Archived: Signature at Westbourne

Signature at Westbourne is a nursing home providing personal care and nursing care to 108 people at the time of the inspection. The service can support up to 114 people. Signature at Westbourne is a purpose-built building and is accessed over four floors by stairs or a lift. People could access the ground and first floors freely, the second and third floor had restricted access to keep people living with dementia safe.

People’s experience of using this service and what we found

People told us they felt safe and were happy living at Signature at Westbourne. Comments included, “this is my home now and I am very happy”, “the staff are lovely” and, “this is the perfect place for me.”

The design and decoration of the premises did not always follow the best practice guidance for supporting people living with dementia. Plans were in place to redecorate these areas. We have recommended the provider consults good practice guidance around providing a dementia friendly environment for people who use the service.

Peoples needs were assessed before they moved into the service. We found people’s protected characteristics had not always been considered as fully as they could have been. A new electronic care planning system was being introduced that included a more robust system for seeking protected characteristics. We recommended the provide consults good practice guidance to ensure assessments fully explored people’s needs to ensure they could be met before they moved into the service.

Staff had assessed people for risks to their health and well-being and created plan to minimise the likelihood of harm occurring. Clinical and non-clinical risks were discussed daily between staff to ensure people were safe. People told us there was enough staff to meet their needs. Staff had been recruited safely into the service and had received a comprehensive induction followed by regular training to ensure they had the right skills to meet people’s needs. Medicines had been managed safely and people were protected from the spread of infections. Lessons were learned when things went wrong.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff worked effectively with other agencies to provide consistent, effective and timely care. Staff supported people to access healthcare when required. People were supported to eat a well-balanced diet. Staff told us they felt supported to carry out their job roles.

People told us they were cared for by staff who knew their needs, were kind, respectful and treated them with dignity. One relative said, “[Person] settled in the home immediately which suggests that they must be doing something right.”

Staff provided people with care responsive to their needs. We identified one person was not always being supported to communicate as fully as they could have been. We brought this to the attention of the registered manager and provider who responded quickly and by the next day of our inspection we observed the way the person chose to communicate had been fully supported. This resulted in the person being able to tell staff their likes, dislikes and wishes.

There was a large activities programme in place, one person told us, “the programme of activities is brilliant.” The activity staff told us the plans they had to improve activities for people living with dementia and people who preferred a 1:1 activity.

People knew how to complain and felt they would be listened to. People were supported to have a dignified and respectful end of life when the time came.

People, relatives and staff spoke positively about the registered manager and management team. People and staff felt comfortable to speak open and honestly and felt they would be listened to. Quality assurance systems were in place to monitor the quality of the service and identify areas of improvement. Signature at Westbourne engaged with people, the public and staff to improve the running of the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 10 December 2021 and this is the first inspection.

The last rating for the service under the previous provider was Outstanding, published on 2 February 2019.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

Protocols for visiting the service were being followed in line with government guidelines. This included professionals evidencing their vaccination status and all visitors having a negative LFT on the day of their visit. Some people had a family or friend designated as an essential care giver. This person was included in weekly home testing and able to visit, even at times when restrictions were placed on visiting due to an outbreak in the home. We observed visitors being provided with PPE and having access to hand cleaning gel. Visiting was by appointment and included the use of a visiting pod that had a safety screen, intercom system, separate external access and a cleaning protocol between visitors.

People were supported to access the community safely. Risk assessments had been completed with people and their families with activities rated from low to high risk. Actions to mitigate risk including following face mask guidance when in the community to carrying out LFT’s for 10 days following a visit to a family members home over Christmas.

Admissions to the home were carried out safely. Two people we spoke with told us this had included a negative PCR test prior to admission, another on day of admission and daily LFT’s. A relative told us, “We had to stay in (relative’s) room until we had the all clear from a PCR”. Activity packs had been created in wipe clean folders for people self-isolating and included activities relevant to the person such as crosswords, word games, art and a daily newsletter.

The home provided spacious accommodation enabling people to keep a safe distance. Changes to the environment had included re-arranging the dining and lounge areas to provide space between seating. People had their own rooms with en-suite facilities. Gardens provided access to outside space. The premises and equipment were clean. One person told us, “I’ve nothing to complain about, the place is absolutely spotless”. The layout of the building enabled each floor of the home to be isolated, if necessary, with separate access arrangements.

Staff had completed infection, prevention and control training, which included correctly putting on and taking off PPE. We observed staff using PPE correctly. PPE was available throughout the home. Staff were participating in both the vaccination and testing requirements. To support staff well-being some staff had trained as mental health first aiders, staff had access to an external confidential helpline and meetings were regularly held which provided an opportunity for sharing information and support.

The organisation had a COVID-19 task force that was able to immediately respond to government changes and kept policy up to date and staff informed of the impact of changes. An audit system was in place that was effective at ensuring policy and procedures were being met.