Westcombe Park care home is located in Blackheath ans provides nursing residential care. The home accepts some residents with dementia but only where their primary need is nursing care. The current patient age range is between 51 and 99. The care home has 45 bedrooms over three floors; on the day of our visit there were 43 residents. Around half of these residents are bed bound. We spoke to seven residents who had mixed communication abilities, and one relative
The Care Quality Commission (CQC) carried out an unannounced inspection of the care home on the 28th and 29th of June 2017. They reported breaches of legal requirements in relation to fire risk and risk assessments, and that care and treatment did not always meet residents’ needs or preferences. Concerns were also received by the CQC around staffing levels. The CQC therefore returned on 14th November 2017 to undertake a focused inspection into the areas of safety and leadership; it was found that action had been taken to comply with the legal breaches at this point. The CQC were not able to change ratings for safety and leadership as the positive changes had not been in place for long enough. At this point, concerns remained around whether staffing levels in the home were sufficient.
Summary of findings
The outside of the care home was clean and tidy, and well signposted. There is a wide, accessible path which leads to a quiet and clean reception area. There was also a security buzzer on the main door which was answered promptly in a very friendly manner.
The reception area of the home is spacious and clean and had a warm and welcoming atmosphere. There were plenty of seats for visitors to sit in the waiting area, as well as magazines and the local Westcombe newsletter on the side table. Communal corridors were very clean and tidy, and felt spacious and light. We saw two noticeboards in the communal corridors showcasing photos of residents’ activities, as well as a signposting board which had information on the latest CQC report, red bag training days and a summary of the latest resident feedback.
The communal dining area on the ground floor was well laid out; tables were neatly set with table cloths, plates and cutlery, and the room was clean and spacious.
On the day of our visit the dining room was well-decorated in a ‘Spring time’ theme with bunting hung. We were told that the theme of the room changes monthly. There was a fridge in the dining area from which residents could help themselves to fresh fruit and cold drinks. We were told that family members could pay a small amount (£5.99) to sit down and enjoy a meal with their family member in the dining area. Staff told us this was a popular service.
There are smaller satellite kitchens on each floor of the house; if residents are assessed as low risk they can independently use a microwave, kettle and toaster as and when they like. We were informed that some residents have small, personal fridges in their rooms in which they can store home cooked food from their family.
Each floor had its own lounge area, with the lounge on the ground floor being by far the largest. There were plenty of comfortable seats, which were facing each other in a way which prompted social interaction. There was also a ‘reminiscence cupboard’ with older toys and objects. Board games were placed on the side, along with the day’s paper, and there was a table where residents could play comfortably. There was a large tv on in the lounge with the sound at an appropriate level. The first and second floor had their own smaller lounges; these could fit far fewer residents but had a similarly welcoming and cosy atmosphere and were well-decorated and furnished. We saw dementia-friendly calendars being used in these areas.
As well as the communal lounge areas there were also smaller quiet areas, which had fewer seats. We were told these are used primarily for private family gatherings or for individual reading and relaxation. These areas had large windows which overlooked the garden. We were told that visitors could come at any time between 6am and 11pm, and that the home encouraged family members and friends to visit.
The care home has a large garden, which is well looked after and mainly well kept, although the lawn was somewhat in need of a trim. The outdoor area is set out with both social seating areas and singular seats. There was a shaded area which we were told would soon be refurbished into a meditative/ quiet space for residents. Around the garden there were plenty of additional attractive garden features, such as statues, bird houses, bird baths and feeders.
The residents’ rooms were a decent size, with some more spacious than others. There were large windows in all rooms, offering lots of light and picturesque views onto the garden or the surroundings. Nearly all rooms in the home were ensuite, although most residents were unable to use these independently.
Residents’ bedrooms were well-decorated and had plenty of personal belongings, particularly photos of family members and friends. All rooms also had a call buzzer. We visited on a particularly hot day, and we noted that all residents had jugs of water placed near their bed; we were told by staff that ice lollies were also provided.
Most resident rooms were well aired with windows open and were odourless. However, we did visit one bedroom which had a strong odour of urine. On discussing this with the home’s resident experience manager, we were informed that staff were aware of the issue, which was being caused by the resident in question wanting to use a urine bottle independently. Staff were cleaning the room and carpet more regularly but had yet to find a solution which could maintain the resident’s independence and keep the room clean.
One of the residents in a smaller room had had the arms of his wheelchair removed to enable it to fit through the narrow doorway.
All bedroom doors had the same picture with the residents’ name written in small writing below.
There were pictorial menus on the wall which staff informed us were changed daily, along with a sign encouraging patients to request an alternative meal if they did not like what was on the menu. We were told that dinner was served between 5.30 and 6pm, and that residents had a choice to eat in the dining area, in the living room area or in their rooms. There are two employed chefs; one who prepares ‘mainstream food’ and another who cooks more culturally diverse dishes for the residents.
Feedback and involvement
We were informed by the manager that the care home’s providers, Bupa, run an annual feedback survey which is implemented by the staff on each site. The home also run their own ‘snap reviews’, especially around the quality of food. Residents are also encouraged to feedback directly any issues they have directly to staff or to management, and then asked to provide the complaint in writing. When we asked about anonymous feedback, we were told that there were forms in the reception area, although we did not see these. We were also told that residents could write a letter anonymously, although it was not clear that this was actively communicated to residents.
We did not see a comments box, and whilst complaints policies were displayed on each floor, it was felt that these could be made more accessible/prominent. We were informed that all residents had their own care plans. However, these were not always shared with the residents, as it was felt that some would not be able to understand them. A named next of kin can request to see care plans when they like.
Overall, we were very impressed with the facilities and the care on offer at Westcombe Park Care Home. Staff appeared to know the residents well and residents had mostly positive feedback about staff, the facilities and the care they received. Whilst we did encounter an issues with odour and the size of the some of the rooms. the home itself was welcoming and homely, hosting a wide range of activities and catering for residents of varying levels of independence. Staff were friendly and helpful, and appeared committed to implementing improvements going forwards.