Westfield Residential 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 good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 63 (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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The provider had a positive culture where incidents, accidents and safeguarding concerns were reviewed, and lessons learned were shared with staff. Following safeguarding incidents, managers discussed lessons learned with staff and developed emergency guidance and checklists to support safer practice. Staff described supportive leadership and regular meetings where improvements and learning were discussed. A member of staff told us," We had a team meeting a couple of weeks ago. They told us what needs to improve in the home." Although, monitoring systems were in place, some records demonstrated learning had not always translated into consistently safe practice or documentation. However, following the inspection feedback the provider developed information sheets for staff with clear guidelines and identifying key messages.

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.

Staff sought advice from a range of professionals and people had access to healthcare services when needed. The provider was transferring records to an electronic care planning system and leaders recognised further work was required to ensure records and risk information were complete and easy to access. The provider responded following inspection by reviewing records and introducing additional governance and monitoring arrangements to strengthen oversight during the transition.

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.

People were protected from abuse. Safeguarding concerns were referred appropriately and monitored through safeguarding and incident oversight systems. Staff were able to describe safeguarding procedures and examples of safeguarding support provided to people. One safeguarding concern involving a person's finances showed staff had worked closely with external agencies to help protect the individual from potential financial abuse. Managers maintained safeguarding records and reviewed incidents to identify learning. One relative told us, "[Name] is safe there.”

The provider did not always work well with people to understand and manage risks. Staff did not always ensure care was safe, supportive and enabled people to do the things that mattered to them.

People's choices were considered when managing risks and care records reflected occasions where people chose to decline aspects of care, including, for example, repositioning support. However, records did not always demonstrate that risks were consistently monitored, reviewed and escalated. Inspection findings identified gaps in repositioning records and incomplete risk documentation during the transfer to electronic records. Some relatives also raised concerns regarding the consistency of risk management arrangements. Following feedback the registered manager had assessed all risks and the provider put in place a system to ensure all risks to people’s care would be in place within the first 24 hours.

The provider detected potential risks in the care environment. They made sure equipment, and technology supported the delivery of safe care. However, not all available controls to minimise risk had been utilised.

The home was well maintained, environmental checks were routinely completed. The service had identified outstanding actions from fire risk assessments and health and safety reviews and had begun implementing action plans to address these. However, the provider had not undertaken, for example, a simulated fire evacuation prior to the inspection taking place and some checks, such as, bed rails were not formalised or monitored. These were put in place following the inspection visit. However, some environmental risks identified through audits, including infection prevention concerns and outstanding fire safety recommendations, had not yet been fully addressed.

The provider did not always make sure there were enough qualified, skilled and experienced staff. They did not always make sure staff received effective support,supervision and development. They did not always work together well to provide safe care that met people’s individual needs.

The provider employed permanent staff and did not use agency workers. This helped to promote continuity of care. Staff received induction, shadowing opportunities, supervision and ongoing support from managers. One member of staff told us, "It was never a case of being thrown in. I got shadowing for two weeks with a senior staff member." However, records did not provide assurance that mandatory training compliance was fully monitored and maintained. For example, training records contained gaps and did not clearly identify mandatory training requirements. The provider took immediate action following the inspection. However, feedback from relatives and staff was mixed regarding staffing levels, with some concerns raised about response times and sufficient staffing arrangements, particularly at night. One relative said, “When [Name] rings their bell it’s not always answered in a timely manner. Sometimes it is up to 20 minutes.”

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 environment was clean and the provider had systems to reduce the risk of infection. For example, cleaning schedules, water safety monitoring and infection control audits were in place. Relatives spoke positively about the environment and practices. One said, “The cleanliness is good and they (staff) wear aprons and gloves when doing personal care.” The provider was following recent recommendations by an external infection prevention and control (IPC) assessment regarding equipment storage. They had identified areas requiring improvement and the provider was taking steps to address issues, including laundry arrangements and equipment storage.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

The provider used an electronic medicines administration system and worked closely with healthcare professionals to review people's medicines. Regular medication reviews were undertaken with GP involvement and medicines information was available to support staff practice. However, medicines records were not always robust and inspection findings identified incomplete PRN protocols, missing dates of opening, and transdermal patch application records that did not fully reflect safe practice guidance. The provider took prompt action following inspection and supplied updated protocols, body maps and additional medicines governance arrangements.