Weston House

Weston House is a residential care home providing personal and nursing care to up to 48 people across four separate units. The service provides support to older people some of whom are living with dementia. At the time of our inspection there were 42 people using the service.

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

People were not always aware of the new management team, however felt able to speak with staff should they have any feedback. Quality assurance tools were not always completed in a timely or effective way to ensure improvements required were identified and actioned.

People were supported by safely recruited staff who had received training. People felt able to share concerns with staff should they arise. People were supported in a timely and caring way by enough staff. People told us they received their medicines as prescribed by trained staff.

People were supported by staff who had received training in and were adhering to infection control guidelines. People were supported to have visitors whenever they would like these.

People had access to healthcare professionals should they require these. Accidents and incidents were reviewed by the management team so that lessons could be learned when things went wrong.

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.

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

Rating at last inspection and update

The last rating for this service was good (published 12 January 2019). At this inspection the rating has remained the same.

Why we inspected

This inspection was prompted by concerns we had received about medicines, assessment of risk and how staff were wearing their protective clothing, such as masks, gloves and aprons. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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.

We found no evidence during this inspection that people were at risk of harm from this concern. However, improvements were required to the oversight at the service. Please see the safe and well led sections of this full report.

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

Follow up

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

Weston House is a Residential Care Home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Weston House accommodates up to 48 people in one adapted building. At the time of the inspection there were 45 people using the service.

There was a registered manager in post at the time of our inspection. 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 safeguarded from abuse. Risks to people were assessed and planned for to keep people safe. People were supported by sufficient safely recruited staff. People’s medicines were administered as prescribed. People were protected from the risk of cross infection. The provider learned when things went wrong.

People’s needs were assessed and plans were put in place to meet them. Staff had access to an induction and training and felt supported in their role. People were supported to live in an environment which was suitable to meet their needs.

People received consistent support from staff. People had a choice of meals and were supported to eat and drink. People were supported to maintain their health and well-being and had their health needs monitored.

People had choice and control of their lives and staff were aware of how to support them in the least restrictive way possible; the policies and systems in the service were supportive of this practice.

People were supported by staff that were caring. People could make choices and were supported to maintain their independence. People had their privacy and dignity protected.

People’s preferences were understood by staff and their communication needs were assessed and planned for. People had access to a range of activities. People were clear about how to make a complaint and these were responded to. People were supported to consider their preferences for care at the end of their life.

Notifications were submitted as required and the registered manager understood their responsibilities. People and their relatives were engaged in the service and felt able to approach the registered manager. Staff felt supported in their role and were involved in the service. Quality audits were in place and were used to drive improvement.

The service was registered to provide accommodation for people who require nursing or personal care, diagnostic and screening procedures and treatment of disease, disorder or injury. They are registered to support up to 48 people. People who used the service had physical health needs and/or were living with dementia. At the time of our inspection 48 people were using the service.

The accommodation at Weston House is all single ensuite rooms, in a four house group arrangement. Two house groups are situated on the ground floor and two on the first floor.

The service 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.

At the last inspection on 7 August 2013, the service met all the outcomes they were inspected against.

People felt safe and staff knew how to protect people from avoidable harm and abuse. People’s risks were assessed and managed to help keep them safe and we saw that care was delivered in line with agreed plans.

There were enough staff to meet people’s needs. We saw that people's needs were responded to promptly and the registered manager reviewed staffing levels to ensure they were suitable. Staff had been checked to ensure they were suitable to work with the people who used the service.

Medicines were safely managed, stored and administered to ensure that people got their medicines as prescribed.

Staff were suitably trained to meet people’s needs and were supported and supervised in order to effectively deliver care to people. Staff understood how to support people to make decisions and when they were unable to do this, support was provided in line with current legislation and guidance.

People were provided with enough food and drink to maintain a healthy diet. People had choices about their food and drinks and were provided with support when required to ensure their nutritional needs were met. People’s health was monitored and access to healthcare professionals was arranged promptly when required.

People were treated with kindness and compassion and staff showed regard for people’s wellbeing in a caring way. People were encouraged to make choices about their care and their privacy and dignity was respected.

People received person centred support from staff who knew them well. They were offered opportunities to participate in activities that interested them and could spend their time how they chose. Care plans contained information on life history and preferences so that staff had the information they needed to be able to provide support to meet individual needs and requirements.

People knew how to complain and staff knew how to respond to complaints. A complaints procedure was in place and we saw that this was followed when complaints were received. People and their relatives were encouraged to give feedback on the care provided. The registered manager and provider responded to feedback and changes were made to improve the quality of the service provided.

The registered manager understood the conditions of their registration with us. We saw that systems were in place to monitor quality and that the registered manager analysed information and took actions to make improvements when required. There was a positive atmosphere at the service and people felt the registered manager was approachable and responsive.

We spoke with the home manager, the deputy manager, eight carers, a housekeeper, the head chef, a visiting commissioner, two people who lived in the home and six relatives.

The accommodation at Weston House is all single ensuite rooms, in a four house group arrangement. Two groups are sited on the ground floor and two groups on the first floor. Some people living at the home were unable to fully communicate with us, due to their health needs, so we used a short observational framework tool (SOFI) to observe the support they received and how they responded to it.

We reviewed how staff gained consent to care for people and how people were safeguarded from abuse. We saw that the care records were well written, informative and updated regularly. Staff told us and we saw records that the staff were trained to safeguard people from abuse. When questioned the staff had a good understanding of what constitutes abuse and how to observe for all types of abuse.

We spoke with staff that told us they were well supported by the senior staff and management team. They received regular supervision and an annual appraisal.

We looked at the complaints process in the home.

Some people living at the home were unable to fully communicate with us, due to their health needs, so we used a short observational framework tool (SOFI) to observe the support they received and how they responded to it. We saw people being prompted appropriately; so that they were able to do things for themselves safely.

An expert by experience took part in this inspection and talked to the people who used the service and their visitors. Our experts by experience are people of all ages, from diverse cultural backgrounds who have used a range of health and/or social care services. They looked at what happened in the house groups and what it was like to live there. They took notes and wrote a report about what they found and details were included in this report.

We saw that documentation was up to date and reflected the current condition of people living in the home. We saw that staff were trained to safeguard people from abuse and had a good understanding of what constituted abuse and how to look for signs. We spoke with staff that told us they enjoyed their work and they were able to discuss their individual roles and responsibilities. The results of a questionnaire, sent to relatives had been fed back to the home manager which had demonstrated almost full satisfaction in all areas.