Westbury Court Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this newly registered service. This key question has been rated Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

Staff asked for consent before any care intervention was undertaken, but records did not demonstrate people’s mental capacity had been assessed or best interest meetings had been held. People’s needs were assessed before moving to the service and regularly thereafter to ensure the care provided remained suitable. Staff used nationally recognised tools and worked with other professionals to ensure best practice. People were encouraged to remain as independent as possible and live healthier lives.

This service scored 71 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People received a detailed assessment before being offered a placement at the service. This ensured the home was suitable and able to meet their needs. Records demonstrated further assessments were regularly undertaken thereafter. These covered the person’s physical and mental health, including areas such as falling and malnutrition.

The provider planned and delivered people’s care and treatment with them, including
what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

The service used nationally recognised assessment tools. This included an escalation tool which was used to assess people’s clinical condition when they became unwell.

Records showed people’s nutrition and hydration needs were assessed and any weight loss was monitored and raised with the GP. Specialist advice was sought, when people’s nutritional or dietary needs changed. For example, staff had liaised with the speech and language therapist (SALT) about one person’s swallow reflex. People were supported to have adaptive cutlery as needed and some people had non-slip, raised edged plates. This promoted independence and minimised the risk of any food being spilt.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff told us they had good relationships with other healthcare professionals. They said the doctor reviewed people by phone every week and visited as needed when called. Another staff member told us the pharmacist also called weekly. Staff knew how to make specialised referrals. This included requesting a dietician and the speech and therapist through the doctor and speaking to district nurses to request a tissue viability nurse. Records showed some people were supported by the care liaison team. This is a specific team who supports, educates and trains care home staff in managing and caring for older people with mental health problems.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Leaders told us people were encouraged to eat healthily and go into the garden for fresh air. Staff confirmed this and said being outside helped some people’s mental health and overall wellbeing. They said some people benefited from going out for coffee or a trip to a local garden centre. One member of staff told us fresh produce, which people helped grow in the vegetable garden, was enjoyed and gave people extra vitamins.

Leaders told us the menu was balanced and based on people’s preferences. There was a choice of food and people were offered an alternative if they did not like what was on the menu. Leaders told us the chef always visited a new person to the home to discuss food and drink preferences. They also attended resident meetings and visited people individually as part of the ‘Resident of the Day’ initiative. This enabled a representative from each department to review their speciality with each person to ensure satisfaction.

People were generally positive about the food provided. One person told us the food was ‘delicious’. Other comments were ‘[Family member] enjoys the food and has always commented there is plenty, and she has choices” and “Prior to the new owner, the food was hit and miss but things have changed.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Records demonstrated monthly review of care interventions. This ensured the person received safe, responsive care which met their individual needs. People also had yearly care reviews, which could be more frequent if needed. Relatives or other representatives were able to attend if the person consented. This enabled a range of feedback to be sought and used to improve the person’s care.

Focus was given to improving outcomes for people through social activity provision. There was a team of designated activity staff who were responsible for individual and group activities. Staff told us all activity provision was based on individual preferences and were both inhouse and within the local community. They showed us photo albums which contained photographs of experiences people had enjoyed.

People were encouraged to have visitors in private or in communal areas including the garden. Relatives were encouraged at any time and welcomed by staff. They were complimentary about care provision, with one relative stating “[Family member] looks better than they have for a number of years.”

People’s experience

The provider did not always tell people about their rights around consent and did not
always respect their rights when delivering care and treatment.

Consent forms were not always fully completed, and records did not demonstrate mental capacity assessments or best interest decision meetings had been undertaken. For example, one care plan showed the person’s care was delivered in their best interests, but there was no information to demonstrate how this decision had been reached.

Consideration had been given to some restrictive practice such as the use of bedrails. However, records did not demonstrate how staff had reached the decision to use them. The use of sensor mats had not been assessed. Sensor mats alert staff if the person stands or tries to walk unaided, so are deemed restrictive. A member of staff confirmed mental capacity assessments were not completed for sensor mats, but they would ensure these were undertaken in the future.

Staff told us they offered people as much choice as possible and asked for their consent before any care intervention. This included asking people where they wanted to sit, what they wanted for their meal and if they needed any help. This was observed during our inspection when staff asked, “Would you like to come with me to the bathroom?” and “What can I get you? Orange or blackcurrant?” One staff member told us it was important not to assume and always give a person choice.