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Inspection Summary


Overall summary & rating

Good

Updated 6 December 2016

This inspection took place on 19 October 2016 and was unannounced. Westminster House is a care home run by the local authority, which provides short term respite to people with learning disabilities. The home can accommodate a maximum of 10 people and on the day we visited there were three people staying. The accommodation was spread over two floors. All areas of the home were accessible via stairs. There were lounges/dining rooms on both floors of the home. There was accessible outdoor space from the ground floor. All bedrooms were for used for single occupancy and some had en-suite facilities.

The home was last inspected on 5 and 8 December 2015, when we found three of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breech of the Care Quality Commission (Registration) Regulations 2009. At this inspection we found improvements had been made in these areas.

There was no registered manager for the home. 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. The previous registered manager left the provider in June 2016. Since that time an interim manager who manages one of the providers other homes had been in place at Westminster House. The provider had not commenced recruitment procedures for a new manager and was unable to say when this would occur.

People and their families were positive about the interim manager but were concerned about upcoming reduction in the number of people who could stay at Westminster House. People and their families were worried about access and availability of respite services and were uncertain about their future respite arrangements. The provider had not ensured they were fully involved or informed about the proposals.

Risks to individuals and the environment were pro-actively assessed and managed. Staff were knowledgeable about putting measures in place to reduce risks. Incidents were analysed to identify triggers and causes with measures put in place to reduce the risk and likelihood of reoccurrence.

Peoples’ care plans were person centred and included information about people’s preferences, routines and prompts for staff to support people to maintain their independence. Care plans were reviewed regularly or when people’s needs changed and were developed with people and their families.

Peoples’ medicines were managed safely. A system of auditing and recording was in place to help ensure people received prescribed medicines. People health was monitored and the provider sought advice from health professionals when people required medical assistance.

People’s dietary requirements and preferences were followed. Staff were knowledgeable about people’s individual needs and guidance around people’s specific requirements were clearly displayed in kitchen areas to reduce the risk that they would be not being supported appropriately.

Staff followed legislation designed to protect people’s rights and freedoms. Peoples’ choice, privacy and dignity were respected and upheld.

There were a suitable number of staff working at Westminster House. They had a thorough knowledge of people and cared for them with kindness and compassion. Many staff had worked at Westminster House for a number of years and had formed strong working relationships with people and their families.

The provider had made improvements to ensure a system as in place to support staff through training and supervision. Further improvements were planned where staff would receive an annual performance based appraisal.

Staff were knowledgeable about safeguarding procedures and could identify the steps needed to help to keep people safe if they had concerns. The provider pro-actively displayed and promoted their safeguarding and whistleblowing polices. They were transparent in reporting significant events that happened in the home to relevant professional bodies and people’s families.

People were supported to maintain friendships and access the community whilst staying at Westminster House. People were supported to attend their regular day activities whilst staying. In addition to this, the provider organised day trips out for people. Activities were tailored around people’s likes and preferences and were a good opportunity for people to spend time with their peers.

Auditing and quality assurances processes were in place and resulted in improvements being made to the service and a safe environment for people to stay in.

The provider had a complaints policy in place which was clearly displayed and promoted within the home. People and their families knew how to make a complaint and felt confident their concerns would be listened too.

Inspection areas

Safe

Good

Updated 6 December 2016

The provider was safe

Risks relating to individuals were assessed and safely managed. Staff were knowledgeable about the measures needed to reduce risk whilst promoting independence and choice.

Medicines were managed safely. Systems were in place to monitor that people were receiving the right medicines

Staff were knowledgeable about safeguarding and were confident in taking appropriate action if they had concerns about people.

There were suitable numbers of staff employed who had the right skills and knowledge to support people. The provider followed safe recruitment procedures.

Effective

Good

Updated 6 December 2016

The provider was effective.

Staff followed legislation designed to protect people’s rights and freedoms.

Peoples’ dietary needs were assessed and people were provided with a diet appropriate to their medical conditions and preference.

Staff knew how to meet people’s needs; they were suitably trained and the provider was making improvements to ensure that staff received support, supervision and appraisal in their role.

People were supported to access healthcare services when needed.

The home provided a suitable environment for people who used the service.

Caring

Good

Updated 6 December 2016

The provider was caring.

Staff had thorough knowledge of the people they supported and cared for them in a kind and compassionate way.

People were supported to maintain friendships and have access to the community.

Peoples’ choice, privacy and dignity were respected and upheld. Staff encouraged people to maintain their independent skills and take an active part in the day to day tasks in the home.

Responsive

Good

Updated 6 December 2016

The provider was responsive.

Care plans were regularly reviewed to reflect people’s most current needs. Care plans included details about people’s life histories and preferences and routines.

A complaints policy was in place and people knew how to complain.

The provider sought feedback from people and their relatives in order to make improvements to the service.

Well-led

Requires improvement

Updated 6 December 2016

The provider was not always well led.

The provider did not have a registered manager in place and had not taken action to commence recruitment of a new manager.

People and their families were positive about the interim manager but were concerned about upcoming changes to Westminster House which they told us they had not been fully informed about.

The provider notified CQC about significant events that happened in the care home.

Auditing and quality assurances processes were in place and resulted in improvements being made to the service and a safe environment for people to stay in.

Incidents were analysed to identify causes with measures put in place to reduce the risk and likelihood of reoccurrence.