Westminster 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. This is the first assessment for this newly registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 75 (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. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

When incidents and accidents happened, these were reviewed and discussed with the staff team so any improvements could be implemented. The management team had several audits they used to monitor improvements and help make sure actions were being taken to improve the experience for people using the service. Staff adapted their practice when supporting people based on learning from incidents and accidents. For example, if people had more incidents at a certain time of day, management and staff would look at potential reasons for this and adapt their support accordingly.

The provider always worked with people and healthcare partners to design, establish and maintain safe systems of care, in which safety was always well managed and monitored. They made sure there was always continuity of care, including when people moved between different services.

Staff contacted professionals such as GP’s or social services, if people needed support. If professionals gave advice that needed to be followed, this was recorded and staff followed this. The management team made sure any changes to people’s support after visiting other services were clearly recorded and shared with the staff team. One relative told us, ‘‘[Family member] sees [health professionals] whenever they need to, and the staff let us know how things are going.’’

One partner told us, “The provider that works very well with health professionals. They are very organised, attend all meetings to present client reports, advise staff to implement the health team's guidance, and effectively supervise implementation.”

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 with the staff who supported them. People’s relatives said they felt confident that the service would listen to them if they raised any concerns or experienced a situation which made them feel their loved one was unsafe. A person’s representative told us their loved one was safe with the staff who visited and commented, “I have no concerns, staff make sure [person] feels safe.”

We observed staff being patient with people and supporting them in line with their risk assessment to keep them safe. For example, a member of staff supported a person to prepare and eat their lunch. This was done at the persons pace with no rushing.

The management team and staff demonstrated a clear understanding of abuse and neglect and knew how to recognise signs that may indicate a person was at risk. Staff gave examples of things they looked out for to help make sure people they supported remained safe.

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.

People were unable to give us feedback verbally about managing risks. People's care plans contained detailed risk assessments linked to their support needs. These plans included details about people's individual health conditions and how staff safely supported them.

Staff understood the need to protect people and keep them safe while enjoying their local community. Staff knew people well and how to manage their risks. One member of staff told us, "We are always risk assessing because things can change and we need to act and support people as soon as we can. The risk assessments are a useful tool, and they help give us guidance.”

Our observations showed staff supporting people safely and managing risks to their welfare and safety. People were supported to carry out tasks around the service that could place them at risk. For example, assisting to make lunch, their risks were assessed, and staff kept people safe.

Risk assessments were in place to support people to be as independent as possible and provided clear and relevant guidance for staff. The risk assessments covered all aspects of people's health, daily living, and social activities. People were kept safe by staff regularly reviewing and updating their risk assessments as needs, interests, and activities changed.

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

Each person had their own bedroom with en-suite. Their room was personalised to reflect their interests and hobbies. A relative commented, “The home is lovely. It’s always clean and bright and [family member] is proud of their room.”A professional said, “Westminster House presents as clean, tidy, personalised with clients’ pictures and activities.”

Staff completed checks of the houses throughout the day and night to observe and monitor any risks. We found the service was clean and well maintained. Routine testing took place in relation to testing of fire alarms, water temperature testing including tests to protect people from the risk of Legionella.

Environmental risk assessments were in place such as fire safety, gas safety and water safety. These were up-to-date and where issues were identified, these had been addressed or there was a plan in place to address them.

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.

There were enough staff to support people safely. People had the correct staffing level throughout the day. For example, people who needed 2 or 3 staff to support them in the community always had this available, so they could leave the service when they chose to. Staff told us there were enough staff to support people and people’s assessed staffing levels were adhered to at all times. Staff were very present at the service, always being on hand to support people at any given moment.

We observed enough staff on duty to meet people's needs. We observed staff to use their skills and knowledge when supporting people living with learning disabilities and autism in a kind and dignified manner.

There were safe systems and processes for the recruitment of staff. We looked at the records of three staff recruited and saw all the required checks had been made before they commenced employment. Staff were provided with a comprehensive training programme to support them in their role. They received specific training to support to ensure they can meet the needs of autistic people and people with a learning disability. Staff rotas showed that sufficient numbers of staff were consistently deployed to fully meet people’s needs.

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

The provider assessed and managed the risk of infection. Staff were trained in infection and prevention control (IPC) and told us they had the necessary equipment to keep the service clean. We observed the service to be visibly clean. Staff supported people to take part in cleaning some areas of the service if they chose to do so. Audits and checks were in place to monitor the cleanliness of the service and the effectiveness of the IPC measures in place.

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.

Effective medicines management systems were in place. The provider had implemented an electronic system for monitoring medicines administration. People’s medicines support needs were documented in their care plan. Care staff recorded medicines administration electronically so that the office could monitor this in real time. We looked at a sample of Medicines Administration Records (MARs) and found that these were completed fully indicating that medicines had been administered as prescribed.

One relative told us, “We know now when [person] takes their tablet. The carers or management will let us know if they refused, but so far everything is fine.”

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened. People’s medication was reviewed to ensure people's behaviour was not controlled by excessive and inappropriate use of medicines. The service understood and implemented the principles of STOMP (stopping over-medication of people with a learning disability, autism or both).

Staff had their competency to administer people’s medicines safely assessed to help ensure they had the skills and knowledge to do so. Staff told us they had received the appropriate training and were confident in administering medicines to people, when required. The systems used for auditing medicines were reliable and robust. We saw the service closely monitored people’s medicines and kept detailed records of all anomalies regarding these.