About the service:

Westerley Residential Care Home for the Elderly provides accommodation, care and support for up to 30 people who experience physical disabilities and those who live with dementia.

There were 24 people living at the service at the time of this inspection.

People’s experience of using this service:

People received safe and effective care from staff who were recruited safely and were clear about how to recognise and report any issues of concern and potential abuse. Risk assessments were in place to manage risks within people’s day to day lives, whilst also promoting their independence. People received safe support with their medicines and the registered provider had systems in place to respond to any medicine errors.

Sufficient staffing levels were being maintained and at the time of our inspection, staffing support matched the level of assessed needs for the people who lived at the service.

Staff induction and on-going training was provided to ensure the staff team had the skills and knowledge needed to carry out the roles they were employed to do. Staff told us they were well supported by the registered manager and their management team.

Staff were caring and treated people with kindness, dignity and respect. People were able to have choice and control over their lives. Wherever possible, people's consent was gained before any care was provided and staff supported people in the least restrictive way possible; the policies and systems in the service supported this practice.

People were involved in reviewing their care and in making any necessary changes to the way care was provided. People had access to a wide variety of food and drinks and care plan records reflected people’s likes, dislikes and overall preferences. People were also supported to access a range of activities and to maintain any individual interests they had.

A process was in place which ensured complaints could be raised. People and their relatives had access to this information so that if needed, they were clear about how to raise any concerns or more formal complaints.

Systems and processes were in place to support the registered persons in their monitoring of the quality of the services provided so that they could quickly take any improvement actions if shortfalls were identified.

There was an open and inclusive culture within the service which enabled people who lived there, and staff, to share ideas and work in partnership with each other. People, relatives and staff, expressed confidence in the registered persons and their approach to leadership.

Rating at last inspection:

Good (report published June 2016)

Why we inspected:

This was a planned inspection based on the rating at the last inspection. The service remained rated good overall.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

This inspection took place on 8 June 2016 and was unannounced. The home is organised to reflect people’s christian beliefs, although people who do not have a religious conviction can live there. Westerly provides care for older people who have mental and physical health needs including people living with dementia. It provides accommodation for up to 26 people who require personal and nursing care. At the time of our inspection there were 20 people living at the home.

There was 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.

On the day of our inspection staff interacted well with people and people were cared for safely. People and their relatives told us that they felt safe and well cared for. Staff knew how to keep people safe. The provider had systems and processes in place to keep people safe.

Medicines were administered safely but medication administration sheets (MARS) were not completed fully.

The provider acted in accordance with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. If the location is a care home the Care Quality Commission is required by law to monitor the operation of the Dolls, and to report on what we find.

We found that people’s health care needs were assessed and care planned and delivered to meet those needs. People had access to healthcare professionals such as the district nurse and GP and also specialist professionals. People had their nutritional needs assessed and were supported with their meals to keep them healthy. People had access to drinks and snacks during the day and had choices at mealtimes. Where people had special dietary requirements we saw that these were provided for.

There were sufficient staff to meet people’s needs and staff responded in a timely and appropriate manner to people. Staff were kind and sensitive to people when they were providing support and people had their privacy and dignity considered. Staff had a good understanding of people’s needs and were provided with training on a variety of subjects to ensure that they had the skills to meet people’s needs. The provider had a training plan in place and staff had received regular supervision. People were encouraged to enjoy a range of hobbies and social activities. They were supported to maintain relationships that were important to them. We saw that staff obtained people’s consent before providing care to them.

Staff felt able to raise concerns and issues with management. Relatives were aware of the process for raising concerns and were confident that they would be listened to. Regular audits were carried out and action plans put in place to address any issues which were identified. Audits were in place for areas such as falls and infection control. Accidents and incidents were recorded. The provider had informed us of notifications as required by law. Notifications are events which have happened in the service that the provider is required to tell us about.

All of the six people we spoke with gave us positive feedback about the service. One of them said, “Nothing is too much trouble for the staff who are quite wonderful and kind. They’ll go out of their way to help you.”

People’s privacy, dignity and independence were respected. Staff were courteous and kind.

People said that they received all of the health and personal care they needed. Records confirmed that assistance had been provided in a safe, reliable and responsive way.

There were reliable arrangements for managing medication so that people safely received the medicines they needed.

Records showed that security checks had been completed on staff to help ensure that only suitable and trustworthy people were employed in the service.

There were measures to check that people were reliably provided with the facilities and services they needed.

When we visited 24 people were receiving support within the home.

During our visit we spoke with nine people who lived at the home, two members of staff, a professional visitor and one other visitor. We looked at three people’s care records in detail and reviewed several others in selected sections. We also spent time observing how people were supported and spoke with the deputy manger.

We saw people received individualised care and support, from staff who were knowledgeable about their needs, wishes and preferences. Staff were trained and supported to provide the care people needed. However, we made comments about how care records were completed.

People made comments such as, “I couldn’t ask for better care”, “I feel safe here, the staff make sure of that. It’s safer than being at home” and “The staff make time to listen to me and sort out anything I have a problem with.”

A professional visitor told us there was a ‘good’ feeling in the home and there was a good quality to the care provided.

Another visitor told us, “It’s a lovely place, very comfortable and clean and they keep me informed.”

One person we spoke with told us “It’s really lovely here. I like to sit by the window in my room and watch the world go by.” Another person said, “The caring is marvellous. I’m in my eighth year here and have never had to make a single complaint.” “There is a complaints procedure but I don’t know that anyone has ever had to use it.”

Another person said “This place is the next best thing to home.”

We spoke with seven different people about the care they received. All said it was very good and the staff were wonderful. Comments made to us included “It’s marvellous.”

All spoke about the cleanliness of the home saying “It’s very clean and comfortable.” “There are never any unpleasant smells.”