Westhope Place is registered to accommodate up to seven people who require support with personal care. It specialises in supporting people with a learning or physical disability. At the time of our inspection there were six women using the service one of whom also had mental health diagnosis. The property is located a short walk from Horsham town centre. There is level access throughout and each bedroom has en-suite facilities. The service also had an adapted bathroom with a high / low bath, overhead tracking and a hoist. This inspection took place on 8 February 2016 and was unannounced.
At the time of this inspection the service did not have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. The day-to-day management of the service was being overseen by a manager who is referred to as the acting manager throughout this report and the provider had given us assurances that the process for submitting a registered manager’s application had been initiated.
Whilst the provider had completed identity and security checks for new staff the character references obtained had not always been provided by the staff member’s previous employer. Full work histories had not always been obtained and gaps in the employment history of some staff had not been accounted for. Therefore the provider could not be assured these staff were suitable to work with adults at risk.
People’s independence was promoted and they participated in a range of activities of their choice such as going to the pub or a café for lunch and going shopping. One person told us “I like colouring and I like going on holiday. In the summer we go on day trips to Eastbourne, London, Brighton and Worthing. On Thursday I’m going shopping and going to the Gateway Club”.
People were supported by kind, caring staff that knew them well and understood their individual needs. One person told us “The staff are very nice and kind. I’m happy with the staff”. People’s relatives and representatives reported that their loved ones were supported by caring staff. One relative told us “It’s a peaceful, friendly home. I feel at home there and feel very happy she is there. They are doing the best for her as far as I can see”.
People could choose their own meal and drinks. One person told us “We have nice food for breakfast and lunch and nice tea. We have all sorts of things. Sometimes we have meetings about what we have to eat”. People were supported to maintain relationships with people that mattered to them and visitors were welcomed. One person's relative told us "I visit at all times of day, they never know I’m coming, I just pop in when I’m in the area". People's relatives and representatives were kept informed of their loved one’s wellbeing and any changes in their needs. One person's representative told us they had been "very impressed" with the support their loved one had received through a period of ill health.
People’s needs had been assessed and planned for. Plans took into account people’s preferences, likes and dislikes and were reviewed on a regular basis. Staff worked in accordance with the Mental Capacity Act (MCA) and associated legislation ensuring consent to care and treatment was obtained. People were supported to make their own decisions and where people lacked the capacity to do so, their relatives and relevant professionals were involved in making decisions in their best interest.
Medicines were ordered, administered, stored and disposed of safely by staff who were trained to do so. Referrals were made to relevant health care professionals when needed and each person had a health action plan in place.
Staff received the training and support they needed to undertake their role and were skilled in supporting people. A staff member told us, “I did shadow shifts when I first started. I didn’t work on my own until I had been shown what to do and had got to know people”. Staff had a good understanding of each person’s communication needs and of how some people communicated their feelings through their facial expressions or their actions. They were able to recognise when a people were feeling anxious and took appropriate action to minimise these anxieties.
Staff knew what action to take if they suspected abuse had taken place and felt confident in raising concerns. Risks to people were identified and managed appropriately and people had personal emergency evacuation plans in place in the event of an emergency. Staffing levels were sufficient to meet people’s assessed needs and for staff to spend one to one time with people.
The management of the service were open and transparent and a culture of continuous learning and improvement was promoted. The provider had ensured processes in place for auditing and monitoring the quality of the service were followed and complaints were responded to appropriately.
We found one area where the provider was not meeting the requirements of the law. You can find what action we have told the provider to take at the back of the full version of the report.