Westerley Residential Care Home for the Elderly - Minehead

Westerley Residential Care Home for the Elderly is a care home providing accommodation and personal care. The home is registered to provide care to a maximum of 30 people. The home specialises in the care of older people. At the time of the inspection there were 26 people living at the home.

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

People felt well cared for at the home.

The home followed a Christian ethos and there were devotional services most mornings which people could choose to join.

People said staff supported them to follow their own routines and lifestyles. People made choices about their day to day lives.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People had their needs assessed and received care and support in accordance with their needs and wishes. Staff knew people well and care plans gave guidance for staff to follow.

People’s nutritional needs were assessed and met. People living at the home were happy with the quality and choice of food.

People’s health and well-being was monitored, and staff worked with other professionals to make sure people received the care and treatment they required.

People had confidence in the staff who supported them. However, some staff said they would appreciate more high-quality training to make sure they could meet people’s increasing needs. Some staff had not received up to date training in subjects required by the provider.

We have recommended that the provider reviews the training available to staff.

People had opportunities to follow their faith and there were activities available. The staff were expanding activities and entertainment available to people following the COVID-19 pandemic.

People lived in a home where the registered manager was very visible in the home and constantly monitored standards of care and sought people’s views.

The provider had some systems in place to monitor quality and plan on-going improvements.

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

Rating at last inspection – The last rating for this service was good (Published 23 October 2017)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We received concerns in relation to person-centred care and how staff supported people to make choices. As a result, we undertook a focused inspection to review the key questions of effective, responsive and well-led only.

We found no evidence during this inspection that people were at risk of harm from this concern.

Please see the Effective, Responsive and Well led sections of this full report.

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 COVID-19 and other infection outbreaks effectively.

The overall rating for the service has not changed from Good based on the findings of this inspection.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Westerley Residential Care Home for the Elderly on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

There is 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.

At the last inspection the service was rated Good. At this inspection we found the service remained Good.

People told us they felt safe in the home. They said they would be comfortable to discuss any worries or concerns with the registered manager. Staff said they knew how to report any concerns and were confident the manager would take appropriate action. People were supported by sufficient staff. The manager was pro-active when there were staffing issues to ensure people were protected and their needs were met.

Staff began work in the home after a robust recruitment process and a thorough induction. Staff were trained to meet people’s individual needs. Staff competency was monitored on an annual basis to ensure staff were able to care for people with skill and knowledge

People received care and support that was personalised and respected their wishes and preferences. People were able to make choices about all aspects of daily living and were encouraged to maintain their independence.

People were offered a choice of food that was wholesome and appetising. People were pleased with the standard of food provided.

People confirmed their health care needs were met in the home. If they were unwell they received prompt attention from their GP and good care from staff. People were supported to attend hospital or clinic appointments. At the end of their lives people received effective and compassionate care from a team of health professionals.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The registered manager was experienced and knowledgeable about the people living in the home and the care and support they needed. They worked well with other health care professionals and maintained good care standards.

Further information is in the detailed findings below

The focus of the inspection was to answer five key questions: Is the service safe, effective, caring, responsive and well led? This was a summary of what we found.

Is the service safe?

People were treated with respect and dignity by the staff. People told us they felt safe. People told us staff answered their bells promptly and came to their assistance during the day and night.

Systems were in place to make sure managers and staff learnt from events such as accidents, incidents, concerns and investigations. This reduced the risks to people and helped the service to continually improve. The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards which applies in care homes. Nobody in the home was subject to a DOLS order at the time of the inspection. The home had policies in place and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. The manager had undertaken training in safeguarding adults and implementing the Mental Capacity Act in 2013.

The service was safe, clean and hygienic. Staff understood how to reduce the risks of infection through routine cleaning and use of thorough hand cleansing. Equipment was well maintained and serviced.

The manager had day to day contact with people in the home. They set the staff rotas and took people's needs into account when making decisions about the numbers, qualifications skills and experience required. For example an additional care staff had been obtained to help care for someone at the end of their life. This helped to ensure all people's needs were met.

Recruitment practice was safe and thorough. No staff had been subject to a disciplinary action. Policies and procedures were in place to make sure that unsafe practice was identified and people were protected.

Is the service effective?

There was a pastoral support team available from the church if people needed it, this meant that when required people could access additional spiritual and emotional support.

People's health and care needs were assessed with them, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People were involved in compiling their plans and they reflected their current needs.

People's needs were taken into account with the layout of the home enabling people to move around freely and safely. The premises had been sensitively adapted to meet the needs of people with physical impairments. People confirmed they were able to see their visitors in private and visiting times were flexible.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. One person told 'I am sure there can't be a better home. Staff are very helpful. I am jolly glad to have help with personal washing. People are very good. They are very quick to see if you needed help and answered bells swiftly.'

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People completed a range of activities both inside and outside the service on a regular basis. The service recognised people wanted to live their lives in different ways and supported them to do so. Some people enjoyed being part of the home community while others preferred the peace and quiet of their own rooms.

People knew how to make a complaint if they were unhappy. There had been no formal complaints however people said that they were able to raise issues "at any time" with the manager.

Is the service well-led?

The service had a manager who was registered with the Commission. The service was well led because the manager was responsive and accessible to people in the home. The service worked well with other agencies and services to make sure people received their care in a joined up way. The service had a quality assurance system which identified shortfalls and addressed them promptly. As a result the quality of the service was continuingly improving.

We spoke with five people who used the service, to the registered manager, as well as five other staff on duty and 3 visitors/ relatives. We observed how care and support was provided to people. We looked at the homes environment and whether it met the needs of the people who lived there.

People told us they were very happy about how care and support was provided to them, and with the staff who provided that care. We were told that they had the help and assistance they needed. We observed that people had good relationships with the staff. , We saw that people and staff interacted well and there was a friendly and sociable atmosphere. People told us that they liked living in the home. One said 'Everyone's falling over themselves to be kind' another told us, 'I would be heartbroken if I had to go anywhere else'

Care treatment and support was planned in a way that ensured people's safety and welfare. One person said 'I feel that I get the support that I need.' Staff were trained to be able to deliver the care and support required by individuals.

We found that there were sufficient staff on duty with the appropriate skills and experience required to meet people's needs. One person said 'We have plenty of training to ensure that we can provide appropriate care at all times.'

We spoke to the service manager, the assistance manager, staff and people who use the service as well as the people who use the services relatives. Comments were received were all positive and included 'This is a lovely place to live you feel that you matter.'

Staff spoken to had a good awareness of the individuals care and support need and the importance of treating people with respect and dignity. This was confirmed by the training provided by the provider around respect and dignity and by talking to people who use the service. One person said ' 'This is a great service where people receive the highest standard of care' and 'The staff are really good to us and they respect our differences and respond appropriately to our needs what more can you ask.'