Archived: West Cliff Hall Care Home

Updated 1 July 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 28, 29 April and 7 May 2015

The inspection was unannounced and was undertaken by of two inspectors.

Before our inspection we reviewed previous inspection reports and notifications we had received. A notification is information about important events which the provider is required to tell us about by law.

We pathway tracked seven people using the service. This is when we follow a person’s experience through the service and get their views on the care they received. This allows us to capture information about a sample of people receiving care or treatment. We looked at staff duty rosters, eight staff files, feedback questionnaires from relatives and checked the homes internal quality assurance auditing systems.

We spoke with the registered manager, eight care staff, four nurses, the matron, nine people, the provider and nine relatives. We observed interaction throughout the day between people and care staff. Some of the people were unable to tell us about their experiences due to their complex needs. We used a short observational framework for inspection (SOFI). SOFI is a way of observing care to help us understand the experiences of people who are unable to talk with us.

We last inspected the home on 28 April 2014 and found the provider did not have suitable arrangements in place to obtain people’s consent to receive care.

Updated 1 July 2015

West Cliff Hall Care Home provides r esidential, nursing and dementia care to older people . At the time of our inspection there were 30 people living there.

There was a registered manager at the home. 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 and associated Regulations about how the service is run.

Documentation relating to people’s care and treatment was not always accurate and did not always reflect the care they received.

At our previous inspection on 4 April 2014 records did not show staff had assessed people’s capacity to consent to care in line with the requirements of the Mental Capacity Act 2005. At this inspection we found the provider had made improvements and implemented MCA assessments which detailed the risks, benefits and alternative options when making decisions. The matron told us some improvements were still required as some people were yet to be assessed using the MCA toolkit they had implemented.

Improvements were required in respect of the environment and layout. People with dementia can often become confused and may misinterpret some things they see. The layout of West Cliff Hall and the environment did not support people to maintain their independence. Healthcare professionals and staff told us the service needed to implement a dementia framework to ensure people independence was maintained.

People were at risk of receiving inappropriate care or treatment as food and fluid records and repositioning records were not always completed once care has been delivered.

Improvements are required in respect of the services leadership. Records showed management had changes on four times in a period of three years. Staff told us the regular change in management was disruptive and did not create a culture of strong leadership. At the time of our inspection the matron had responsibility for managing the service with the support of the registered manager. After the inspection we were notified the current registered manager with us resumed their responsibilities as the manager of West Cliff Hall.

Staff were appropriately trained and skilled to ensure the care delivered to people was safe and effective. They all received a thorough induction when they started work at the home and fully understood their roles and responsibilities.

The registered manager and matron assessed and monitored the quality of care by involving people, relatives and professionals. Care plans were reviewed regularly and people’s support was personalised and tailored to their individual needs. Each person and every relative told us they were asked for feedback and encouraged to voice their opinions about the quality of care provided. They told us they were satisfied with the care provided.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. One person living at the home was currently subject to a DoLS. The manager understood when an application should be made and how to submit one and was aware of a recent Supreme Court Judgement which widened and clarified the definition of a deprivation of liberty.

Staff talked to people in a friendly and respectful manner. People told us staff had developed good relationships with them and were attentive to their individual needs. Staff respected people’s privacy and dignity at all times and interacted with people in a caring and professional manner. People told us they felt staff were always kind and respectful to them.

Referrals to health care professionals were made quickly when people became unwell. Each health care professional told us the staff were responsive to people’s changing health needs.

Staff were encouraged to raise any concerns about possible abuse. People and relatives knew how to make a complaint if they needed to. The complaints procedure was displayed in the home. It included information about how to contact the ombudsman, if they were not satisfied with how the service responded to any complaint. There was also information about how to contact the Care Quality Commission (CQC).

The provider had made some improvements from our last inspection, however at this inspection we identified one breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see the action we have asked the provider to take at the back of this report.