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Inspection carried out on 30 November 2017

During a routine inspection

This inspection took place on 30 November 2017 and was unannounced.

At the last inspection on 13 October 2015 the service was rated Good.

At this inspection we found the service remained Good.

Western House is managed by Derbyshire Care Services Limited. The service is in Mickleover near Derby and provides accommodation and personal care for five people with mental health needs. At the time of our inspection there were five people using the service.

Western House has a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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.

People told us they felt safe at Western House. Staff knew how to protect people from harm. The service was well-staffed so staff could support people both at the service and in the wider community if required.

People told us they helped to keep the premises clean and tidy and took pride in how it looked. The premises were spacious and comfortably furnished and surrounded by secluded gardens. People had their own personalised bedrooms which gave them a place where they could spend time alone if they wanted this.

People said staff knew them well and gave us examples of how staff had supported them to settle into the service, become more independent, and access both work and leisure opportunities in the wider community. Staff were qualified and experienced in supporting people with mental health needs in both health and social care settings.

People told us they liked the food served. Mealtimes were flexible to fit in with people’s work and other leisure activities. People helped to choose the menus and prepare the meals served.

Records showed that staff assessed people’s health when they came to the service and arranged for them to see specialist heath care professionals as necessary and have annual well-being checks with their GPs. If people wanted a healthier lifestyle staff supported them to achieve this.

People told us staff at the service were caring and kind and the service had a family atmosphere. Staff shared interests with people they supported and talked with them about what they liked. People had their own bedrooms and TVs and said staff respected their privacy and dignity.

People told us the service provided was open, honest and fair and focused on empowering people and supporting them to move towards independent living. People and staff were listened to and changes made to the service in response. People and staff said the service was well-led and the management team caring and supportive.

The providers used a variety of quality monitoring and auditing tools to ensure the service met its legal and regulatory responsibilities. Records showed the service was continually improving. Staff worked in close partnership with other agencies to ensure people were supported by a range of health and social care professionals.

Inspection carried out on 13 October 2015

During a routine inspection

This inspection took place on 13 October 2015 and was unannounced.

Western House is registered to provide residential care and support for five people with mental health needs. At the time of our inspection there were four people using the service. The service provides five individual bedrooms of which three have an en-suite facility. The service is a detached dwelling located within a residential area of Derby.

Western House had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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.

People told us they feel safe at Western House as the staff and the building itself make them feel secure. People’s needs are supported by risk assessments that identify potential risks due to people’s lifestyle choices and guidance for staff as to how risk is to be minimised was recorded. Staff were aware of their responsibilities in promoting people’s safety and this was reflected within the training they undertook.

There are sufficient staff available who have undergone a robust recruitment process and who have the appropriate knowledge, skills and understanding that enables them to meet people’s needs and to keep them safe.

A system of assessing risk and developing plans of care was in use which has been developed specifically for people who require support with their mental health; this enables the staff to provide effective care based on best practice to ensure people’s needs are recorded and responded to.

People are involved in all decisions with regards to their care which includes their understanding of any restrictions placed on them which have been applied by external agencies to ensure their safety and well-being. People told us they regularly meet with staff to discuss and review their goals and aspirations.

Discussions with those using the service and records we viewed identified that people have access to a range of health care professionals and are supported to manage both their physical and mental health with the support of staff where the person themselves has requested this.

People using the service spoke to us of their goals and aspirations for living independently and how staff within the service support them to achieve this. They told us they shop for groceries and prepare and cook meals. People told us that staff support them with their decisions to gain paid and unpaid employment.

People were complimentary about the staff and the service they receive and told us how the staff work with them in a non-judgemental manner with consideration to their privacy and dignity.

People we spoke with told us that their mental health has improved and were able to give us examples as to how this has had a positive impact on their well-being.

People were able to make an informed decision as to whether they wanted to use the services of Western House. They had visited the service and met with staff and people who were already using the service before coming to a decision. People told us that the staff spoke with them about the aims of the service to enable them to decide whether this was the right environment for them.

People are confident that they can raise concerns and have received information as to how to make a complaint. They have the opportunity to attend meetings both within the service and externally, providing them with opportunities to speak with people independently.

People are involved in the day to day running of the service through formal and informal meetings, both collectively and individually, having the opportunity to comment on all aspects of their care and support.

The registered manager and other staff are supportive of the needs of people and regularly meet with them to ensure that the service is working well for them.

The registered manager has a good oversight as to the service provided and has a range of systems, which includes the supervision and appraisal of staff and the auditing of practices within the service which identifies that the service is being well-led.

Opportunities are in place for people using the service, their relatives, the staff employed and external professionals to comment on the service. Information about the service and people’s views is available on the services website.

Representatives of external agencies which include health and social care services provided us with positive feedback about the management of the service and how the registered manager and staff had a positive impact on the lives of people who receive a service.

Inspection carried out on 26 September 2013

During an inspection to make sure that the improvements required had been made

Two people who used the service told us that they were satisfied with the meals provided, and that they received enough to eat and drink. One person told us that "the meals included home cooked foods, and that they were being supported to cook and budget more to maintain their independence".

We found that the provider had taken further steps to ensure that people received a choice of suitable and nutritious food to meet their needs.

Inspection carried out on 29 May 2013

During a routine inspection

We spoke with three out of four people who used the service and two relatives.

People told us they were happy with the care and service they received, and felt that their needs were being met. Comments received from people included ‘’the service has contributed greatly to my continued recovery, the staff ask after my welfare and have time for a chat and my views are taken into account and are never dismissed.’’

People also said that they were satisfied with the meals provided, and that they received enough to eat and drink. We found that some choices and foods provided affected the ability to fully meet people’s nutritional needs.

People said that they felt they received the help they needed as there was usually enough staff available to meet their needs.

People’s medicines were handled appropriately and they received them at the times they needed them.

Arrangements were in place to protect people against the risk of abuse. People told us they felt safe. They also said that they felt listened to and able to report any concerns they may have to staff.

Procedures were in place to ensure that complaints were dealt with appropriately and resolved, where possible.

Inspection carried out on 4 October 2012

During an inspection to make sure that the improvements required had been made

People we spoke with told us they were happy with the care and service they received and felt that their needs were being met.

Inspection carried out on 12 July 2012

During a routine inspection

This was the first review of the service since the provider was registered in October 2011. We spoke to four people who use the service and three relatives.

People told us they were happy with the care and support they received, and felt that their needs were being met. People liked the fact that the service is small and homely.

One person told us ‘’I get on well with the staff and can talk to them and I feel that staff are genuinely interested in my welfare, and helping me to move on’’. Another person told us ‘’this is a good place to live compared to other places I have stayed. The atmosphere is relaxed and calm and the staff are friendly and helpful’’.

People felt that staff respected their dignity, privacy and independence.

People also felt safe and able to raise concerns with staff if they were unhappy.

People told us they were supported to maintain contact with their family and friends.

Relatives we spoke with told us they were happy with the care and support their family member received, and felt involved in decisions about their care and treatment. One relative told us ‘’Western House provides an excellent service; their family member had improved since moving there’’.