Westerley provides care and accommodation for up to 28 people. The home specialises in the care of older people in a homely environment. The home provides a Christian ethos which is delivered to people through daily acts of worship and close links to local churches. People living at the home and staff working there are sympathetic to the Christian beliefs. At the time of the inspection 22 people were living at the service. One of the beds was reserved for people staying for a period of respite.

There is 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.

At the last inspection the service was rated Good. At this inspection we found the service remained Good.

People told us they felt safe in the home. They said they would be comfortable to discuss any worries or concerns with the registered manager. Staff said they knew how to report any concerns and were confident the manager would take appropriate action. People were supported by sufficient staff. The manager was pro-active when there were staffing issues to ensure people were protected and their needs were met.

Staff began work in the home after a robust recruitment process and a thorough induction. Staff were trained to meet people’s individual needs. Staff competency was monitored on an annual basis to ensure staff were able to care for people with skill and knowledge

People received care and support that was personalised and respected their wishes and preferences. People were able to make choices about all aspects of daily living and were encouraged to maintain their independence.

People were offered a choice of food that was wholesome and appetising. People were pleased with the standard of food provided.

People confirmed their health care needs were met in the home. If they were unwell they received prompt attention from their GP and good care from staff. People were supported to attend hospital or clinic appointments. At the end of their lives people received effective and compassionate care from a team of health professionals.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The registered manager was experienced and knowledgeable about the people living in the home and the care and support they needed. They worked well with other health care professionals and maintained good care standards.

Further information is in the detailed findings below

This inspection was unannounced and took place on 20 and 21 October 2015.

The last inspection of the home was carried out on 24 April 2014. No concerns were identified with the care being provided to people at that inspection.

There is 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.

People told us they felt safe at the home and with the staff who supported them. One person said “I feel very safe. It is hard to think how you could be safer.” Another person said “I am very safe! I wouldn’t want to move from here. My family know I am safe. I don’t like to go downstairs much but I like to go to the devotions.”

People were supported by sufficient numbers of staff to meet their needs in a relaxed and unhurried manner. When staff were needed they came promptly. People said this was the same for day and night staff.

There were systems in place to reduce people’s risks whilst maintaining their independence and freedom to make choices about how they lived.

People’s medicines were administered safely by senior care staff who had received appropriate training.

People received effective care and support from staff who had the skills and knowledge to meet their needs. The health and well- being of some people improved after they came to live there.

People enjoyed the food provided in the home. There was a varied choice at all meals. People with specific nutritional needs had been assessed and received appropriate and effective support.

People said they were supported by kind and caring staff. All comments about staff were very positive. One person said “We are very well looked after. I can’t fault any of them. They are diligent. We are very lucky.” Another person told us “The staff are lovely people. We are ever so well looked after.”

The home aimed to meet people’s spiritual needs as well as providing mental and physical care. People valued the Christian  values and ethos of the home. There were acts of worship in the home called devotions each day. These readings and prayers were enjoyed by people who attended.There were close links with local churches.

People received care that was responsive to their needs and personalised to their wishes and preferences. People were able to make choices about all aspects of their day to day lives. They chose where and how to spend most of their time. Some people enjoyed participating in the range of activities available. Other preferred to follow their own interests in their rooms.

Staff demonstrated an excellent knowledge of the people who lived at the home which enabled them to personalise their approach to each person. Staff were able to tell us about how different people liked to be supported.

People, staff and visitors felt the service was well led by an open and enthusiastic manager. The registered manager was always ready to listen and was continually looking at ways to make improvements to the home and the care provided. Staff said they felt well supported and had a clear idea of what was expected from them.

There were effective quality assurance systems in place to monitor care and plan ongoing improvements. There were audits and checks in place to monitor safety and quality of care. Senior staff actively sought the views of people living in the home on a regular basis to ensure they were satisfied with the care provided.

We made an unannounced visit to the service on 24 April 2014 when we met people who lived in the home and spoke to staff. We reviewed staff recruitment and quality assurance documentation. There were 21 people living in the home and we met with all of them in communal or private settings.

The focus of the inspection was to answer five key questions: Is the service safe, effective, caring, responsive and well led? This was a summary of what we found.

Is the service safe?

People were treated with respect and dignity by the staff. People told us they felt safe. People told us staff answered their bells promptly and came to their assistance during the day and night.

