Westwood Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always have a proactive and positive culture of safety. Staff did listen to concerns about safety and reported safety events. However, lessons were not always learnt to continually identify and embed good practice.

Incidents and accidents were being recorded and reviewed on an individual basis by the home manager. However, these were not analysed to look for patterns and trends, meaning robust oversight of learning opportunities was lacking. Action had been taken to minimise risk following singular incidents but an overall view of the wider impact of these was missed. The home manager was seeking support with the electronic system to improve this.

Staff knew how to report accidents and incidents and spoke of confidence in doing so. Staff told us that any immediate changes were communicated through handover meetings.

The provider demonstrated a willingness to learn and improve including responding to concerns raised by the inspectors.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Management and staff had good working relationships with external professionals, enabling clear and concise communications and pathways. The home had an electronic care planning system, and information could readily be obtained from this to support people with transitions to other services, such as hospital. This process ensured a streamlined approach to people’s care and support delivery and enabled all important information to travel with the person for joined up care.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

Staff were knowledgeable about recognising and responding to abuse and took appropriate actions to keep people safe. One staff member said, “I would speak to [home manager], I am confident that they would deal with it.” People and their relatives told us they felt safe at Westwood and would raise concerns if they needed to. Staff had undertaken training to ensure they could robustly identify any areas of concern. Safeguarding matters had been reported to the appropriate agencies and action taken to minimise risks.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act (2005) (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We found the service was working within the principles of the MCA. Mental capacity care plans were in place and DoLS were requested as appropriate. The home manager had good oversight of these, including any conditions and when they were due for review or renewal.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risks had been assessed and measures taken to minimise these. Staff knew people well and understood risks involved in their support. These were clearly documented in people’s care plans, with guidance for staff on how to keep people safe. One staff member said, “We are continuously monitoring people’s needs, and we adjust to any changes to keep risks down.” Risks were managed in the least restrictive way and where possible, people were encouraged to be independent.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

During the inspection, we found some bathrooms were being used as storage rooms. These were open and accessible to people. Whilst we did not see evidence of people coming to harm because of this, this was still a risk. There were also areas of the home which needed repair, such as some linoleum which had come loose, creating a potential trip hazard. We found a couple of doors which were unsecured and could lead to people exiting to the street. The provider was receptive to this feedback and by the second day of inspection, action had been taken to address these matters.

Some of the home décor was worn and needed attention. The provider was receptive to this feedback from inspectors and action was being taken to arrange redecoration of some areas. Health and safety checks of equipment were in place and up to date, showing items were compliant and in safe working order. The home had an up-to-date fire risk assessment and regular fire safety checks were completed and recorded. People had suitable Personal Emergency Evacuation Plans (PEEPs) in place.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Staff received training and support which gave them the skills, knowledge and confidence to carry out their role safely and effectively. One staff member said, “Yes, we get training and I think it covers everything we need here. We can always mention if there’s something we feel is missing.” Another told us, “There have been improvements recently and we get regular support sessions.”

We observed enough staff to meet people’s care needs. We discussed with the provider the possibility of reviewing staff deployment, to free staff up for more meaningful activity to take place. The home manager had begun using a dependency tool to review this.

There was a robust recruitment process which included pre-employment checks, such as references, to assure staff were suitable for their role. Where people had gaps in their employment history, these had been explored and explained.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The home was clean, and people were protected from the risk and spread of infections. A housekeeping checklist was followed by staff to ensure each area was kept clean. We observed people’s rooms being deep cleaned throughout the inspection days. Staff knew how to protect people from the risk of infection and had training in infection prevention and control (IPC). We observed appropriate hand washing and use of personal protective equipment (PPE).

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. However, some improvements in documentation were needed.

Medicines were stored, administered and disposed of safely. People received their medicines as prescribed and in line with their preferences. Staff received training in the management of medicines and their competency to remain safe to do so was regularly checked. We found PRN (as required) medicine protocols were not always in place. This meant staff did not have clear guidance on when these medicines should be given, which may lead to inconsistent administration. We discussed this with the home manager who took immediate action to address this concern.