Westfield House

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 changed to good. This meant people were safe and protected from avoidable harm.

The provider was previously in breach of the legal regulation in relation to
safe staffing. Improvements were found at this assessment and the provider was no longer in breach of this regulation.

This service scored 69 (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.

There was a learning culture in the service, which the registered manager was improving. Staff were aware of procedures to follow to report and record incidents. The registered manager reviewed and analysed accidents and incidents to identify themes and trends, and feedback was provided to the staff team. The manager shared this with staff through daily ‘flash’ meetings and regular team meetings. Staff told us communication had improved, and they were listened to ensuring lessons were learnt.

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.

The service collaborated with people and healthcare partners to establish and maintain safe systems of care, ensuring safety was effectively managed and monitored. People had initial assessment documents in place which covered all appropriate areas and helped to formulate their care plans.

Records showed people were referred to other healthcare professionals when needed. There was a weekly GP review, and staff told us it was easy to contact a GP for advice between weekly visits. Staff told us they worked well with health and social care professionals and had developed good working relationships. Staff followed clear processes to ensure people’s current information was safely shared.

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.

Staff received training in safeguarding and demonstrated their understanding of safeguarding issues, including the procedures for reporting concerns. They expressed confidence in the management team responding appropriately to any concerns they raised.

Where previous safeguarding issues had been raised, these had been thoroughly investigated and the outcome recorded and shared to reduce future risks.

People told us they felt safe. One person said, “Oh I feel very safe. It’s never occurred to me not to feel safe.” Relatives told us they felt able to raise any concerns or worries they might have with staff or the registered manager.

The provider 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.

Risk assessments addressed all aspects of people’s care and support needs.Risks to people’s health and wellbeing had been identified, assessed and planned to support them to stay safe. Records showed staff followed the assessments to keep people safe. Staff knew people well and understood the risks people were exposed to.

We observed staff supporting people to move safely around the service using the correct equipment. Staff told us they had enough information about people’s risks and used the electronic care planning system.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Records showed checks on equipment were undertaken to ensure they were safe for use and fit for purpose, this included mobility equipment and portable electrical appliances. Fire safety was regularly checked, and staff had received fire safety training and attended fire drills to help keep people safe in an emergency. Each person’s records had guidance in place relating to the support required if the service needed evacuating. There was a contingency plan in place which provided guidance in an emergency, including a gas leak or flood.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Staff were recruited safely and had robust pre-employment checks carried out before starting work. We observed there were enough staff available to support people safely on both days of our site visit. New staff received an induction when they started work which provided them with the training needed. Staff told us this was regularly refreshed. Training was provided in a range of areas including specialist training for behaviour support, diabetes and dementia.

There was some agency staff being used to cover gaps in staffing numbers at short notice. The registered manager told us they used the same agency staff who knew people well.

We received mixed feedback regarding staffing levels. One person told us, “It takes more staff to take me for a shower. They are a bit stuck for staff.” A relative told us, “On the whole I think they have enough staff to meet the needs of the residents, and they do seem to have some time for staff to sit and talk to residents. If they notice a resident become a bit agitated especially if with another resident, then they do respond quickly and remove the person in a gentle way so that they deescalate the situation.”

The provider did not always assess or manage the risk of infection.

While the service was clean overall, we identified paintwork to handrails throughout the service were chipped exposing porous wood meaning they could not be cleaned effectively. The carpet in the main lounge area was also observed to be heavily stained. However, there was an ongoing programme of refurbishment and redecoration at the service which included plans to replace the carpet.

No concerns were raised with us from people or relatives about infection prevention and control. One relative told us, “The environment is always very clean and there are no trip hazards or anything.”

We observed staff following safe infection prevention and control guidelines. Staff wore personal protective equipment when needed. The provider shared concerns with appropriate agencies promptly where required.

The provider did not always make sure that medicines and treatments were safe.

Medicines were not always stored safely. While regular storage temperature checks were being completed, we identified on numerous occasions the fridge temperature had dropped to below the required 2°C and this had not been actioned. Not storing in line with recommendations can affect the efficacy of the medicines, however it was reported to the registered manager during the assessment and was rectified immediately.

If people had ‘as required’ medicines, there were protocols available to guide staff on when to administer them. Staff had received training on medicines administration, and their competence was checked by senior staff.

The provider involved people and their relatives in planning, including when changes happened to people’s medicines. Comments from relatives included, “They changed one of [Relative’s] medications to a patch and the seniors talked us through the pros and cons before it was done so we feel very involved.” And “I do feel that they are responsive to any changing of [Relative’s] needs for example if [they are] not responding to the medications then they have the GP in to review [their] medication.”