Westwood

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 Good. At this assessment the rating has remained Good. This meant people were safe and protected from avoidable harm.

This service scored 78 (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 promoted a proactive and positive culture of safety based on openness, learning, and improvement. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Staff said they felt comfortable raising issues with management. A staff member commented, ‘I feel comfortable raising concerns because the management team encourages open communication and takes concerns seriously. I understand my duty of care and would always report anything that could affect people’s safety. Following incidents or audits, risk assessments and care plans are updated, additional training is provided where needed and new procedures are introduced to reduce the chance of similar incidents happening again.’

Duty of candour and accident reporting policies were in place and accessible to staff. Incident forms were completed and analysed for themes. We saw evidence of lessons learned with staff through the electronic care record system which also tracked when staff had read any messages to ensure learning took place.

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.

People experienced safe care, with effective systems for managing risks and transitions. Referrals to partners were made in a timely way.

Systems were in place to provide information to healthcare partners in the event of an emergency admission to hospital. Care plans were reviewed if people’s needs changed following discharge from hospital. Care records included information from hospitals to support these reviews.

A staff member commented, ‘Our manager regularly prompts all staff to read through care plans, which has supported taking the initiative to ensure that care plans are read thoroughly when we welcome a new resident to the home, if a resident has returned from hospital, or when a resident may be experiencing a mental health relapse, for example.’

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.

People felt safe. A person said, “It’s a safe place. I feel safe here and the staff are lovely and protective and keep me safe and secure.” Another person said, “I like it here because it's very safe.” A relative said, “I feel confident that [my family member] is safe here.”

Staff understood their safeguarding responsibilities. They were able to explain the actions they would take if they suspected abuse. Staff had completed safeguarding training and safeguarding policies were in place. Accessible information on safeguarding was available to people who used the service.

Safeguarding records were in place which included referrals to the local authority and notifications to the CQC.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). A DoLS policy was in place and a tracker was in place to ensure appropriate and timely action was taken in relation to people with an authorised DoLS in place. DoLS conditions were being followed by the service.

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.

Leaders and staff supported people to effectively manage known risks. All areas of risks identified for people were clearly assessed and planned for. This included a distress assessment which identified actions to take if a person was assessed to be at risk of distress. We found care plans contained best practice guidance for staff to follow. This included a cognition and mood care plan, as well as guidance for specific risks such as choking. Staff completed training regarding the management of risks including positive behaviour support and crisis management, choking and first aid training.

Documentation was completed when people showed distress and these events were analysed to minimise the risk of reoccurrence. Staff told us they always involved people as much as possible in decisions about their care which included positive risk-taking.

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

People told us they were happy with their rooms and knew where the call bells were if they needed assistance.

The premises were very well maintained, comfortable and safe. The front garden was well-kept and plans were in place to improve the rear garden area.

Ongoing work was taking place in the home during the assessment to further improve the home environment. Any work that took place was planned to minimise disruption to people living there and management told us that they had helped to supervise the main entrance while the corridor floor was being replaced outside normal working hours to minimise disruption. Electrical work was being completed during the assessment and management told us that this was being carried out over an extended period of time, small parts of the home at a time, to minimise the impact on people.

Staff had completed training in areas relevant to maintaining a safe environment. For example, in health and safety and fire awareness, as well as how to safely store and use cleaning chemicals and legionella awareness. Our observations showed the care home environment had implemented measures to ensure a safe environment. For example, window restrictors prevented windows being opened too far, heavy items of furniture, such as wardrobes were securely fastened to walls to prevent them from tipping over. Cleaning chemicals and medicines were stored securely.

The provider organised and maintained safety checks on all aspects of the premises, equipment and utilities. For example, documentation was in place to show safety checks were made on gas safety, portable electrical appliances, and water safety checks to ensure the risk of legionella disease was well managed. Risks from hot water were managed and equipment used to transfer people, such as hoists, slings and the passenger lift were all regularly serviced and checked.

Health and safety policies were in place and health and safety audits took place.

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.

