About the service: Westbrook House provides accommodation, care and support for up to six people with a learning disability. It is a three storey house close to the seafront in Cromer. There were five people living at the service on the day of inspection.

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

People’s experience of using this service:

¿ People and their relatives made positive comments about the care provided at Westbrook House. Comments included, “I am happy here and I have a big bedroom,” and, “I have always been pleased with the service, it is first class.”

¿ Measures were in place to ensure people and the environment they lived in was safe.

¿ People's health was well managed and there were links with other services to ensure that individual health needs were met.

¿ People received their medicines when they needed them.

¿ Staff were recruited safely and staffing levels were sufficient to meet people’s needs.

¿ Staff were knowledgeable and were kind, caring and patient.

¿ People were treated with dignity and respect.

¿ Staff knew people well and had developed meaningful relationships with them. Support was provided in a person-centred way based on people’s preferences.

¿ The outcomes for people using the service reflected the principles and values of ‘Registering the Right Support’. People were supported to be as independent as possible and given opportunities to participate actively within their local community.

¿ People were supported to have maximum choice and control in their lives and staff supported them in the least restrictive way.

¿ People could take part in a range of activities which promoted their wellbeing.

¿ The service was well managed and staff felt supported.

Rating at last inspection: Good (report published 29 March 2016)

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor all intelligence received about the service to ensure the next planned inspection is scheduled accordingly.

This inspection was carried out by one inspector 10 February 2016 and was unannounced.

Westbrook House provides accommodation, care and support for up to six people with a learning disability. At the time of our inspection there were six people living in the home.

The service 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.’

This inspection found that mental capacity assessments had not been carried out when necessary for people who were unable to make their own decisions. This meant that the service had not acted in accordance with the Mental Capacity Act 2005.

People were safe living in the service and were supported by staff that were knowledgeable about safeguarding matters. There were enough staff available to meet people’s needs and to provide caring and personalised support. Recruitment procedures were robust and people’s medicines were safely managed.

Staff received effective and comprehensive training which was specifically tailored to meet people’s individual needs when this was necessary. People enjoyed the food in the home and were able to participate in choosing what meals they wished to have. Where people had specific nutritional needs these were planned for and met. Prompt referrals were made to health professionals when necessary and people benefitted from a wide range of health professionals involved in their support.

People received care from staff that were patient and friendly. Positive relationships had been developed between people and staff. Staff used a variety of methods to communicate with people in order to support them to express their views. People’s privacy and dignity was supported.

The service was responsive to people’s needs and staff had a thorough understanding of people’s likes and dislikes. They were supported to maintain as much independence as was possible. People we spoke with told us they would be happy to raise any concerns if they had any and felt that staff would take any concerns seriously.

The service was well managed which helped ensure people’s welfare. Staff were supportive of the management team and an open culture had been fostered which ensured that staff felt comfortable to raise any queries or make suggestions for the benefit of people living in the home. There were systems in place to ensure people’s views were frequently obtained and to ascertain and improve the quality of the service people received.

We met all six people who lived in Westbrook House. A few people were not able to communicate verbally with us but we saw them moving about the home in a confident manner and we saw staff supporting them in a positive way. One person was able to communicate, with gestures and limited speech, that they were happy. We also spoke with two other people and both said that they were very happy living there. They said they liked the staff and knew who to speak with if they had any issues. One person said, “I like it here. I like everyone here.”

We experienced a friendly and positive environment and all rooms were appropriately furnished. All bedrooms were personalised and had individual items and objects of interest in them. A number of rooms also contained musical instruments.

We saw evidence that everyone who used the service was engaged in a wide range of meaningful activities throughout the whole week.

We spoke formally with two members of staff. Both staff said they were happy working in the home and that they were supported well in their work. One staff member said, “My days are well planned and I get on well with all the staff". We saw evidence that staff were well trained and received regular supervision and appraisals.

We observed that medicines were administered correctly and in a safe manner. We saw evidence that people who used the service were offered a healthy and balanced diet and that staff understood and supported their specific nutritional needs.

One person we spoke with wasn't able to clearly communicate verbally but, with gestures, vocalisation and some speech, they told us that they were happy and they liked reading their books.

Other people we met and spoke with told us that they were happy and one person told us that they had regular meetings in the home, which they liked to call 'family' meetings. The person told us the meetings were good and that they talked about everything.

This person also told us that, although they had a choice, they didn't want to move away from Westbrook House because they were happy and settled there.

One person told us that they did horticulture a few days a week, which they enjoyed.

One person we spoke with told us that they liked the staff and said that they supported them well. Another person also smiled, nodded and made positive gestures when we asked them about the staff.

One person we spoke with showed us their room and indicated that they liked it. The person pointed things out to us that were personal to them and smiled a lot.

People with whom we spoke told us that they liked living in the home and got on well with the staff. One person said, "I'm happy with everything." Both said that they had keys for their own rooms so they could keep things private. One told us that they had a key for the front door of the home.

One person was able to tell us about their 'key worker' who they said helped them with things. They said they were very happy with how this happened.