The Westbury Care Home

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 69 (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.

People and their relatives told us they were confident that concerns raised would be addressed by leaders. We saw that regular feedback was sought from people and their families. The provider demonstrated how they recorded and took learning from incidents to improve support to people. The provider ensured learning was shared with staff,

Staff we talked to could explain the process for reporting safety incidents to leaders.

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.

People told us their transition to the service was smooth. One person described the positive experience they had had when visiting to see if the service was suitable and shared they would “not want to be anywhere else”. One relative described how leaders had been engaging and had gone through how they support transitions to ensure the person felt safe and supported during their move to the service.

We saw people had important health information easily accessible on the providers electronic records in case of emergencies.

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.

Staff and leaders could describe what steps they would take if they identified a safeguarding concern.

People and their relatives told us they felt safe in the service.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this is done through a procedure called the Deprivation of Liberty Safeguards (DoLS) which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working appropriately relating to how they managed DoLS. We found that the provider was able to identify when people were potentially being deprived of their liberty and took appropriate action.

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.

We saw within people care plans that risks had been assessed and mitigated by staff in discussion with people and their relatives. For example, some people had been assessed as high risk of falls. Leaders had completed risk assessments to reduce these risks.

One person who was on epilepsy medication had recently moved to the service. Leaders did not have any seizure management plan during the first day of inspection. On the second day we saw leaders had liaised with the doctor and now had detailed guidance in place to support the person appropriately. Leaders had ensured staff had appropriate training in managing epilepsy. Staff we spoke to could describe how to support someone who experienced a seizure including calling an ambulance when required.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

During the inspection we found issues with radiators throughout the home, with some radiator valves that were seized up and were stuck on hot at all times and other radiators situated in bathrooms that were rusty. The provider had identified these issues and was planning to address them during the warmer months to not inconvenience people, however this meant people had been left with radiators they could not turn of during a time of intense heat.
We saw communal areas were being used to store equipment, for example a bathroom on the first floor had occupational therapy equipment in it.
The kitchen was cluttered creating a higher risk of accidents.The provider shared they were in the middle of planned improvement within the home which included a refurbishment of the kitchen which was due to start the following week.

The communal areas of the service were clean and spacious, and we saw that window restrictors were in place.

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.

We saw staff were recruited safely and in line with current legislation. Staff received regular training, supervisions and team meetings.

Staff told us they were supported well by leaders with learning and development. Staff felt they worked effectively as a team. One staff member said, “we all pull together when needed and help each other out”.

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 service was cleaned by a team of cleaners and was well maintained. Staff were using personal protective equipment as required to prevent the spread of infection.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

One person who received rescue epilepsy medicine, did not have a detailed care plan with information on their seizure types or clear guidance for staff on how to recognise seizures. There was also no seizure monitoring diary in place to document seizure activity or interventions provided. This meant the provider could not be assured the rescue medicine was administered for the prescribed purpose and health professionals could not effectively monitor the effectiveness of the rescue medication due to the lack of documentation.

Daily temperature monitoring of refrigerated medicines was undertaken; however, on 2 occasions, a medicines fridge exceeded the maximum temperature limit of 8°C, with no evidence that this had been identified, investigated or acted upon. This increased the risk that medicines may have been compromised due to inappropriate storage conditions

Prescribed creams were administered appropriately.

Suitable arrangements were in place for the ordering, storage and disposal of medicines, and appropriate records were maintained for medicines requiring additional security.

A review of medicines administration records (MARs) showed that people received their medicines as prescribed. Medicines prescribed on an ‘as required’ (PRN) basis were supported by protocols that provided staff with guidance on how these medicines should be administered.