Westwood

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question Good. At this assessment the rating had changed to Outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 88 (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 always made sure people’s care and treatment were effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

People were actively involved in reviewing their care and support, enabling them to discuss their changing needs, preferences and goals and ensure their care remained relevant and responsive to their individual circumstances. Discussions took place regularly and where people’s circumstances changed, which enabled staff to respond quickly and tailor support in line with what mattered most to them. Families were also involved in annual reviews where appropriate. A relative said, “I was asked my views about [my family member’s] care preferences right at the beginning and they ask me each time they call.”

Staff demonstrated a detailed understanding of people's health, wellbeing and communication needs, People’s needs were assessed and reviewed regularly. Clinical assessment tools were used to support the assessment of needs and review including pressure care and oral health. This allowed prompt intervention and reducing the likelihood of deterioration. A range of policies were in place to support staff to meet people’s needs including catheter care and care for people at risk of choking.

Care plans were comprehensive, personalised and regularly reviewed. This included detailed information on clinical needs including diabetes which included information on symptoms of deterioration and when to request further medical advice.

Staff described a strong culture of communication and accountability. A staff member commented, ‘Changes to people’s needs are identified, recorded, and shared through a simple but reliable process that keeps everyone up to date. Care workers identify changes by observing the person’s behaviour, mood, mobility, appetite, or health, and by listening to feedback from the individual or their family. Any changes are recorded straight away in daily notes, updated care plans, incident forms, or monitoring charts so the information is accurate. These updates are then shared with staff during handovers and team meetings.’ This approach helped ensure support remained effective and focused on achieving the best possible outcome for people.

The provider always planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation. They worked to develop evidence-based good practice and standards.

Care and treatment reflected current best practice and guidance and were planned and delivered with people, focusing on what is important to them and supporting them to achieve their individual goals. The provider used recognised best practice assessment tools, including assessments of an individual’s risk of malnutrition and skin damage, to proactively identify risks and opportunities to improve people’s health and wellbeing. Policies were also in place to support staff which included guidance on catheter care and supporting people with epilepsy.

The service demonstrated an exceptional commitment to evidence-based care and treatment, using recognised best practice to achieve meaningful improvements in people’s health, wellbeing and independence. Leaders ensured care planning, risk management and clinical monitoring reflected current legislation, NICE guidance and recognised best practice. The provider used recognised best practice assessment tools including assessments of an individual’s risk of malnutrition and skin damage. However, leaders and staff went beyond following the guidance by working closely with people, their families and health care professionals to continually review and improve outcomes to improve people’s independence. A person said, “The staff and care they give are great, I really like them and being here.”

People consistently experienced highly personalised care that achieved positive health and wellbeing outcomes. Staff adapted support in response to people’s changes in needs and aspirations, helping them achieve outcomes that exceeded expected standards of practice. Examples included a person who, following support from staff and professionals was no longer under any formal restrictions regarding their mental health, significantly improving their independence, confidence and quality of life. People who had been supported to achieve and maintain healthier weights, to minimise risks to their health and the need for medicines and a person who had been supported to no longer need support around their continence care or the use of a pressure relieving mattress, leaders reflected that the person’s progress had been transformative, enabling them to live more independently. These outcomes demonstrated the provider’s commitment to helping people achieve meaningful and lasting improvements on people’s health and wellbeing.

Staff demonstrated a detailed understanding of people's nutritional needs, preferences and cultural requirements. Mealtimes were relaxed, inclusive and person-centred, with people encouraged and supported to maintain their independence wherever possible. People received assistance where they required it, Staff adapted their approach to ensure people were able to eat and drink comfortably and safely and with dignity. Staff told us that people’s cultural needs would be catered for. Staff wore appropriate personal protective equipment when serving food. People ate together in the dining room or ate in their rooms if they preferred to do so.

Feedback from people consistently reflected positively with the food provided. A person said, “The food is excellent.” Another person said, “It’s fantastic food and there’s always enough on the plate.” A third person said, “The food is very good and they look after you.” A relative said, “[My family member] is fussy about food and they always offer [them] an alternative.”

People were offered choices and staff were responsive to their wishes. A wide range of drinks were available throughout the day. Staff closely monitored nutrition and hydration and ice lollies were being eaten as the day got warmer. A person said, “There are plenty of drinks all day, and I do like the different juices.” The provider's focus on person-centred outcomes, partnership working and proactive intervention ensured people experienced care that promoted independence, improved health and supported a better quality of life.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff were confident in referring to other organisations. People received effective monitoring of their health and where concerns were observed, appropriate referrals to partner healthcare partners were made in a timely way. The registered manager told us that a hospital passport was in place for a person with a learning disability and contained personalised information about the person’s communication needs, health conditions, preferences and reasonable adjustments, supporting continuity of care during any hospital admission.

A professional commented, ‘Good communication although difficult to get through on the phone at times but I am usually copied into emails regarding my client that resides with them, they alert me to any early signs of concern to enable me to respond quickly.’ Another professional commented, ‘We have had no issues with communication, they follow the processes we have in place to support them.’

A staff member commented, ‘We work closely with GPs, district nurses, hospitals, occupational therapists and community mental health teams. For example, if someone’s health changes, we report our observations, follow professional advice and update the care plan to reflect any new recommendations.’

Staff described excellent communication within the service and that managers were described as knowledgeable and approachable.

The provider always supported people to manage their health and wellbeing to fully maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Leaders and staff demonstrated an exceptional commitment to supporting people to achieve the best possible health outcome. Staff worked proactively with people, healthcare professionals and community services to identify opportunities to promote good health, prevent deterioration and improve wellbeing. Support was tailored to each person’s goals and focused on enabling people to understand and manage their own health conditions, attend routine health appointments and make informed lifestyle choices.

Records demonstrated that this approach had led to significant and sustained improvements to health outcomes, increased independence and a reduction in future healthcare risks for people who used the service. A person had been supported through personalised health and nutritional support, enabling them to successfully manage their diabetes and no longer require medicines to manage their diabetes. Another person, who had previously declined healthcare interventions due to anxiety, was supported through a patient and person-centred approach to build trust and confidence, had been supported by staff to engage with healthcare interventions involving needles and to attend an eye operation which improved their health outcomes.

Staff were skilled and knowledgeable about individuals’ health and wellbeing needs, this meant they had the confidence to be proactive in their approach to improving people’s health and wellbeing need, which as a result meant peoples overall quality of life improved.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Outcomes were monitored and used to drive improvement. Monitoring tools were used to identify and then monitor any emerging healthcare needs and external professionals were involved in helping to address these needs.

Team meetings, supervisions and regular reviews of people’s care all considered outcomes and how to improve outcomes for people.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People’s consent was sought and respected. People raised no concerns in this area. A relative said, “I have no concern about staff not respecting [my family member’s] wishes.”

Policies were in place and mental capacity was considered where appropriate. Advanced decisions were clearly documented in care records.

Staff demonstrated an excellent understanding of the Mental Capacity Act. Staff had completed training on consent and the Mental Capacity Act. A staff member commented, ‘I always assume a person has capacity unless assessed otherwise. If they lack capacity, I follow the Mental Capacity Act, involve family members or advocates where appropriate, support best-interest decisions and encourage the person to be involved as much as possible.’