Westwood House

We found the following examples of good practice.

¿ There was protocol in place to ensure that all visitors were supported to complete the screening process and adhere to safe hygiene procedures before entering. There was a clear process for the booking and managing of family visits to the service.

¿ The service has devised a Covid-19 admissions flow-chart to ensure all new admissions are completed following current best practice guidelines.

¿ Staff were observed using the appropriate personal protective equipment (PPE) . There were donning and doffing reminders and posters situated throughout the service.

¿ The home environment was extremely clean and well maintained. Cleaning staff followed an increased cleaning schedule. There were regular infection control audits and checks to ensure high standards of cleanliness were maintained.

¿ All staff received appropriate training on Covid-19, infection control and the use of personal protective equipment (PPE). A senior clinical development nurse has been stationed at the service during the pandemic to support the registered manager and staff in understanding and adopting the new ways of working.

¿ The service had considered the risks associated with health conditions and ethnicity for people receiving care and staff. The service was engaging in ongoing ‘whole service’ testing following current government advice.

Further information is in the detailed findings below.

Westwood House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The service can accommodate up to 49 people.

At the time of our inspection 39 people were living in the care home.

At our last inspection of the service on 18 May 2016 we rated them ‘Good.’ At this inspection we found the evidence continued to support the rating of ‘Good’. There was no evidence or information from our inspection and ongoing monitoring that demonstrated any serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Most people living in the care home and their relatives we spoke with told us they remained happy with the overall standard of care and support they or their loved one/s received at Westwood House. Staff consistently demonstrated warmth, respect and empathy in their interactions with people they supported at the care home. Our discussions with external community health and social care professionals supported this.

People continued to receive a safe service where they were protected from avoidable harm, discrimination and abuse. Risks associated with people’s needs including the environment, had been assessed and planned for and these were monitored for any changes. There were sufficient numbers of staff on duty to meet people’s needs and safe staff recruitment procedures were in place and used. The environment was kept hygienically clean and staff demonstrated good awareness of their role and responsibilities in relation to infection control and food hygiene. People received their prescribed medicines safely and these were managed in line with best practice guidance.

People continued to receive an effective service. Staff received the training and support they required including specialist training to meet people’s individual needs. People were supported with their nutritional needs. Staff identified when people required further support with eating and drinking and took appropriate action. The staff worked well with external health care professionals, people were supported with their needs and accessed health services when required. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The principles of the Mental Capacity Act (MCA) were followed. Since our last inspection the premises had been refurbished and decorated.

People continued to receive care from staff who were kind, compassionate. Staff treated people with dignity and respected their privacy. Staff had developed positive relationships with the people they supported, they understood people’s needs, preferences, and what was important to them. Staff knew how to comfort people when they were distressed and made sure that emotional support was provided. When people were nearing the end of their life, they received compassionate and supportive care. People were supported to do as much as they could and wanted to do for themselves to retain control and independence over their lives. People were supported to maintain relationships with their relatives and friends.

People continued to receive a responsive service. People’s needs were assessed and planned for with the involvement of the person and or their relative where required. People received person centred care and support that was tailored to their individual needs and wishes. Each person had an up to date and personalised care plan, which set out how their care and support needs should be met by staff. People received opportunities to pursue their interests and hobbies, and social activities were offered. There was a complaint procedure and action had been taken to learn and improve where this was possible.

The service continued to be well-led. The registered manager and senior nurses continued to be well-regarded by people living in the home, their relatives, external health and social care professionals and other staff who worked in the care home. The monitoring of service provision was effective because repeated shortfalls were identified and resolved. Accidents and incidents were analysed for lessons learnt and these were shared with the staff team to reduce further reoccurrence. The service had an open and transparent culture. People were asked to share their feedback about the service and action was taken in response.

Westwood House is a nursing and residential care home for up to 43 people. At the time of the inspection the service was providing support to 40 people.

The service had a registered manager at the time of the 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 in the service were safe because staff had the training and knowledge to identify abuse and take steps to protect people if they suspected they were at risk. Staff assessed people’s risks to ensure they were safe from preventable harm. People were assessed for their risk of pressure ulcers and action was taken when people’s skin integrity was threatened. There were enough staff available at all times to support people and they were recruited using robust procedures to ensure they were safe to work with potentially vulnerable people. Staff ensured that medicines were administered safely and that mobility equipment was safe to use.

Trained staff were supervised and their delivery of care to people was appraised by their managers. People consented to the support staff provided and staff delivered support in line with mental capacity legislation. People were supported to eat and drink sufficient amounts and support was provided to people with specific dietary needs. People had timely access to healthcare professionals and care plans were produced to implement professional guidance.

People received support from staff who were caring. People made choices about the care they received and they were treated with respect. Staff addressed problematic behaviours with kindness and sensitivity. People approaching the end of life were treated with compassion and dignity.

The service was responsive to people’s changing needs. People’s needs were identified through assessments and care plans were written to meet identified needs. People were involved in their assessments and care plans ad these were updated following reviews. People were supported to participate in a range of activities. People and their relatives had a number of opportunities to share their views about the quality of the service being received and complaints were dealt with appropriately.

The service was well run by the registered manager who was open in their management style. The quality of service delivery was the subject of on-going auditing and the service worked in partnership with other organisations to ensure people experienced good care.

People who use the service were positive about the care and treatment they received from staff at the home. One person commented "I'm very happy here." Another person told us "nothing is too much trouble for them."

We saw from the records we checked and from speaking to people who used the service they were able to express their views and make choices about where they lived and how their care and treatment was to be given.

We found that staffing levels were appropriate to meet the needs of people and staff were well supported by the provider. One person said "On the whole mostly they are good". Another said "They feed you up."

We observed staff supporting people in a friendly, patient and professional manner. Staff had a good understanding of the needs of the people they supported and the potential risks they faced.

People and their families told us they had good access to health care professionals such as doctors, dentists and chiropodists. Relatives told us that the home kept them updated about people's health issue.

We observed that people were treated with care and consideration. The staff asked for people's consent and acted in accordance with their wishes. We observed that staff offered options, and people gave their verbal consent before they received care and support. People were treated with dignity and respect.

We saw that in most cases, people using the service had up to date care plans and risk assessments. People told us that they were involved in their care planning, and that staff listened to their views and opinions. We observed that people using the service knew the names of their key care staff. Staff and people using the service felt there were enough staff available.

There were suitable arrangements in place which ensured the safe management of medicines.

We found that there were good quality assurance systems in place and opportunities for people to tell the provider what they thought about the service and how it could be improved.