About the service Weyspring Park is registered to provide nursing care and residential care for up to 34 people with a range of care needs, including frailty of old age, people living with dementia, and mental health conditions. At the time of our inspection, 32 people were living at the service.
People’s experience of using this service and what we found
People told us that they could talk to staff and that they felt safe living in the service. One person told us they had moved to Weyspring Park for convalescence and liked it so much they asked to stay. Relatives told us they felt people were safe and well looked after. We found people were not always supported to have maximum choice when moving around the service. Blanket measures designed to keep people safe were restrictive to some people.
Risks to people were not always identified and managed. Care plans lacked information about people’s dementia and how this impacted on their behaviour and communication.
People were not always receiving safe care. As required medicine (PRN) protocols and care plans failed to provide guidance to staff on when it was appropriate to administer a particular medicine or associated risks. We identified occasions when people had been administered PRN medicines without due consideration of this being the least restrictive or necessary option for the person.
Staff did not always receive effective training or support. Staff had not received training on people’s specific health conditions to support safe and consistent care. Some staff told us they had not had recent support or training. Some staff felt supported by managers however others disagreed.
Existing leadership and governance measures were not effective in identifying service shortfalls and failed to assess, monitor and mitigate risks relating to health, safety and welfare for people.
There were indications of a closed culture at Weyspring Park. A closed culture is a poor culture in health and social care that increases the risk of harm. This includes abuse and human rights breaches and may be deliberate or unintentional. During the inspection we made the provider aware of our concerns.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
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 20 December 2018)
Why we inspected
We undertook an initial targeted inspection to follow up on a specific concern we had received about the service. The inspection was prompted in part due to concerns received about safeguarding, staffing and infection prevention and control (IPC). A decision was made for us to inspect and examine those risks. We inspected and found there was a concern with restrictions for people, staff training and support and the culture of the service so we widened the scope of the inspection to become a focused inspection which included the key questions of safe, effective and well-led. This necessitated the team returning to the service to undertake a second day of inspection. We identified concerns with medicines and therefore returned with a pharmacy inspector to examine those risks to people.
The provider needs to make improvements. Please see the action we have told the provider to take at the end of this report. The provider has taken some action following our feedback during the inspection process and provided assurances of their improvement plan.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Weyspring Park on our website at www.cqc.org.uk.
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
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to safeguarding, safe care and treatment, staffing and good governance at this inspection. Please see the action we have told the provider to take at the end of this report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded
Follow up
We sought some immediate assurances following the first site visit due to the level of concern we had about the standards of quality and safety. We will request an action plan from the provider to understand what they will do to continue to improve the standards. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.