Westwood

Updated 31 December 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we could understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

There was one inspector.

Service and service type

Westwood is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement dependent on their registration with us. Westwood is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We reviewed the information we held about the service and the service provider. We looked at notifications we had received for this service. We sought feedback from the local authority and professionals who work with the service. Notifications are information about important events the service is required to send us by law. We used all this information to plan our inspection.

During and after the inspection

We spoke with 6 people and observed staff interacting with others to help us understand the experience of people living at the service. We spoke with 5 care staff, the registered manager and the deputy. We spent time reviewing records, which included 3 care plans. We looked at 2 staff files and documentation related to the management of the service such as accidents and incidents and medicines management. We also looked at staff rotas, and records relating to health and safety and the management of the home. Following our inspection, we also spoke or received correspondence from 6 people’s relatives and from 2 professionals. We also continued to seek clarification from the provider to validate the evidence found. We looked at audits, training data, quality assurance records and meeting minutes.

Updated 31 December 2022

About the service

Westwood is a residential care home providing accommodation and personal care to nine people at the time of the inspection. There were no vacancies. Some people have specialist needs associated with Downs syndrome, dementia, autism or mental health.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Care

There were not always enough staff to meet people’s needs in the evenings and at night. This was reviewed following our inspection and staffing levels were increased. Staff had the skills, knowledge and experience to meet people’s needs and more specialist training was being sought in relation to Makaton (a sign language) and Positive Behavioural Support. Agency staff were used to cover staff sickness or annual leave. Wherever possible the same agency staff were used which provided people with a consistent approach.

People’s medicines were stored safely, and people received their medicines in line with their prescriptions. Where appropriate, people were supported to manage their own medicines.

Right culture

There were good systems for auditing medicines, health and safety and care plans, and any shortfalls were addressed promptly. External oversight was not so thorough, monthly audits had not picked up on matters identified at inspection such as the impact of low staff numbers.

Although there were established systems to hear people’s views either through keyworker meetings, house meetings and surveys, records did not demonstrate how people’s wishes were being met. There were no recent surveys to seek the views of people’s relatives or staff. People told us they were happy living at Westwood. Overall, we received very positive feedback from relatives we contacted, and they spoke very warmly of the care and support provided at Westwood.

Staff told us they felt supported and they attended regular supervision meetings and staff meetings where they had opportunities to share their views on the running of the service.

Right Support

People were supported to have maximum choice and control of their lives and were supported in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. There were systems to ensure people's needs were assessed and reviewed. Westwood was kept clean.

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

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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 coronavirus and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service remains Requires Improvement.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We have identified a continued breach in relation to good governance at this inspection. We have also identified a new breach in relation to staffing.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.