Westmead

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.

At our last assessment we rated this key question inadequate. At this assessment the rating has changed to 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 service had a proactive and positive culture of safety. Since our last inspection, processes had changed to ensure accidents and incidents were appropriately recorded, monitored by managers and lessons learnt during debrief reflections, supervisions and team meetings. Risks associated with closed cultures were identified and mitigated. There was an open and honest culture within the team, with channels to ensure clear communication. For example, the registered manager encouraged staff to give feedback via a pulse survey after each team meeting; this information was reviewed and used by the management team to make improvements of how staff was managed and care delivered.

The service worked with healthcare professionals to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care and people were supported to be as independent as possible to access the services they required. Professionals comments included, “The staff are receptive to professional advice and have enabled to support this individual to now attend outpatient clinic appointments in person to review medication, which could previously only be done as home visits. This is a positive step.”

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They 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 service shared concerns quickly and appropriately. One relative commented on the reduction in incidents their loved one experienced since living at the home; their comments included, "the support staff, they are absolutely brilliant, they take on board whatever I discuss with them, they also have such a relaxed demeanour, that brought my [name of person] down from calm play. You couldn't stand next to [person] a couple of years ago without [person] possibly pushing or getting aggressive or even hitting you. That is the kind of change and I don't take no single-handed credit for that, this has come from having the right people around [person].”

There was a commitment to minimising the use of restrictive interventions. We reviewed evidence of how some people's restrictions had been reduced. Appropriate processes were followed where it was deemed necessary to use restrictive physical intervention. This had been agreed by professionals and staff described how it was used as a last resort, for the minimum time.

At our last assessment, we found concerns with how people's finances were managed. At this assessment, we found processes had been implemented to improve safety and fairness of how this area of people's care was managed.

During our last assessment, we found concerns in how risks were managed. At this assessment we found the provider worked well with people, relatives and relevant healthcare professionals 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. Staff were knowledgeable about people’s risks and how these were managed. Risk assessments were specific to individual needs and were detailed. Risk assessments were in place for areas such as specific health conditions, mobility, personal care, behaviour, outings and Personal Emergency Evacuation Plans (PEEPS) and correspondent care plans put in place. For example, one person had a detailed plan for staff to follow when a person accessed the community to keep them and others safe.

The service supported people to engage in positive risk taking and provided many examples of this. One person had been supported by staff to start attending their GP surgery for routine appointments instead of having those appointments at home. Other person was supported by staff to engage in activities they enjoyed doing at adventure parks.

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

At our last assessment, the provider had failed to complete fire drills and there were faults with the fire alarm system. At this assessment, we found works were carried out to ensure an effective alarm system was fitted in January 2025 and an updated fire risk assessment was put in place. Fire drills had been carried out on a monthly basis however, we noted night-time fire drills had not been completed. This was completed before we finalised this assessment.

At our last assessment, we found some areas of people’s homes were not fit for purpose and repairs were needed. At this assessment, we found the provider had made improvements and carried out works to ensure people’s environments were safe, clean and made to feel homely. One person’s flat had been completely redecorated, with new floors and a new bathroom fitted. Another person’s flat had been decorated with their favourite football stickers and posters. As part of managing risks, the provider ensured in some areas that plug sockets, and light switches were covered to prevent people from harming themselves and other items such a televisions were stored in protective equipment to prevent damage or any harm to people.

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.

At the last assessment, we found people did not receive all their funded hours as shown on the staff rota and staffing was not always adequately deployed to provide safe care to people. At this assessment, the provider showed us the improvements they had made which included, additional floating staff during the day to support staff on their breaks; an additional waking night shift for further support and a new system to manage staff’s breaks. One staff member told us, “There is enough staff.” Relatives shared positive feedback about staffing. One relative told us, “I do believe [person] receives safe care in the property, [person] has two-to-one care, which is what [person]'s been assessed for and [person] has anything that may be unsafe for [them] removed, for example, sharps and things like COSHH stuff."

The service had a robust recruitment process to ensure positions were offered to suitable applicants. These included establishing their employment history and reference checks as well as Disclosure and Barring Service (DBS) checks. This protected people from receiving support from unsuitable staff.

Overall, the provider assessed and managed well the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. During our assessment, we found people’s homes to be clean and staff wore personal protective equipment (PPE) when needed for example, when preparing food. The registered manager told us they now employed an additional cleaning staff member to allow time for this to be completed following our last inspection when issues were raised about the cleanliness.

We found most people’s food was labelled with an opening date to ensure people did not eat food that had passed its expiry date. On our first visit, we found a few examples of milk not being labelled; we discussed this with the registered manager and they took appropriate action. We also reviewed evidence confirming this was an area of ongoing work where improvements needed were discussed with staff during staff meetings.

Medication was safely managed. The provider made sure medicines and treatments were safe and met people’s needs and preferences. People were supported to take their medication out with them when on outings, in a safe way. One person required emergency medication to be administered if they had a seizure; this was with staff supporting this person, who had been trained to administer this medication.

Some people had been prescribed 'as and when required' medication to manage their behaviour and support their health. In our review of care plans, protocols and records of care, we were assured this type of medication was only used when required and not excessively to control people's behaviours. Some people required their medication crushed and we reviewed evidence showing this had been discussed with the person’s GP or pharmacist and records confirmed this.

Staff were trained and were assessed as competent to administer medicines safely.