About the service: West Hall is a care home for older people, some of whom are living with dementia. The service is registered to accommodate up to 117 people living in three separate lodges. The site also has a main house which accommodates the activity centre, hairdresser and a bistro. At the time of our inspection, 107 people were living at the service.

People’s experience of using this service:

People told us they lived in a service where staff were exceptionally caring and kind. We observed staff displaying a strong, visible person-centred culture enabling people to express their views and making people feel they were really cared for and mattered. Staff were highly motivated to offer care that was kind.

People who were at the end of their life and their families received outstanding end of life care from a staff team who was understanding and had distinctive skills.

People were cared for by staff who had superior skills in being able to recognise people’s needs in relation to their well-being and social happiness. This resulted in people having an enhanced sense of wellbeing and great quality of life. People’s care was planned proactively with them and staff were flexible and responsive to people’s individual care needs.

Staff took a key role in the local community and engaged with services outside of the service. Networks with external agencies was encouraged and met people’s individual wishes to achieve things they had always wanted to do. This practice had been sustained since our last inspection.

People told us they felt safe living at West Hall. People received the medicines they needed in order to maintain good health and any risks that had been identified for them had been responded to.

People said they did not have to wait to be assisted as there were sufficient staff on duty. They told us they enjoyed the food and the choices they had and were supported to live healthy lifestyles as they had access to health care professionals when needed. People lived in an environment that was adapted to suit their needs and was extremely clean.

The registered manager strove to provide an excellent service to people and the vision and values were person-centred to make sure people were at the heart of the service. They had sustained the level of good practice within the service and had continued so support staff and lead by example. This had all helped to ensure people received the best care possible.

Rating at last inspection: We last inspected this service on 30 June 2016 when we rated the service as Outstanding. Our report was published on 15 October 2016.

Why we inspected: This was a routine scheduled inspection based on the rating at our last inspection.

Follow up: We will continue to monitor this service and will next inspect it in line with our published inspection process and methodology.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

West Hall is a large care home for older people, some who are living with dementia. The home consists of a main ‘manor house’ which has communal areas such as a dining area and recreational facilities. There are three separate self-contained purpose built lodges within the grounds. Each lodge has their own kitchen, dining and lounge areas and is managed by a deputy manager. On the day of the inspection 81 people were living at West Hall.

This was an unannounced inspection that took place on 30 June 2016.

The home had a registered manager. 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 and associated Regulations about how the service is run. We were assisted by the registered manager, the general manager and the deputy managers during our inspection.

People were extremely satisfied with the care they received and could not speak highly enough about the staff. People told us they were treated with the utmost respect and kindness and were at the heart of the home. People were made to feel as though they mattered and staff took time to get to know people in order to develop close relationships with them. The skills staff had learnt through working with external providers had a positive impact on people’s well-being and daily lives.

People and their relatives felt involved in their care planning and in control of the care they received. Care plans were comprehensive and written in a person-centred way. Accidents and incidents were monitored and people provided with suitable aids to help ensure that further accidents did not happen.

The premises were designed in a way that was suitable for people living with dementia. The grounds were easily accessible to people. People’s individual rooms were personalised and included tailored signposting so people could identify their own room.

There was a wide variety of activities for people to participate in both within and outside of the home. Activities were individualised and meaningful to people and designed around people’s own interests and hobbies. Staff ensured people received a nutritious, balanced diet and people who required it were supported to eat their meals. People were very happy with the quality of their meals and said they were given enough to eat and drink.

There were procedures and risk assessments in place that staff implemented to reduce the risk of harm to people. This included staff’s understanding of the signs of abuse. Staff understood the main principles of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DOLS).

People received their medicines safely and the premises were designed in such a way that they were safe for people. There were a sufficient number of staff on duty which meant people did not have to wait for their care. In the event of an emergency there were suitable arrangements in place to help ensure people’s care continued uninterrupted.

People were cared for by staff who were recruited through a thorough recruitment process. Appropriate checks were carried out on applicants before they began to work with people. The majority of staff were experienced care workers who had the skills, knowledge and experience to care for people safely. Staff understood their roles and responsibilities and were supported by the management through relevant training and supervision.

People’s healthcare needs were met by suitably qualified staff as people had access to healthcare professionals who regularly visited the home.

There were systems in place to assess and monitor the quality of care people received. People felt able to express their views and told us the management and staff were responsive to their complaints and comments.

Quality assurance procedures were robust and any actions identified through routine au

We inspected West Hall to check that the provider had made improvements in the area of the administration of medication.

We spoke with four staff, including the newly appointed manager. On the day of our visit it was not possible to see all of the evidence required. The senior manager was not available so we requested additional information. Some of this was sent to us following the inspection.

We found that staff had received training in medication administration and were knowledgeable about medication procedures.

We saw that the provider had carried out a number of audits and had put systems in place to improve the quality of medication administration.

We noted that overall the provider had made improvements in the area of medication.

There were 19 people resident at West Hall when we inspected the service. During our visit we spoke with four people who used the service and one relative. We spoke with five care staff and one senior member of staff. We also spoke with the Chief Executive who was visiting that day and spoke to a director on the telephone.

We carried out some observations during the course of our visit and noted that the interaction between staff and people who used the service was positive.

People told us that they thought the staff at West Hall were “Wonderful” and that they were “Very well looked after”. People told us that staff asked for permission before providing any care or support. One person told us “Yes, certainly they do”.

We had received some concerns about the way the provider managed people’s medication. We found that the service had taken action to improve and we saw that there was an action plan in place, but there was still work to do.

We looked at staff records and saw that the provider had carried out relevant checks on staff before they started work.

We looked at the way the provider managed complaints and saw that these had been dealt with appropriately.

We spoke with four out of the nine people using the service. They all gave positive comments to us, such as “West Hall was a fabulous home with very caring and kind staff.”

We were told that they were continually being asked their views about the service that was being provided. Residents of the home confirmed that the management team had listened to them and made changes where necessary.

People using the service told us they enjoyed the facilities that were available to them. They told us they had visited the hairdressers and were aware that they could have a beauty treatment if they wanted.