Archived: Westy Hall Residential Care Home

The last inspection took place in May 2014. At that time the service was not in breach of any of the Regulations.

Westy Hall is close to bus routes, local shops and other public amenities. It is registered to provide care for up to 39 older people. Ten of the places provide accommodation and care for people living with dementia, within a dedicated unit. The service is run by CLS Care Services Limited, a not for profit organisation that runs a number of homes in the North West of England.

On the day of our inspection there were 34 people living in the home.

The home had a registered manager who had been in post for six and a half years. 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 we spoke with were happy with the care they received. We observed caring relationships between staff members and the people living in the home.

Some people who used the service did not have the ability to make decisions about some parts of their care and support. Staff had an understanding of the systems in place to protect people who could not make decisions and followed the legal requirements outlined in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS).

People's needs were assessed and care plans identified people's needs, whilst fostering and maintaining independence where possible. People's care and support needs were met and their medicines were administered appropriately. Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as necessary to maintain their health or support them at the end of life.

The organisation had thorough recruitment practices so that suitable staff were employed. They received induction and training to meet the needs of people living at the home and were well supported by the manager. This meant people were being cared for by suitably qualified, supported and trained staff.

We saw that the service had a safeguarding policy in place. This was designed to ensure that any safeguarding concerns that arose were dealt with openly and people were protected from possible harm. Staff were knowledgeable about the risks of abuse and the reporting processes.

There was a flexible menu in place which provided a good variety of food to the people using the service. There was also a programme of activities to provide people with options for meaningful activity and social stimulation.

The registered provider had a quality assurance system that included seeking the views of people who used the service, staff and visitors. This helped to develop and drive improvement.

During our two day inspection we spoke with the registered manager, home services manager, five staff, four relatives, a health care professional and nineteen people who used the service. Some of the people living in the home were unable to talk to us about their experiences so we carried out an observational activity called a "Short Observational Framework for Inspection" or SOFI. SOFI is a specific way of observing care to help us understand the experience of people who may have difficulty expressing their views.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Policies and procedures had been developed by the registered provider (CLS) to provide guidance for staff on how to safeguard the care and welfare of the people using the service. This included guidance on the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS).

The registered manager reported that they had completed training on the MCA and DoLS together with some senior staff. We noted that the manager was seeking training for other staff from the local authority to increase their awareness and knowledge.

The manager advised us that appropriate procedures, including review were in place should anyone need to be subject to a Deprivation of Liberty Safeguard (DoLS) application or plan. DoLS is part of the Mental Capacity Act (2005) and aims to ensure people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom unless it is in their best interests.

The registered provider had developed a 'safe and secure handling and administration of medicines' procedure to provide guidance for staff responsible for the administration of medication.

We observed a member of staff administering medication and reviewed a sample of Medication Administration Records (MAR) within the residential area during our visit. The MAR viewed had been completed to a satisfactory standard and contained a running balance of medication stocks. Systems were also in place for the return of medication.

Is the service effective?

Comments received from people using the service included; 'This is my home and I view the staff as my family. The carers are always civil and polite'; 'I am very well cared for and couldn't be any happier'; 'It's not a bad place to live. There is plenty to do and I'm looking forward to playing bingo later'; 'I played table tennis today and sometimes I play the piano too' and 'I have no complaints. I am looked after well and the manager and staff are lovely.'

Likewise, feedback received from relatives included: 'Overall we are very happy with this home. It always smells beautiful and staff are always visible should assistance be needed' and 'In my opinion the standard of care here is excellent. I visit regularly and have no concerns.'

We noted that people using the service were offered a choice of meals and support was available for people requiring support with eating and drinking. Comments received from people using the service included: 'The meals are fabulous'; 'I get a choice of what I want to eat and the food is nice' and 'There is always sufficient to eat and drink here. You don't go hungry.'

Is the service caring?

We talked with the staff and watched their interactions with people using the service during our visit. We observed staff spending time engaging with the people living at Westy Hall in a respectful and dignified manner. Staff were also noted to be responsive to the needs of the people using the service.

Some of the people living in the home were unable to talk to us about their experiences so we carried out an observational activity called a "Short Observational Framework for Inspection" or SOFI. SOFI is a specific way of observing care to help us understand the experience of people who may have difficulty expressing their views.

The atmosphere in the home was relaxed and sociable. We observed staff carrying out their duties and responsibilities with confidence and skill, in good humour and in a relaxed and positive manner. Interaction between staff and people using the service was also noted to be positive and people appeared happy and content in their home environment.

Is the service responsive?

The provider had developed a comprehensive care planning document entitled 'My life plan'. We sampled a selection of three life plans and found that plans had been written in a person centred manner. This means that the individualised care plans focused on the person's individual assessed needs and on how they could be met. The care plans focused on providing support to an individual in different aspects of their daily life, for example, how the person was to be supported with communication or getting out and about. Records viewed had been kept under review each month and updated when necessary.

Is the service well- led?

The registered manager has managed Westy Hall for approximately four years and worked well with the Care Quality Commission (CQC). The manager is aware of the need to keep CQC updated on any significant events via statutory notifications.

Staff spoken with during the inspection confirmed they felt supported in their role and confirmed they had access to regular supervision and support. Staff also confirmed they had confidence in the manager's leadership.

The service continued to utilise a comprehensive internal quality assurance system and has developed systems to involve and obtain feedback from people using the service and / or their representatives. This showed that the provider ensured that there was an effective system to regularly assess and monitor the quality of service that people received.

People using the service at Westy Hall confirmed that they were treated with respect and their dignity was maintained. People also told us that they were satisfied with the standard of care provided and were of the opinion that staff understood their needs.

Comments received from people using the service included: 'I've just come back from a Christmas meal at the Hollow Tree pub. It was great'; 'The care staff are wonderful and go out of their way to help'; 'I love living here. It took me a while to settle but the care is superb'; 'Up to know my experience of living at Westy Hall has been first class'; 'The manager and staff are always friendly and helpful'; 'I'm quite happy and the food is wonderful' and 'There is always plenty going on and we have activities that we can join in with if we want.'

Systems were in place to offer protection to the people who use the service from abuse and people spoken with confirmed that they felt safe and had no concerns regarding the care provided.

Comments received included: "If I had a problem I would tell the manager'; 'I'm very happy with the standard of care I received but I know how to complain should a problem arise' and 'I have every confidence that if I needed to complain the problem would be rectified quickly.'