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CQC report explained · a nursing home, run by Barchester Healthcare

Westvale House

Old Hall Road, Great Sankey, Warrington, WA5 9PA

Requires improvementpublished 1 February 2024, 2 years ago

Rated Requires improvement: inspectors found the service was not performing as well as it should and told it what to change.

The five questions inspectors ask
Safe?
Requires improvement
Inspectors found problems with risk management, response to call bells, repositioning, hydration records, staffing deployment and medicines. This was a breach of Regulation 12.
Effective?
Good
This question was not inspected during this focused inspection. Its previous rating was carried over.
Caring?
Good
This question was not inspected during this focused inspection. Its previous rating was carried over.
Responsive?
Good
This question was not inspected during this focused inspection. Its previous rating was carried over.
Well-led?
Requires improvement
Audits and care records did not reliably identify or show that people's needs were being met. Communication about care was not always effective, and this was a breach of Regulation 17.
The latest report, explained

What inspectors found, February 2024

Westvale House was rated Requires Improvement; inspectors found risks with medicines, care records, staffing and monitoring.

This was an unannounced focused inspection. Inspectors looked at Safe and Well-led, spoke with people, relatives and staff, observed care, and checked records, medicines, recruitment files and the home.

The home was not always safe. Inspectors found that call bells were not always answered quickly, people were not always repositioned as required, fluid records were unreliable, and medicines records and checks were not always safe. Staff were also not always deployed where they were needed.

The home was not always well-led. Audits had failed to find important problems, and daily care records and communication about people's needs were incomplete. The provider had recruited staff and made management changes, which appeared to be helping, but improvements had not yet been fully established.

The overall rating changed from Good at the previous inspection in 2018 to Requires Improvement. The report says the provider must send an action plan, and CQC will monitor progress with the provider and local authority.

What inspectors praised
  • People felt safe

    People told inspectors they felt safe, and staff understood their safeguarding responsibilities.

    I feel safe and if I had any problems I would talk to staff.from the report
  • Kind interactions

    Inspectors saw positive interactions, and staff knew the people they supported well.

    We observed positive interactions between staff and people who lived at the service.from the report
  • Action on feedback

    The registered manager was open to feedback and took some immediate steps to address concerns during the inspection.

    The provider was responsive to feedback and took immediate action to address some of the concerns raised.from the report
  • Infection control

    Inspectors found that staff followed safe infection prevention and control practices.

    People were protected from the risk of infection as staff were following safe infection preventionfrom the report
What inspectors were concerned about
  • Risks were not managed reliably

    serious

    Call bells were not always accessible or answered quickly. Records and practice did not always show that people received the repositioning, fluids and dietary support they needed.

    Systems had not been effective to assess, monitor and mitigate risks to the health, safety and welfare of people using the service.from the report
  • Medicine checks were not safe enough

    serious

    Medicine records did not always show the correct creams or doses given. Inspectors also found expired equipment and medicines that had not been destroyed when no longer needed.

    The oversight of medicine was not robust enough to ensure people where safely given their medicines.from the report
  • Staffing deployment

    needs fixing

    Staff were not always easy to find on the unit, and people were sometimes left without their assessed level of support. CQC recommended reviewing how staff are deployed.

    Staff were not always effectively deployed, and we found occasions where staff could not be located on the unit for periods of time.from the report
  • Weak monitoring and records

    serious

    Audits did not identify all the problems found by inspectors. Daily records had gaps, so the home could not be certain they accurately showed the care people received.

    We therefore could not be certain of the accuracy of any records held regarding people's daily care.from the report
  • Communication gaps

    needs fixing

    Information from outside professionals and changes in people's care were not always recorded or shared clearly with staff.

    Systems to ensure communication of relevant information relating to people's care needs was not always effective.from the report
Questions to ask them, based on this report
  1. 01What has been changed to make sure medicines, including creams and variable doses, are recorded and checked correctly?
  2. 02How do you make sure call bells are answered promptly and people are repositioned, hydrated and supported according to their care plans?
  3. 03How do you check that enough staff are available on each unit, including when staff are absent?
  4. 04How are gaps in daily care records and communication from health professionals being prevented?
  5. 05What actions are in your improvement plan, and how will you show families that they have been completed?

This was a focused inspection of Safe and Well-led only; the other ratings were carried over from the previous inspection in 2018. This explanation was written from the published report of 1 February 2024 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.

The story over the years

Every inspection of Westvale House

4 rated inspections over 9 years: the service has slipped, from Good to Requires improvement.

  1. February 2024Requires improvementcurrent rating
    Safe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement

    Read what inspectors found at Westvale House

  2. March 2021Inspected but not rated
    Safe: Inspected but not rated

    We are reading this report · the original is on cqc.org.uk

  3. December 2018Goodup from Requires improvement
    Safe: GoodWell-led: Good

    Read this report on cqc.org.uk

  4. June 2017Requires improvementdown from Good
    Safe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement

    Read this report on cqc.org.uk

  5. March 2015Good
    Safe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good

    Read this report on cqc.org.uk

  6. January 2014

    Report published without a new overall rating.

    Read this report on cqc.org.uk

  7. December 2012

    Report published without a new overall rating.

    Read this report on cqc.org.uk

  8. November 2011

    Report published without a new overall rating.

    Read this report on cqc.org.uk

  9. February 2011

    Registered with the Care Quality Commission on 15 February 2011.

Ratings and report dates from the Care Quality Commission. A service can also be visited without a new rating being published, so the timeline shows published inspections, not every contact the CQC has had with the service.

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