People told us that it felt like the service was a little short of staff when they wanted to go out somewhere but some people also told us that staff did regularly accompany them out of the home. A relative said, “There are always plenty of staff on, there's always someone with the residents, they are never left alone.”

We observed that staff were available at all times during our assessment and people did not wait for support. The registered manager explained staffing levels were set having, ‘… completed a dependency-based assessment considering resident occupancy, dependency levels, individual risk assessments, appointments, clinical needs, incidents, and the overall day-to-day operation of the service.’

Staff told us that there were enough staff to meet people’s needs. A staff member commented, ‘Our manager provides a rota that is fair to our team and ensures residents have an appropriate and safe amount of staff in the building at all times. If there is any staff sickness and cover is required, this is covered promptly and I don’t ever have to worry that our residents and team wouldn’t have enough staff in the building.’ Another staff member commented, ‘Staffing levels and ratio I feel are correct. This is due to mornings having 4 staff members as during the weekdays there is appointments, visitors, phone calls and 1 to 1 taking place. This also allows time for key working and spending 1 to 1 time with the residents.’ Staffing levels were maintained to meet people’s dependency levels and rotas showed staffing was consistent.

Staff told us that they felt very well supported and received induction, training, supervision and appraisal. A staff member commented, ‘Our manager will communicate with us and ask how we feel regarding any further training and give staff members the opportunity to complete this. I have recognised the value of our manager’s experience and knowledge and how this has supported my own ongoing learning. Our manager is great at recognising strengths and areas of improvement, and I feel that staff members are provided with equal opportunities with training and ongoing learning.’ Another staff member commented, ‘I am well supported by managers and leaders because they give me clear guidance, provide regular feedback, and make sure I have the training and resources I need to work safely. They are available when I need help, encourage good communication, and check in to make sure I understand my role. This support helps me feel confident, valued and able to provide safe effective person-centred care.’

Records showed that staff had completed an induction and received regular quarterly supervision and annual appraisal. Quarterly spot checks of staff competency were also completed by management. The registered manager provided some tutoring to staff in her own time and the range of training completed by staff was wide-ranging. Training included usual mandatory training in areas like safeguarding and infection control but also widened to specific mental health conditions, for example, personality disorder and physical health specialty training, for example, sepsis. The training matrix listed over 80 courses which included in person and online training. Staff completion of this training was very high.

Staff recruitment processes were followed to ensure all the required checks for when staff worked in care had been completed. This included obtaining references of previous work experiences, checking the reasons for any gaps in employment history, obtaining a Disclosure and Barring Service (DBS) check. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

The provider thoroughly assessed and managed the risk of infection. They always quickly detected and controlled the risk of it spreading and always shared concerns with appropriate agencies promptly.

Nearly every person spoken with commented specifically on how well the housekeeper cleaned their room and their bed linen. People were also very happy with the laundry service. A relative said, “The home is spotlessly clean.” Another relative said, “It’s very, very clean.”

The home was immaculately clean in all bedrooms and communal areas. Staff were observed to follow appropriate infection control practices throughout the assessment. A staff member commented, ‘I follow hand hygiene procedures, wear the correct PPE, clean equipment properly and safely dispose of waste. Yes, we have access to gloves, aprons, masks, hand sanitiser and cleaning products whenever needed.’

Suitable equipment was in place to enable effective infection prevention and control (IPC). Cleaning schedules were fully completed and comprehensive IPC audits and checks took place of the premises and equipment used. Staff completed regular training.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Medicines were managed safely and effectively. Staff received training and their competency was assessed. Medicines policies were in place.

People did not raise any concerns regarding medicines management at the service.

Medicines audits were completed; medicines errors were investigated and lessons learned shared with staff.

Protocols were in place for ‘as required’ medicines. The registered manager had identified that these required further detail and work was in progress to do this.

Creams and medicines were stored securely in bedrooms with temperatures being monitored. Processes were in place to move medicines into the clinical room if temperatures became elevated. A number of people required blood monitoring because of the nature of the medicines they were taking and the provider had systems in place to ensure this took place at the required frequency.