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Inspection carried out on 23 August 2019

During a routine inspection

About the service: Westwood is a residential care home that provides personal and nursing care for up to 24 people. At the time of our inspection 22 people lived in the service. Two people were in hospital but were expected to return to the service.

People’s experience of using this service:

People that we spoke to said that Westwood was a good place to live and that staff treated them with respect and kindness.

People’s health and social care needs were managed well by management and the staff team. There were positive relationships with professionals which supported people’s overall wellbeing.

Medicine was administered safely and there were clear protocols in place for medicine which was taken when required. Records were kept up to date and medication administration records (MAR) were all correct and checked by staff and the registered manager.

The registered manager showed evidence of ongoing quality monitoring across all aspects of the service. Any concerns raised by residents’ relatives or staff were investigated and addressed. This was also used to inform improved practices throughout the home.

People had enough to eat and drink. People were offered choices and had an input into the menu planning. The lunchtime experience was relaxed, and staff helped with serving meals and assisting people where necessary.

There were a variety of activities, both to keep people occupied and to entertain them. There were also physical activities to assist with people’s mobility. People were consulted on what they wanted to do, giving people choice and control.

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 inspection rating was good (published 24 November 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner

Inspection carried out on 24 November 2016

During a routine inspection

We inspected this service on 24 November 2016. This was an unannounced inspection and was the first inspection of this service.

The service was registered to provide support and accommodation to 24 people who may have a mental health condition or maybe living with dementia. There were 21 people living in the home at the time of our inspection.

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.

People felt safe and staff understood their role in protecting people from the risk of harm. Risks in relation to people’s daily life were assessed and planned for and these were discussed with people to ensure they understood how to keep safe. People’s preferences were incorporated in their support plan and there were regular reviews of people’s care to ensure it accurately reflected their needs.

The staff were friendly and professional in their approach and people were treated with dignity and respect and had their choices acted on. People could make decisions and chose how to spend their time; staff knew how to act if people did not have the capacity to make decisions and where restrictions were placed on people, applications had been made to ensure these were lawful.

The staff were kind and caring when supporting people and people were confident that staff supported them in the way they wanted. Staff had the knowledge and skills to provide safe care and there was sufficient staff available to support people the way that they wanted.

People could eat and drink what they liked. People enjoyed activities and opportunities to socialise. People stayed in touch with people who were important to them and spent time with friends and family in the home and could choose to stay away from the home. People knew who to speak with if they had any concerns and they felt these would be taken seriously. Arrangements were in place so that actions were taken following any concerns which were raised.

Health concerns were monitored and people received specialist health care intervention when this was needed. Medicines were managed safely and people received their medicines at the right time, as prescribed.

Quality assurance systems were in place to assess and monitor the quality of the service and the focus was on continuous improvement. There was regular communication with people and staff whose views were gained on how the service was run; their views were used to make continuous improvements.

Inspection carried out on 21 August 2013

During a routine inspection

People we spoke with gave positive feedback about living at Westwood. People told us they received good care and support and felt that their needs were being met. One person told us “I do like living here. Everyone is so helpful and supportive”. Another person said “When I first came here I was very quiet and timid. I would sit in the corner and not speak to anybody. Living here has helped me so much; I’m getting my life back on track. I’m speaking to you now, which I would never have done”.

People told us that the food at the home was very good and they always had enough. People said there was a menu planned for a month but they could request alternatives if they did not like the menu for the day. Staff, including the cook, we spoke with were aware of people’s dietary needs. They ensured that people’s dietary needs were always met.

We saw that the provider had effective procedures in place to ensure that people received their medicines safely. Some people self-administered their medicines and this was risk assessed by the provider before taking place.

The provider had sufficient staff to meet the needs of people using the service. People told us that there were always enough members of staff to provide help and support.

We saw that records kept by the provider were accurate, fit for purpose and kept securely. Records were regularly checked to ensure that they were accurate.

Inspection carried out on 23 October 2012

During a themed inspection looking at Dignity and Nutrition

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a Care Quality Commission (CQC) inspector joined by an Expert by Experience who has personal experience of using or caring for someone who uses this type of service.

We saw that people were encouraged to remain as independent as possible. People were encouraged to clean and tidy their own rooms, as well as do their own laundry. We found that people were generally supported by care workers in choosing how to spend their days. A number of people went out into the community independently during our visit. People were making good use of all three lounges, either watching television, reading a newspaper or writing letters.

One person told us “I like it here” and explained that it had been noisy in their previous care home. They also told us they had shared a room at their previous care home and now “I have my own room and I like that.”

People were generally positive about the food provided. One person told us the food isn’t bad, and they enjoyed traditional English food. Another person told us the food was alright but they were bored of the menus, “They never change them, I want some variety and it’s the same thing each week.” We looked at the menus and found that only one choice of meal was offered. We found that the planned menu was not being followed, which could potentially confuse people who used the service.

People told us they were generally happy with the staff’s attitude towards them, and how the service was run. One person said they felt much safer at Westwood than living on their own ‘outside’. Two people told us they would approach the manager if they wanted to complain. Staff had a good understanding of the forms of abuse people would need protecting from. They said they had no concerns to share with us about any risks to the safety of people who used the service.

We saw that most people did not seem to wait if they asked care workers for assistance. One person did comment that they like to go to the shops with a member of staff but they are unable to go as staff do not have the time to take them. Care workers told us they did not always have enough time for one to one activities with people depending how many staff were on duty.

We saw that people had been involved in developing their care plans and reviewing their care. However, we found that care plans had been written for all identified needs.

Inspection carried out on 20 September 2011

During a routine inspection

People told us that they were involved in making decisions about their care. They had a flexible routine and had their privacy and dignity respected.One said “they are all nice to you here”. Another person told us they were involved in making decisions about their care. They said “I have got a care plan and they (staff) ask me about it”. Three people told us that they had seen their care plan. One said “they (staff) ask you to read it and you have to sign it”. This person told us that they could see their care plan at any time and said “I think it reflects what my needs are, it mostly does”.

People told us that although there was not much to do during the daytime they were satisfied with the levels of activity provided. People could access their local community freely. One person told us “I might go into town this afternoon; I’ll see how I feel”.

People felt safe living in the home and also that staff had the right skills to care for them properly. Their comments included said “all the staff are alright here”; “I think they make you safe here” and “I talk to my key worker, they know about me”.

People felt consulted about the running of the service. One person told us “we have resident’s meetings about every two months”. They told us that they could say if they were not happy about anything and that their opinions were valued. Another person told us “I had a word with the manager this morning about something, I am sure she will sort it out”.

Reports under our old system of regulation (including those from before CQC was created)