Westwood House

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 inspection we rated this key question good. At this inspection the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 66 (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 had a proactive and positive culture of safety, based on openness and honesty. Risks relating to closed cultures were identified and mitigated. Leaders investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. Staff told us they felt there was a culture of learning. One staff member told us, “We always do that if there is anything risky, or anything that happens, we sit down and discuss where we went wrong, how we can do it right if we face the similar incident and share ideas.” We saw learning took place following incidents and complaints. The operations manager told us that they had experienced a huge learning curve following recent times at the service,

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. Staff understood the process in relation to safe pathways, to ensure people safely transitioned to other services such as the hospital. People living at the service had ‘emergency admission packs’ to take with them if they were admitted to hospital, which contained information about people’s health needs, communication preferences and any other relevant information. Staff understood the process where a person was admitted to hospital. Relatives felt the service supported safe transitions into other services and told us staff stayed with people following admissions into hospital to promote continuity of care.

People and their relatives’ felt people were safe living at the service. The provider shared concerns quickly and appropriately. Staff understood signs of abuse and how to safeguard people. One staff member told us, “All sorts of abuse you put to safeguarding to protect the people you support.” The operations manager told us they ensured staff understood safeguarding through policies and procedures, staff training, and discussing safeguarding in meetings and workshops. Staff received regular training in safeguarding. There was a policy which outlined the service’s procedure. There were no restrictive practices at the service at the time of our inspection. However, one relative told us they had not been informed of incidents regarding their relative at the service. We raised this with the operations manager, who told us they would improve the shift handover to include reminders to staff to inform relatives of incidents and remind staff about recording incidents clearly.

Some staff raised concerns about how risks to a person’s health were managed following the removal of a safety gate into the kitchen. Some staff told us this was negatively affecting a person’s health. We raised this with the operations manager during the inspection who told us they had removed the gate as this was a restrictive practice. They told us, “Better plans were put in place to support [person] with managing [this condition], easy reads and social stories were also used to ensure [the person] was understanding… [person] has taken on board and his [condition is] being extremely well managed”. During the inspection we found one person had not been fully involved in supporting them to manage their own risks. The provider had implemented a strategy to manage a risk to a person living at the service. However, the person did not fully agree with this strategy. The provider had not worked with the person to find a more agreeable way of managing this risk.

However, staff had a good understanding of people’s risks. People had clear information within their care and support plans about how staff should manage any risks.

The provider detected and controlled potential risks effectively in the care environment. The provider completed regular health and safety checks and audits at the service. People and their relatives felt the environment was safe and free from hazards. People were protected from the risk of fire as the provider had completed the appropriate checks. There was an up-to-date fire risk assessment and the actions from this assessment had been completed. The provider made reasonable adjustments where appropriate. For example, a person had been offered a different bedroom at the service, following their needs changing. This was in line with ‘Right support, right care, right culture’.

Staff had completed a wide variety of training. However, some staff told us they felt more training was required in supporting people who experienced distressed behaviours. One staff member told us training should be individualised to a person’s needs. We found there had been a high number of safeguarding incidents at the service regarding supporting people with behaviours of distress. This meant the training available to support staff managing behaviours of distress may not have been effective.

However, staffing levels met the service’s assessed staffing dependency levels, and staff told us they felt these staffing levels met people’s needs. Most relatives told us they felt staffing levels met people’s needs. The provider made sure staff received effective supervision and development, in line with the provider’s policy. Staff had been recruited safely and in line with legislation. Staff competencies had been assessed prior to supporting people, in line with ‘Right support, right care, right culture’.
 

We received mixed feedback from staff and relatives about the cleanliness of the service. One staff member told us, “[The cleanliness of the service] is not up to what I would say is clean. It needs some improvement, the general cleaning, and especially [people’s] rooms”. Additionally, a relative also told us, “Room and hygiene is not as good as it could be, and I have complained in the past.”

However, other staff and relatives told us they felt the service was clean. One relative told us, “It always looks nice and clean there, yeah definitely. And tidy”. Staff felt there was enough PPE available and knew when this needed to be worn. Infection prevention and control (IPC) audits were completed in line with the service’s policies and procedures. The service was clean and tidy at the time of our site visit. Staff had completed training in IPC.

The provider made sure medicines and treatments were safe and met people’s needs, capacities and preferences. People were involved about decisions relating to their medicines in line with ‘Right support, right care, right culture’. Medicines were stored and administered safely. People had protocols for ‘when required’ medicines (PRN).

The service was following the principles of ‘Stopping the over medication for people with a learning disability’ (STOMP). People and their relatives felt that medicines were managed safely.

However, people did not have individual risk assessments for paraffin-based creams where appropriate, due to their flammable properties. We raised this with the operations manager who has since completed these risk assessments.