This inspection was carried out on 4 July 2017 and was unannounced. At their last inspection on 3 November 2015, they were found to be meeting the standards we inspected. At this inspection we found that they had continued to comply with regulations however there were some areas that required improvement.

Westbourne Care Home provides accommodation for up to 27 older people, including people living with dementia. The home is not registered to provide nursing care. At the time of the inspection there were 25 people living there.

The service had a manager who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.

People felt safe and staff knew how to report any concerns. People’s individual risks were assessed. However, unexplained injuries required consistent monitoring. People’s medicines were managed safely.

People were supported by sufficient staff. However, recruitment processes needed further development to ensure they were robust. We found that staff felt trained and supported.

People’s ability to make decisions was assessed and the principles of the Mental Capacity Act 2005 were adhered to. Their consent was sought before care was given and they were treated with dignity and respect. People were supported to eat and drink sufficient amounts and there was appropriate access to health and social care professionals.

People or their relatives were involved in their care planning and their confidentiality was promoted. People’s care needs were met and their care plans were clear and up to date. People enjoyed the activities available and were able to enjoy going out into the community.

People and staff were positive about the management of the home. There were quality assurance systems in place. We found that complaints were responded to and feedback was sought.

This inspection was carried out on 4 July 2017 and was unannounced. At their last inspection on 3 November 2015, they were found to be meeting the standards we inspected. At this inspection we found that they had continued to comply with regulations however there were some areas that required improvement.

Westbourne Care Home provides accommodation for up to 27 older people, including people living with dementia. The home is not registered to provide nursing care. At the time of the inspection there were 25 people living there.

The service had a manager who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.

People felt safe and staff knew how to report any concerns. People’s individual risks were assessed. However, unexplained injuries required consistent monitoring. People’s medicines were managed safely.

People were supported by sufficient staff. However, recruitment processes needed further development to ensure they were robust. We found that staff felt trained and supported.

People’s ability to make decisions was assessed and the principles of the Mental Capacity Act 2005 were adhered to. Their consent was sought before care was given and they were treated with dignity and respect. People were supported to eat and drink sufficient amounts and there was appropriate access to health and social care professionals.

People or their relatives were involved in their care planning and their confidentiality was promoted. People’s care needs were met and their care plans were clear and up to date. People enjoyed the activities available and were able to enjoy going out into the community.

People and staff were positive about the management of the home. There were quality assurance systems in place. We found that complaints were responded to and feedback was sought.

The Inspector gathered evidence to help answer our five key questions; Is the service safe? Is the service effective? Is the service caring, Is the service responsive? Is the service well led?

Below is a summary of what we found based on the evidence gathered during our inspection carried out on 20 August 2014. This included speaking with members of staff and looking at records.

The detailed evidence that supports our findings can be read in the full report.

Is the service safe?

At our previous inspection carried out on 03 June 2014, we found that people had not been adequately protected against the risks of health care associated infection. This was because appropriate standards of cleanliness and hygiene had not been maintained in all areas of the home.

During our inspection carried out on 20 August 2014, we found that necessary improvements had been made and that the regulations in relation to cleanliness and infection control had been met.

Is the service effective?

We saw that the provider had systems in place to assess and reduce the risks of health care associated infection. These included policies and procedures that had been based on current Department of Health guidelines. This meant that people had been protected against the risks associated with health care associated infection.

Is the service caring?

We saw that people had been cared for and supported in a clean, hygienic and well maintained environment that promoted their dignity.

Is the service responsive?

New cleaning schedules had been drawn up and put in place which gave staff clear guidance about roles, responsibilities and the standard of cleanliness required. We spoke with members of staff who demonstrated a good understanding of infection control policies and procedures together with how to achieve and maintain appropriate standards of cleanliness.

Is the service well led?

We saw that the manager had taken steps to ensure that the improvements necessary had been made. We saw that posters reminding staff about their responsibilities had been displayed around the home and that infection control issues had been discussed at staff meetings.

The Inspector gathered evidence to help answer our five key questions; Is the service safe? Is the service effective? Is the service caring, Is the service responsive? Is the service well led?

Below is a summary of what we found based on the evidence gathered during our inspection carried out on 03 June 2014. This included speaking with people who used the service, some of their relatives and members of staff who supported them and by looking at records.

The detailed evidence that supports our findings can be read in the full report.

Is the service safe?

