The inspection took place on 20 October 2016. It was undertaken by two adult social care inspectors and was unannounced. At the last inspection of this service, which was undertaken on 11 November 2013 no breaches of regulation were found.

Westbourne House is registered to provide accommodation for 71 people who require nursing or personal care with a range of medical and mental health needs. It is in the Fir Vale area of Sheffield, close to all local amenities. The service can take people who are living with dementia. At present 29 beds are allocated for the provision of intermediate care for people who are admitted to the service from the community or from local hospitals. This is a provision undertaken via a National Health Service contract which commenced at the service in August 2016. The intermediate care beds have been allocated at the service to help ease the winter pressures on the acute health care services in the area. One unit of 14 beds is located on the ground floor, as well as 15 beds on the first floor of the service. On the ground floor of the service a 20 bedded unit was provided which cared for people living with dementia, there were 17 people living on this unit at the time of our inspection. Rooms on the first floor were used for residential, nursing and intermediate care.

The service has 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 2008 and associated Regulations about how the service is run.

Staff knew how to protect people from abuse and knew they must report concerns or potential abuse to the management team, local authority or to the Care Quality Commission (CQC). This helped to protect people.

Staffing levels provided on the day of our inspection were adequate to meet people’s needs. Staff understood the risks to people’s wellbeing and knew what action they must take to help minimise risks to people’s wellbeing.

Staff helped people to maintain or increase their independence working alongside health care professionals. This enabled some people to leave the intermediate care beds at the service and go back home or reside in other local care services.

Staff were provided with training in a variety of subjects which was updated periodically to help develop and maintain the staff’s skills. Supervision and appraisal was provided to all staff which helped support them and identify further training or development needs.

People’s nutritional needs were assessed and monitored. Their special dietary needs were provided. Staff encouraged and assisted people to eat and drink, where necessary. Advice was sought from relevant health care professionals to ensure people’s nutritional needs were met.

People were supported by staff to make decisions for themselves. Staff reworded questions or information to help people living with dementia understand what was being said. We saw people chose how to spend their time and gave consent to their care and treatment.

People who used the service were supported to make their own decisions about aspects of their daily lives. Staff followed the principles of the Mental Capacity Act 2005 when there were concerns people lacked capacity and important decisions needed to be made.

Activities provided at the service were varied and creative which helped to stimulate people. People were encouraged to maintain their hobbies and interests, where possible.

General maintenance occurred and service contracts were in place to maintain equipment so it remained safe to use.

A complaints policy and procedure was in place. This was explained to people living with dementia or to their relations so they were informed. People’s views were asked for formally through surveys and informally on a daily basis by the staff. Feedback

We found people’s views and experiences were taken into account in the way the service was provided and delivered in relation to their care. People told us they had the choice to do things they wanted and when they wanted to.

People told us that they were happy living at the home and satisfied with the care and support they received. Their comments included,” Lovely staff,” “I’m so happy here,” “Would recommend this place to anyone,” “I can’t fault any of them [staff] I couldn’t be happier,” and “They [staff] are kind, I’m settled here.”

Relatives we spoke with said that they were happy with the care their loved one received. They told us, “We’re very happy with the care, we visit every day and we can go home relaxed knowing he is safe and well cared for” and “He has some special carers [staff] who mean a lot to him.”

At this inspection we saw that staff had positive interactions with people, they spoke patiently and kindly whilst offering choices and involving people.

We found that people's needs were identified in care plans. Records showed that people had been involved in the care planning process.

Medication records checked were up to date and medication was stored securely.

The provider had an effective recruitment and selection procedure in place to ensure that staff were appropriately employed.

We found people were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records had been maintained.

People experienced care delivered in an unhurried and patient manner. We observed staff supporting people to decide whether they wanted any food or a drink. They used communication methods appropriate to the person’s needs and took time to ensure that they communicated with them in a way people appeared to be comfortable with.

People’s files contained documentation showing that they agreed to each care package that had been devised.

Where people needed specific equipment as part of their care delivery, for example to help with their mobility, it was readily available. Where staff were using equipment to help people they did so in a safe and appropriate manner.

Staff were encouraged to identify areas for growth and development, and managers gave meaningful feedback to staff to help them develop their skills.

A thorough investigation was carried out by the provider in response to any complaints they received. We saw that individual responses were sent to complainants when the investigation had been completed.

Some people at Westbourne House have some conditions that mean we had difficulty talking with them. Other people were able to express their views clearly.

Due to people’s communication needs we used a formal method of observation during the site visit. We call this the ‘Short Observational Framework for Inspection (SOFI). This involved us observing up to five people who use services for a period of up to one hour and recording their experiences at regular intervals. This included people’s mood, and how they interacted with staff members, other people who use services, and the environment.

Throughout the observation we saw all staff treat people with dignity and respect by using a positive, friendly and kind approach. We observed examples of good communication skills by staff that utilised eye contact and touch to engage people who use services. For example, one person who was sitting quietly regularly had their hand held while the carer talked to them and assisted them to have a drink.

We were able to talk to a number of people who use the service at this home, including relatives. Generally people told us they were very happy with their care and felt staff were friendly and supportive. We were told how the people’s rooms and the home are kept very clean and the majority were very happy with the food they received.

We spoke with 6 relatives who were visiting the home and they confirmed that they were very satisfied with the care provided. One told us "We have no worries or concerns about the home and think it's good in every aspect." And another confirmed that "Our mother's quality of life is much better here than it was before she came to live in the home."

One relative said “This a wonderful and a very special home, the care is excellent and we couldn’t wish for better.”

A visiting health care professional said that they visited regularly and said “The care is very good here.”

We spoke with Sheffield Local Authority, Contracting, Commissioning and Safeguarding and they told us that they had not identified any concerns at the home.