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Inspection carried out on 16 January 2017

During a routine inspection

We inspected Westwood on the 16 January 2017 and the inspection was unannounced. Westwood provides accommodation and support for up to nine people with a learning disability who require accommodation and personal care. The service was in a house and people had bedrooms on the ground and first floor which were accessed via a staircase. Care and support was provided to people living with a learning disability, dementia and mental health needs..

The service had a 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.

People were safe. Staff understood the importance of people's safety and knew how to report any concerns they might have. Risks to people's health, safety and wellbeing had been assessed and plans were in place, which instructed staff how to minimise any identified risks to keep people safe from harm or injury.

There were suitable arrangements in place for the safe storage, receipt and management of people’s medicines. Medicine profiles were in place which provided an overview of the individual’s prescribed medicine, the reason for administration, dosage and any side effects.

There were sufficient numbers of staff employed to meet people’s needs and staff knew people well and had built up good relationships with people. The registered provider had effective recruitment procedures in place.

The registered manager and staff had received training to meet people’s needs and were knowledgeable about of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Mental capacity assessments had not been completed for every decision taken for people who may not be able to consent.

Staff treated people as individuals with dignity and respect. Staff were knowledgeable about people's likes, dislikes, preferences and care needs. Staff were skilled to approach people in different ways to suit the person and communicate in a calm and friendly manner which people responded to positively.

Peoples' health was monitored and referrals were made to health services in an appropriate and timely manner. Any recommendations made by health care professionals were acted upon and incorporated into peoples' care plans.

People who wanted to be occupied had busy lifestyles which reflected their lifestyle choices and likes and dislikes. People’s privacy and dignity were respected and upheld by staff who valued peoples’ unique characters.

Staff were kind and caring and treated people with dignity and respect. Good interactions were seen throughout our inspection, such as staff sitting and talking with people as equals. People could have visitors from family and friends whenever they wanted.

People received a person centred service that enabled them to live active and meaningful lives in the way they wanted. People led full and varied lives and were supported with a variety of activities often with one to one support.

Complaints were used as a means of improving the service and people felt confident that they could make a complaint that any concerns would be taken seriously.

There was an open, transparent culture and good communication within the staff team. Staff spoke highly of the registered manager and their leadership style. The management team had positive relationships with the care staff.

The registered manager took an active role within the service and led by example. There were clear lines of accountability and staff were clear about their roles and responsibilities. The provider had robust systems in place to assess and audit the quality of the service. However the quality checks that we could see were happening were not always written down in one document.

Inspection carried out on 27 October 2015

During a routine inspection

This inspection took place on 27 October 2015. To ensure we met staff and the people that lived at the service, we gave short notice of our inspection.

This location is registered to provide accommodation and personal care to a maximum of nine people with learning disabilities. Nine people lived at the service at the time of our inspection.

People who lived at the service were younger and older adults with learning disabilities. People had different communication needs. Some people were able to communicate verbally. Some people used non-verbal communications to include writing notes, gestures and body language. We talked directly with people and used observations to better understand people's needs.

The home had a registered manager. 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.

Medicines were stored, administered and recorded correctly. Staff were trained in the safe administration of medicines and kept relevant records that were accurate. However when medicines errors occurred, the registered manager did not routinely re-assess staff competence to reduce future risks to people.

There was a whistleblowing policy in place. Prior to the inspection we received reports of concern from an anonymous whistleblower. The registered manager worked closely with the local authority and CQC to investigate the concerns reported. It was concluded that there was no evidence to corroborate the reported concerns. The registered manager acknowledged the need to review the whistleblowing policy to ensure staff used this for legitimate purposes to safeguard the needs of people at the service.

There were audit processes in place to monitor the quality of the service and promote continuous service improvements. However where people had identified goals to achieve these were not consistently monitored and outcomes recorded as part of their care reviews. In addition, the registered manager and CEO talked about service developments they intended to implement. However developments and timescales for completion had not been recorded as part of a service improvement plan.

Staff were trained in how to protect people from abuse and harm. They knew how to recognise signs of abuse and how to raise an alert if they had any concerns. Risk assessments were centred on the needs of the individual. Each risk assessment included clear control measures to reduce identified risks and guidance for staff to follow to make sure people were protected from harm. Risk assessments took account of people’s right to make their own decisions.

Accidents and incidents were recorded and monitored to identify how the risks of reoccurrence could be reduced. There were sufficient staff on duty to meet people’s needs. Staffing levels were adjusted according to people’s changing needs. There were safe recruitment procedures in place which included the checking of references.

Staff knew each person well and understood how to meet their support needs. Each person’s needs and personal preferences had been assessed and were continually reviewed.

Staff were competent to meet people’s needs. Staff received on-going training and supervision to monitor their performance and professional development. Staff were supported to undertake a professional qualification in social care to develop their skills and competence.

The Care Quality Commission (CQC) is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager understood when an application should be made and how to assess whether a person needed a DoLS.

Staff supported people to make meals that met their needs and choices. Staff knew about and provided for people’s dietary preferences and needs.

Staff communicated effectively with people, responded to their needs promptly, and treated people with kindness and respect. People were satisfied about how their care and treatment was delivered. People’s privacy was respected and people were assisted in a way that respected their dignity.

People were involved in their day to day care and support. People’s care plans were reviewed with their participation and relatives were invited to attend the care reviews and contribute.

People were promptly referred to health care professionals when needed. Personal records included people’s individual plans of care, life history, likes and dislikes and preferred activities. The staff promoted people’s independence and encouraged people to do as much as possible for themselves. People were involved in planning activities of their choice.

People received care that responded to their individual care and support needs. People were provided with accessible information about how to make a complaint and received staff support to make their views and wishes known.

There was an open culture that put people at the centre of their care and support. Staff held a clear set of values based on respect for people, ensuring people had freedom of choice and support to be as independent as possible.

People and staff were encouraged to comment on the service provided and their feedback was used to identify service improvements.

Inspection carried out on 12 September 2013

During a routine inspection

There were eight residents living in the home on the day of our inspection, one was in hospital. The home had one vacancy.

We spoke to four people who lived at the home. We spoke with three staff. We looked at three care plans and three staff files.

We found that people were involved in the planning of their care. People were treated with respect.

Care plans were up-to-date and reflected the care that was provided.

The building was seen to be safe and suitable for people living and working in the home and for their visitors.

The home had effective recruitment procedures.

The home had an effective complaints policy and procedure.

Inspection carried out on 31 October 2012

During a routine inspection

During our visit we spoke with two people who lived at Westwood and two staff members.

The people we spoke with told us they enjoyed living at Westwood. One person told us “I love living here, I’ve been here a long time and it’s home to me. I’ve had my room decorated just as I want.” Another person told us about how they felt about living at Westwood. She said “I’ve no complaints and everyone’s friendly. I have a job in town in a charity shop. I love my job.”

The staff we spoke with were knowledgeable about people’s needs and what support they required.

We saw the service ensured that staff were able to deliver care and treatment safely due to the training and audits in place. The service had assurance systems in place to monitor the quality of the service provided and to gain the views of the people who lived there.