During our inspection we saw that people who lived at the home were treated with consideration and respect. Staff provided care and support in a way that promoted people’s dignity, privacy and independence.

We looked at the care records relating to four people who lived at the home. These showed that people’s individual needs had been assessed, documented and reviewed. They provided staff clear guidance about the care and support that people needed in a way that ensured their health and safety.

During our inspection we walked around the home and found that most areas, including people’s bedrooms, corridors, communal lounges and the dining area, were clean and smelt fresh. One person who lived at the home told us, “They [staff] keep my room beautifully clean.” Another person commented, “My room and toilet are kept spotlessly clean.”

However, we found that two of the shared bathroom and toilet facilities we checked had not been maintained to the required standards of cleanliness and hygiene. For example, we saw that the toilet bowl in the first floor bathroom was dirty and stained with what appeared to be dried on faecal matter. There were a number of shed body hairs in the bath together with a rubber anti-slip mat that was dirty and badly perished in places.

We saw that people’s health and welfare needs had been met by sufficient numbers of appropriate staff. One person who lived at the home told us, “There are always plenty of staff around and they come very quickly when you call for them.”

Is the service effective?

We looked at care records which showed that people’s choices and preferences had been taken into account in the planning and delivery of the care they received.

We saw that risk assessments had been completed and regularly reviewed in relation to a wide range of issues relevant to people’s care needs and personal circumstances. These included assessments relating to the management of people’s medicines, skin integrity and risks associated with pressure care, nutrition and hydration, mobility and the risk of falls.

Is the service caring?

We observed the lunchtime meal and saw that staff provided appropriate levels of support where necessary to help people to eat and drink in a calm, patient and dignified manner.

Everybody we spoke with told us they were happy at the home and with the levels of support and care they received. One person said, “I am very happy here and have absolutely nothing to complain about. All of the staff are lovely and look after us very well.”

Is the service responsive?

We saw that people’s views, experiences and choices taken into account in the way that care, support and treatment was delivered.

People told us they liked the activity opportunities provided at the home. These had included themed meals and events to celebrate Burn’s night, Shrove Tuesday [Pancake Day], St. Patrick’s, Valentine’s and Mother’s Day, Easter and people’s birthdays. We saw that staff had arranged cooking and reminiscence activities, crossword quizzes, church services, charity fund raising events, gardening sessions and visits by children from a local primary school.

Is the service well led?

A relative of a person who lived at the home commented, “[Family member] decides what help and support they need. We sit down regularly [with staff] to review the care plans and agree any changes that need to be made.”

During our inspection we saw that people had access to relevant health care professionals where necessary and appropriate. These included community nurses, opticians, chiropodists, GPs and occupational therapists.

Systems had been put in place to assess and monitor the quality of services provided. These included processes to identify, assess and manage risks posed to the health, welfare and safety of people who lived at the home. This meant that people had been protected against the risks of inappropriate or unsafe care.

During our inspection of Westbourne Care Home on 22 July 2013, people told us they had been fully involved in decisions taken about their care and support. One person told us, “We decide what happens with our care. We are involved in what goes on.”

We saw that suitable arrangements had been put in place where necessary to assess people’s ability to make decisions in line with published guidance relating to the Mental Capacity Act (MCA) 2005.

We observed that staff treated people with respect and kindness while delivering appropriate levels of care and support. We also saw that care was delivered in a way that met people’s individual needs and welfare requirements. A relative said, “We think it’s excellent here and really cannot fault it. The staff are very kind and caring.”

We saw evidence that people were provided with a good choice of food and drink in a way that both encouraged and promoted a healthy balanced diet. One person told us, “There is a very good choice of food. They [staff] ask us what we want and like. There is plenty of drink available at all times.”

The premises were safe, suitable and fit for purpose. Adequate emergency procedures were in place and the safety equipment we saw had been regularly checked and well maintained.

Records showed that the provider had put recruitment procedures in place to ensure that staff were fit, able and properly trained to meet the needs of people who used the service. This included carrying out appropriate checks before staff began work.

A complaints policy and procedure had been put in place and we saw evidence that people’s comments, feedback and suggestions had been regularly sought.

We spoke with six people who lived at the home and their feedback was overwhelmingly positive, including the remarks, "Suits me", "Been very good", and "Seems alright to me". A visitor told us that their friend was, "Very well looked after" and said they were, "Very impressed". People said they felt safe and one person said, "We always have the call bell". Regarding complaints another said "You can have your say and people will listen to you".