Systems were in place to make sure managers and staff learnt from events such as accidents, incidents, concerns and investigations. This reduced the risks to people and helped the service to continually improve. The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards which applies in care homes. Nobody in the home was subject to a DOLS order at the time of the inspection. The home had policies in place and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. The manager had undertaken training in safeguarding adults and implementing the Mental Capacity Act in 2013.

The service was safe, clean and hygienic. Staff understood how to reduce the risks of infection through routine cleaning and use of thorough hand cleansing. Equipment was well maintained and serviced.

The manager had day to day contact with people in the home. They set the staff rotas and took people's needs into account when making decisions about the numbers, qualifications skills and experience required. For example an additional care staff had been obtained to help care for someone at the end of their life. This helped to ensure all people's needs were met.

Recruitment practice was safe and thorough. No staff had been subject to a disciplinary action. Policies and procedures were in place to make sure that unsafe practice was identified and people were protected.

Is the service effective?

There was a pastoral support team available from the church if people needed it, this meant that when required people could access additional spiritual and emotional support.

People's health and care needs were assessed with them, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People were involved in compiling their plans and they reflected their current needs.

People's needs were taken into account with the layout of the home enabling people to move around freely and safely. The premises had been sensitively adapted to meet the needs of people with physical impairments. People confirmed they were able to see their visitors in private and visiting times were flexible.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. One person told “I am sure there can’t be a better home. Staff are very helpful. I am jolly glad to have help with personal washing. People are very good. They are very quick to see if you needed help and answered bells swiftly.”

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People completed a range of activities both inside and outside the service on a regular basis. The service recognised people wanted to live their lives in different ways and supported them to do so. Some people enjoyed being part of the home community while others preferred the peace and quiet of their own rooms.

People knew how to make a complaint if they were unhappy. There had been no formal complaints however people said that they were able to raise issues "at any time" with the manager.

Is the service well-led?

The service had a manager who was registered with the Commission. The service was well led because the manager was responsive and accessible to people in the home. The service worked well with other agencies and services to make sure people received their care in a joined up way. The service had a quality assurance system which identified shortfalls and addressed them promptly. As a result the quality of the service was continuingly improving.

At the time of the visit there were 18 people living at Westerley Residential Care Home for the Elderly - Minehead. We reviewed five care records, staff training/supervision records and other records relating to the management and administration of the service. We also used information we had received about the home since the last inspection in February 2013.

We spoke with five people who used the service, to the registered manager, as well as five other staff on duty and 3 visitors/ relatives. We observed how care and support was provided to people. We looked at the homes environment and whether it met the needs of the people who lived there.

People told us they were very happy about how care and support was provided to them, and with the staff who provided that care. We were told that they had the help and assistance they needed. We observed that people had good relationships with the staff. , We saw that people and staff interacted well and there was a friendly and sociable atmosphere. People told us that they liked living in the home. One said “Everyone’s falling over themselves to be kind” another told us, “I would be heartbroken if I had to go anywhere else”

People's privacy, dignity and independence was respected, as people understood the care and support choices available to them. One said 'I am very happy to be living here I am able to live life in an environment where I am respected.'

Care treatment and support was planned in a way that ensured people's safety and welfare. One person said 'I feel that I get the support that I need.' Staff were trained to be able to deliver the care and support required by individuals.

We found that there were sufficient staff on duty with the appropriate skills and experience required to meet people's needs. One person said 'We have plenty of training to ensure that we can provide appropriate care at all times.'

We spoke to the service manager, the assistance manager, staff and people who use the service as well as the people who use the services relatives. Comments were received were all positive and included 'This is a lovely place to live you feel that you matter.'

Staff spoken to had a good awareness of the individuals care and support need and the importance of treating people with respect and dignity. This was confirmed by the training provided by the provider around respect and dignity and by talking to people who use the service. One person said ' 'This is a great service where people receive the highest standard of care' and 'The staff are really good to us and they respect our differences and respond appropriately to our needs what more can you ask.'

People who lived at the home told us they were able to make choices about their day to day lives. People said they were able to choose what time they got up, when they went to bed and how they spent their day.

One person said “I find it very good here. You can spend the day as you wish. I usually go for a walk. I have breakfast in my room. I do a lot of reading.”

People were very positive about the care they had received in the home.

“The staff are very nice. It is a good home. They do their very best. Last year I went to hospital and I was so glad to be back here. Back home I called it.”

People living at the home appeared very comfortable and relaxed with the staff who had supported them. We observed that staff interacted with people in a polite and friendly manner.

People told us “We are well looked after. Staff are splendid….always very helpful.” “Staff are all very good and kind.” We saw that staff knew people well and were attentive to their needs.