaint. This showed us the complaints policy was effective and staff followed the correct procedure.

The registered manager ensured a robust programme of quality assurance was in place. We saw regular quality audits fed information into an action plan to help improve the service. The action plan was then worked through to make the necessary changes.

We carried out this visit to look at the arrangements for handling medicines. We checked the records and a sample of medicines for seven people who lived in West Lane. We spoke with the deputy manager, a care worker and a nurse. We tried to speak with people who lived in the home but found it difficult to obtain their views about how medicnes were handled.

Overall we found some improvements were required to help make sure medicines are handled safely.

We were not able to speak with people who used the service because they had complex needs which meant they were not able to tell us about their experiences. We used a number of different methods to help us understand the experiences of people, such as reviewing care records, observing care and speaking with people's relatives and representatives.

We spoke with six people's relatives and one person's advocate. Overall people told us they were happy with the care and support their relatives received. However, two people told us staff did not always involve them in making decisions about their relatives care.

People we spoke with told us they felt their relative was safe at West Lane. One person explained how they had previously raised concerns with staff. They said they felt staff had listened to them and dealt with the issues raised.

Overall most people told us they thought staff were good. One person said 'you can't fault the staff'. Another said 'staff are always helpful; some are brilliant'. However, two people explained how they felt staff morale at the home was 'low' and this sometimes created an 'atmosphere' in the home.

We were not able to speak with people who used the service because they had complex needs which meant they were not able to tell us about their experiences. We used a number of different methods to help us understand the experiences of people who used the service, such as reviewing care records and observing care.

We saw positive interactions between staff and people. Staff spoke with people in a kind and respectful way and had a clear knowledge of people's individual preferences. Whilst supporting people staff explained their actions, offered choices and gave people the opportunity to respond and make a decision. People looked clean, well cared for, and were appropriately dressed.

Although some processes were still being developed, which meant we were unable to test their efficiency during this visit, the provider had taken steps to ensure they assessed and monitored the quality of service people who lived at West Lane received.

We found evidence that people were not always protected from the risks of unsafe or inappropriate care and treatment as the documentation we saw was inconsistent and unclear.

We carried out this inspection to follow up on compliance actions we made during our inspection on the 10 July 2012 and because we had received concerns about the care and treatment people were receiving from the Bradford Independent Review Team (BIRT) and other agencies who had visited the service. Three inspectors from the Care Quality Commission (CQC) visited the service, three on 20 August 2012 and two on 21 August 2012.

During our visit we used a number of different methods to help us understand the experiences of people using the service. This was because some of the people using the service had complex needs which meant they were not able to tell us their experiences. We spent time on the ground floor and first floor lounge observing how staff engaged with people living in the home. We engaged with the Northern regional manager of the service, the head of service and development, the temporary manager, six staff and one relative. We also sought information from other health professionals who had been visiting the home.

The relative we spoke with told us they were satisfied with the care and treatment their relative received. The registered care provider had sent out eight questionnaires to the relatives of people using the service. Two had been fully completed and both stated the care was excellent.

However, we observed during people's day to day life that care and treatment was not planned and delivered in a way that ensured people's safety and welfare. We observed that people continued to not be consistently offered the opportunity to make decisions about their care and treatment. We saw that people were sometimes offered choices but staff did not wait for their response. We saw that people's privacy and dignity was not always maintained. We also found the systems in place to monitor the quality of the service provided were not robust or sufficient to ensure people were receiving good outcomes.

We were not able to speak with people who use the service because they had complex needs which meant they were not able to tell us their experiences. We used a number of different methods to help us understand the experiences of people using the service, such as reviewing care records and speaking to the relatives of people who lived at the home.

People we spoke with told us that they were involved in making decisions about their relatives care and treatment.

People said staff were supportive, worked hard to stimulate people and helped their relatives to live as independently as possible. However, one person told us they were concerned that activities were not always appropriate to their relative's needs and preferences.

One person said that West Lane provided their relative with a, 'stable and secure home environment'.

Relatives told us they had never been given the opportunity to provide formal feedback about the quality of the service provided at West Lane.

Archived: West Lane

All Inspections

3 December 2014

During a routine inspection

29 January 2014

During a routine inspection

12 June 2013

During an inspection looking at part of the service

4 December 2012

During an inspection looking at part of the service

21 August 2012

During an inspection in response to concerns

10 July 2012

During an inspection in response to concerns