Westerley Residential Care Home for the Elderly - Westcliff-on-Sea

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 remained requires improvement.

This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed. The provider did not ensure all required recruitment checks were completed on staff. The service was in breach of legal regulation in relation to fit and proper persons employed.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported incidents. However, there was no recent record of lessons learnt available on the day of the inspection.

The registered manager told us they are always discussing how to move forward and improve the service. The management shared learning with staff from incidents, accidents, complaints and safeguarding so that the service could continually improve and develop positive outcomes for people. However, we found some concerns from the previous assessment had not been addressed. Lessons were not always learned and embedded into practice.

The service 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 told us they read through the care plans to ensure they had all the information they needed to provide support safely. Relatives told us they were happy with the initial assessment process and the way the support package was put into place. A relative told us, “The initial assessment was done at the hospital and then [relative] was transferred to the Home and decided they wanted to stay because it was lovely and they were comfortable. We do have a care plan; I was involved and signed it all off. They review every year and in between if necessary. We have a PEACE document for end of life which was done in discussion with the team. We talk a lot, a really good relationship with the home.”

The service 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 service shared concerns quickly and appropriately. The registered manager had raised safeguarding concerns appropriately and had worked with the local authority to investigate these to ensure people were being safeguarded.  Staff understood how to recognise the signs of abuse and could describe the actions they would take to safeguard people including informing other agencies if they were concerned about action being taken. A staff member told us, “I would report to my manager, and I would escalate to the Local Authority if I needed to.”

A relative told us, “[Relative] is so safe that I am going away for 12 days and confident they will be so well looked after. They have even arranged that they will support WhatsApp calls from me to [relative] while I am away.” A person told us, “Of course I feel safe here. It is my home. They all look after me very well.”

The service 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 to people had been assessed and risk assessments had been put in place to help mitigate these. Risks included areas such as supporting people with physical healthcare needs, use of mobility equipment and with personal care. Staff knew the risks to people well and told us they were kept up to date if there had been any changes to risk assessments. Staff told us they always read the care plan and checked the care planning application, they used on their handheld devices, to see if there had been any changes to planned care.

A relative told us, “The staff are all very good, we have confidence in all of them. They did hoist [relative] once and they went downstairs and loved it, but [relative] is not keen on hoisting.” Another relative told us, “They hoist [relative] every day, there are always 2 staff, and [relative] has never complained about the hoisting. The staff seem very competent and understanding.”

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. We found improvements had been made since the last inspection.

The environment was adapted to meet the needs of people living there. People had access to outdoor spaces, providing an opportunity to enjoy fresh air and relax in the garden. Maintenance staff were employed to ensure the premises were well-maintained and safe. There were systems in place to ensure any maintenance needed were recorded and responded to promptly. Records of checks on equipment and the premises were up to date. Fire safety and evacuation processes had been reviewed and improved, and new compliant fire doors had been installed throughout the service. However, during the assessment we identified a number of issues with fire doors such as not closing properly and gaps preventing doors sealing effectively. The provider took steps to address these issues, and we saw on the second day of our visit these areas had started to be addressed.

Risks relating to the service's fire arrangements were monitored and included individual Personal Emergency Evacuation Plans [PEEPs] for people using the service. However, some of the information lacked detailed. Following this inspection the management team updated the PEEPs for each person to ensure they were detailed, up to date and accurate.

The registered manager had not always ensured staff were safely recruited. Relevant recruitment checks were not always completed before staff started work. We saw gaps in recruitment files, such as some staff did not have completed references and references received had not been verified. The deputy manager had completed staff file audits. However, the audits did not include reference verification details. The registered manager had not completed the appropriate checks to ensure that staff were recruited safely into the service. Following our visit, the deputy manager introduced new verification template and ensured risk assessments were completed whilst waiting for references.

Most relatives told us they felt there was enough staff. However, some staff told us they felt they needed an extra member of staff to provide support to people. A relative told us, “I think they could do with an extra member of staff. From [relative’s] point of view, it would be nice if the staff spent a bit more time in the room, I know they are busy, but [relative] would really appreciate some company.” A person told us, “I do think they need more staff. There are activities going on downstairs, but I don’t often have someone coming to see me in my room. Its usually to just serve me my food. I would enjoy talking to someone, but they are very busy and don’t often have the time.”

The service assessed and managed the risk of infection. They detected and controlled the risk of infection spreading and shared concerns with appropriate agencies promptly. The service was clean and tidy with no odours. Staff had personal protection equipment situated throughout the service giving them easy access to wear when needed. The deputy manager carried out regular checks and completed regular audits to monitor the cleanliness of the service.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. We found improvements have been made since the last inspection. The registered manager told us, "Staff did not support people with medicines until they had completed the required training, and medicine competency assessments were completed." Medicine competency assessments were seen on staff files. People had care plans and risk assessments in place which detailed what medicines they were prescribed and how they liked to be supported. Protocols were in place for as and when required medicines (PRN). The deputy manager carried out regular audits and where discrepancies were noted these were investigated to identify the cause and any actions needed. There was a system in place to identify any shortfalls and to ensure people received their medicines safely.