The inspection was unannounced, which meant the provider did not know we were coming. It took place on 7 December 2016. The home was previously inspected in July 2015 and was rated requires improvement with breaches of regulations in The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Following that inspection the registered and general manager sent us an action plan to tell us what improvements they were going to make. They told us the improvements would be completed by the end of January 2016.

Westfield House is a care home for people with a mental health diagnosis. It comprises of two units. Westfield House has 12 single rooms with en-suites and one self contained flat, Westfield Mews has nine self-contained flats. It is situated in Parkgate close to Rotherham town centre.

The home had 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. The registered manager was registered at a number of locations and there was a general manager at this service who also had management responsibilities. The registered manager was on leave at the time of our inspection. However, the general manager who had day to day responsibility for the service was available.

We saw there were systems and processes in place to protect people from the risk of harm. Staff we spoke with were knowledgeable about safeguarding vulnerable people and were able to explain the procedures to follow should an allegation of abuse be made.

People’s needs were assessed and care and support was planned and delivered in line with their individual support plan. The individual plans we looked at included risk assessments which identified any risk associated with people’s care.

Systems were in place to ensure people received their medications in a safe and timely way from staff who had been trained to carry out this role. However, we identified some minor improvements could be made.

We found the service to be meeting the requirements of the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). The staff we spoke with had a good understanding of the requirements.

People were supported to eat and drink sufficient to maintain a balanced diet. People we spoke with who used the service told us they liked the food and could choose what they wanted and when they wanted to eat.

At the last inspection the provider agreed to increase the staffing numbers to be able to meet people's social needs and to be able to access the community with support if required. We found at this inspection the numbers had predominantly been maintained to ensure peoples needs were met. We also found staff had the right skills, knowledge and experience to meet people’s needs.

Staff were provided with appropriate training, support and supervision to help them meet people’s needs.

Systems were in place to assess and monitor the quality of the service, including obtaining feedback from people who used the service and their relatives. Records showed that systems for recording and managing complaints, safeguarding concerns and incidents and accidents were well managed.

People we spoke with told us they were looked after and the staff were good. One person told us, “It is the best place I have lived in and I have been in some care homes.”

People expressed their views and were involved in making decisions about their care and treatment.

We found that the environment was well maintained in a clean and hygienic condition. We also found systems were in place to reduce the risk and spread of infection. Work to improve the environment was on-going at the time of our visit.

We found there were effective recruitment and selection processes in place. Staff received appropriate professional development. However the documentation required to be available in respect of a person employed was not always available at the service.

There was an effective system to regularly assess and monitor the quality of service. The systems were also being improved further at the time of our visit.

People told us they liked their independence and staff supported them to be independent.

We were also told the staff were good listeners and always helped resolve any issues. Staff were very good and understood what support they needed and respected their decisions.

People told us, ‘I am happy with all the service provided, there is nothing I want to change’.

‘I am happy with everything’.

People told us they completed questionnaires, where they could record their views of the home. People also said they were invited to a meeting sometimes they went but not always but that was their choice.

The inspection took place on 1 and 6 July and was unannounced on the first day. We last inspected the service in October 2013 when it was found to be meeting the regulations we assessed.

Westfield House is a care home for people with a mental health diagnosis. It comprises of 13 single rooms with en-suites and nine self-contained flats. It is situated in Parkgate close to Rotherham town centre.

There was a registered manager at the time of our inspection. 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. The registered manager was registered at a number of locations and there was a general manager at this service who also had management responsibilities.

People who used the service who we spoke with told us the service was very good, staff were excellent and they felt safe living at Westfield House. However, we identified a number of concerns. Our observations and the records we looked at did not always match the positive descriptions people gave us. We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We identified that people did not always receive safe care and treatment that was person centred, infection control measures were not satisfactory, there were not always enough staff on duty to meet people’s needs and the quality monitoring of the service was not always effective

During our inspection we saw staff encouraged people to be as independent as possible while taking into consideration their wishes and any risks associated with their care. People’s comments and our observations indicated they received the care and support they needed from staff who knew about their individual needs and helped them meet them. However, risks had not always been identified or documented in people’s plans of care. We also identified that people’s physical health was not always monitored as required.

There were not always enough staff to meet people’s needs. People who lived at the home told us they did not think there was always enough staff on duty to meet their needs. One person said, “I would like to go out but need staff to support me, so I don’t get out much.” The provider has addressed this since our visit.

People were not always protected against the risks associated with infection prevention and control. The systems in place were not effective in ensuring the service maintained standards.

People were protected against the risks associated with the unsafe use and management of medicines. Appropriate arrangements were in place for the recording, safe keeping and safe administration of medicines.

We found that staff we spoke with had a good understanding of the legal requirements as required under the Mental Capacity Act (2005) Code of Practice. The Mental Capacity Act 2005 sets out how to act to support people who do not have the capacity to make some or all decisions about their care.

People were supported with their dietary requirements. We found a varied, nutritious diet was provided.

We found staff approached people in a kind and caring way which encouraged them to express how and when they needed support. People we spoke with told us that they were able to make decisions about their care and how staff were to support them to meet their needs.

There were robust recruitment procedures in place. Staff had received formal supervision and annual appraisals had been completed. These ensured development and training to support staff to fulfil their roles and responsibilities was identified.

Staff told us they felt supported and they could raise any concerns with the general and registered managers, and felt that they were listened to. People told us they were aware of the complaints procedure and said staff would assist them if they needed to use it

The provider had a system to monitor the quality of the service provided. However, some of these were not fit for purpose and were therefore not always effective.