This inspection took place on the 12, 13 and 16 March and 15 and 24 April 2018 and was unannounced.

Weston Park was previously inspected on 3, 4 and 5 October 2017. During the inspection we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 related to: staffing; training; recruitment of staff; safeguarding service users from abuse and improper treatment; records; medicine management; seeking consent in accordance with the Mental Capacity Act 2005; providing person centred care and governance arrangements. We also found a breach of the Care Quality Commission (Registration) Regulations 2009 as the registered person had not always notified the Commission of incidents or allegations of abuse.

We took enforcement action and we rated the service as 'Inadequate' and placed it into Special Measures. Following the inspection, the provider formulated an action plan and sent us updates in response to the breaches and concerns we had identified. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures. At this inspection the overall rating for the service is ‘Requires Improvement’

At this inspection, we found that the provider was taking action to address the previous concerns we had raised. Further improvements were still required and the provider remained in breach of Regulations 12, 13 and 17 of The Health and Social Care Act 2008 (Regulated Activity) Regulations 2014 in relation to management of risk, safeguarding and good governance. We considered however, that sufficient action had been taken to meet the further breaches identified at the last inspection.

Weston Park is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Weston Park accommodates up to 103 people across four separate units, each of which have separate adapted facilities. Two of the units had been temporarily closed and there were 58 people living at the home during the inspection.

At the time of the inspection there was no 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. A new manager had been appointed in January 2018 and had made an application to register with CQC.

Overall people, relatives and staff told us that they had seen improvements to the service. People were generally positive about the support they received.

There remained some concerns that staff did not always follow safeguarding procedures in a robust manner. We found that some improvements were being made to manage risks more safely, however there remained some gaps in the effective implementation and evaluation of risk assessments.

At this inspection we found that the usage of agency staff had reduced significantly. There had been a period of recruitment including a new chef, head housekeeper, a nurse and care staff. Managers had taken a lead on recruitment, which focussed on quality to fill staffing gaps and was on-going. There were sufficient staff to meet people's needs and provide personalised care and support with activities. There was a new management team in place including the home manager, quality assurance manager and two unit leads. There had been a focus on the organisation and allocation of roles within the s

The inspection took place on the 3, 4 and 5 October 2017. Weston Park is registered to provide accommodation and nursing care for up to 118 people. At the time of our inspection, 79 people were using the service. People lived in four separate units, which ranged from general nursing support to specific units for people who were living with dementia.

There was no registered manager in post. 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. Two managers had been running the home and were responsible for separate units; both had resigned from their posts. One had already left and the other was due to leave during the week of the inspection. Neither of these managers had registered with CQC. The registered provider had employed a new manager who had been in post for one day when we undertook the inspection. The manager told us that she intended to apply to register as soon as possible.

At this inspection we found that the provider had taken action to meet the requirement meeting people’s nutritional needs and consent to care. However, we still had concerns relating to the safe care and treatment of people, how people were cared for, how people were protected from abuse and harm, staffing, consent to care and the governance of the service. The provider had not taken the necessary actions to meet the requirements. We also found further breaches during our most recent inspection. Following this inspection, we are taking further action against the provider for repeated and serious failures to meet the regulations. Full information about CQC's regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

People could not be assured that appropriate action was taken when there was an allegation or concerns of abuse or avoidable harm. Risks associated to people's health and care needs had not always been appropriately assessed, monitored and reviewed. Staff did not always follow the guidance where risk assessments had been completed. This impacted on people's safety and welfare.

Recruitment procedures had not always been followed robustly and there was a risk that the systems in place did not ensure that suitable people were employed. We found that systems to ensure that there were sufficient staff on duty were not always effective, because there were occasions when staff absences could not be covered. There was a high usage of agency staff and some people said that agency staff weren’t always as familiar with people’s needs. The provider told us that recruitment was a priority.

People's medicines were not managed or administered in a safe way. People did not always receive their medicines as prescribed and thickener was not always administered correctly.

Staff had received some induction and training, but not all staff had received adequate training. Records could not evidence that staff received appropriate supervision and appraisal.

Previously, we found that people’s nutritional needs were not being met effectively. At this inspection we found that some improvements had been made and we received some positive feedback from a visiting dietician. However further improvements were still required regarding the standard of the food provided.

Further improvements were required to ensure that The Mental Capacity Act (MCA) was always followed where necessary.

Whilst individual staff were mostly kind and caring to people, we saw instances where people's dignity and privacy was not respected.

Whilst some people spoken with were positive about their support and treatment this was inconsistent. We were concerned that people did not always receive care and support which was resp

This inspection was unannounced and took place on 15 March and 19 April 2017. The second day of the inspection was delayed due to a vomiting outbreak at the home which meant that inspectors were unable to visit for a second day as planned, but returned on 19 April. Weston Park is registered to provide accommodation and nursing care for up to 118 people. At the time of our inspection, 81 people were using the service. People lived in four separate units, which ranged from general nursing support to specific units for people who were living with dementia. The Tatton Unit had been closed for a number of months but had been re-opened when inspectors visited on day two of the inspection.

A manager was in post but they were not yet registered with the Care Quality Commission. 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.

We had previously inspected the home on 12 and 14 July 2016, when it was under a different provider. When the new provider took over the home in September 2016, the deputy manager was subsequently appointed as manager and a number of the staff remained the same. This was our first inspection since the location had been re-registered with us.

At our last inspection, we told the provider to take action to make certain improvements. These included improvements to staffing, safeguarding, consent, good governance and nutrition and hydration. The provider at that time sent us an action plan stating how they would address these issues.

At this inspection, we found that the new provider had started to take action to make improvements but further improvements were still required. We found that improvements were needed to ensure people received consistent support from staff that knew them and their needs well. We also found that improvements were needed to ensure that people received care that was individual to them and responsive to their needs. We had concerns that some people did not have their nutritional needs met safely. People did not always have the opportunity to participate in stimulating activities and we found that people’s dignity was compromised at times. There were also issues with the quality assurance systems within the home. Following the first day of the inspection, we asked the provider to send us an immediate action plan to tell us how they would address the concerns we had identified.

We identified seven breaches of the relevant legislation. You can see what action we told the provider to take at the back of the full version of the report.

People’s views varied on staffing levels, some said there were sufficient staff whereas others felt that staffing was low at times. We found that staff were not always sufficiently deployed. The home was very dependent upon agency staff. The provider and manager told us that the recruitment of new staff was a high priority and they were actively recruiting, but that this was dependent upon appropriate applications being received. There had been high staff turnover and the manager told us they were now focused on the quality of the new staff being recruited. A new management structure was being implemented.

Staff spoken with understood what safeguarding was and knew how to report any concerns within the organisation. We found that the home was clean, well decorated and maintained. The maintenance person ensured that all appropriate checks were carried out and recorded.

During the inspection we found that the principles of the Mental Capacity Act 2005 (MCA) had not been followed to ensure people's rights were always protected. MCA assessments had not always been recorded correctly where necessary and DoLS had not been followed robustly enough.

We found that people did not a