Westlands is a residential care home for up to 7 people. Care is provided across two floors in one adapted building. At the time of our inspection, there were 7 people living at the home. People living at the home had learning disabilities, autism and some had additional support with their mobility.

At our last inspection we rated the service ‘Good’. At this inspection we found the evidence continued to support the rating of ‘Good’ and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection..

At this inspection we found the service remained Good.

Why the service is rated Good

People lived in a safe environment which was clean and regularly checked. Individual risks to people were assessed and plans were put in place to keep people safe whilst encouraging their independence. Where incidents had occurred, staff took appropriate actions to ensure people’s safety. There were sufficient numbers of staff present at the home to ensure that people were safe and staff were knowledgeable about how to manage risks and respond to potential safeguarding concerns. Staff were trained in how to administer people’s medicines safely and the provider maintained good practice in this area.

Staff had been given the right training and support to carry out their roles. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. People received a thorough assessment before coming to live at the home and the home environment was suited to people’s needs. Staff supported people to prepare meals that they liked and that matched their dietary needs.

People were supported by kind staff that knew them well. Staff routinely involved people in decisions about their care and identified ways to encourage people to develop skills and independence. People’s privacy and dignity was respected by staff when providing care.

People were supported to identify and achieve goals and care was planned in a person-centred way. Regular reviews were carried out to ensure care plans reflected people’s current needs and any changes were responded to. People had access to a range of activities that suited their interests as well as their needs. There was a clear complaints policy in place and the provider took proactive steps to identify and respond to feedback from people and their relative.

People and relatives spoke highly of the management at the home and the registered manager was accessible to people at all times. Staff praised the support that they received from management and there were systems in place to encourage staff to make suggestions and identify improvements. The provider regularly sought the feedback of people and relatives and involved them in decisions about their care at the home. There were a variety of checks and audits in place to monitor and assure the quality of the care that people received.

Further information is in the detailed findings below.

We carried out this inspection on 12 June 2015 and it was unannounced.

Westlands provides accommodation and support for up to seven people who have a learning disability or autistic spectrum disorder. On the day of our inspection there were seven people living at the service, two of whom were away on holiday. The accommodation is provided over two floors that are accessible by stairs and a passenger lift.

At the time of our visit a new manager was in post and had submitted an application to register with the Care Quality Commission (CQC). The previous manager was working for the provider but was still registered with the CQC as the manager and was supporting the new 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 were aware of their responsibilities to safeguard people from abuse and were able to tell us what they would do in such an event. People’s care would not be interrupted in the event of an emergency and people needed to be evacuated from the home as staff had guidance to follow.

People were safe living at the service as appropriate checks were made on staff before they commenced working at the home.

Where there were restrictions in place, staff had followed legal requirements to make sure this was done in the person’s best interests. Staff understood the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) to ensure decisions were made for people in the least restrictive way.

Staff were provided with training specific to the needs of people. This allowed them to carry out their role in an effective way. It was evident staff had a good understanding of the individual needs of people.

There were enough staff deployed in the home. There were enough staff to enable people to go out each day and to go away on holidays.

People received their medicines in a safe way. People were encouraged to eat a healthy and varied diet and were involved in choosing the food they ate.

People were supported to keep healthy and had access to external health services. Professional involvement was sought by staff when appropriate. Relatives told us staff referred people to health care professionals in a timely way.

Staff encouraged people to be independent and to do things for themselves, such as help around the service or do some cooking.

Staff supported people in an individualised way. They planned activities that people liked doing.

Relatives were involved in developing the care and support needs of their family member.

Staff responded to people’s changing needs and encouraged individuals to try different things to give them a varied and stimulating life.

A complaints procedure was available for any concerns and relatives and people were encouraged to feedback their views and ideas into the running of the home.

The provider and staff carried out a number of checks to make sure people received a good quality of care.

Staff felt supported by the new manager and had regular team meetings where they discussed events at the service and how it was run.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

This inspection was unannounced.  The last inspection was undertaken on the 5 March 2013, no concerns had been identified.  Westlands provides accommodation and support for up to seven people who have a learning disability or autistic spectrum disorder. On the day of our inspection there were seven people living at the service.  The accommodation is provided over two floors that were accessible by stairs and a passenger lift.  There was a registered manager at the service.   A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

Applications for the Deprivation of Liberty Safeguards were in the process of being completed in relation to the key pads used on the front door that restricted people’s freedom.  The provider had not ensured people had been assessed as being able to give consent to take their medicines.  

There was a relaxed atmosphere at the home and we saw staff interacting with people in a calm, polite and caring manner.  Staff supported people as and when required and were aware of the communication needs of each person.  People were going out to attend external activities.  Other people returned from their activities at varied times during the day and made their lunch and relaxed doing what they wanted to do.

Staff told us, and we saw evidence, that they had received training that had enabled them to recognise and report abuse.  They told us that they would report all bad practice to the manager and were confident that action would be taken.  We saw in the staff training files we sampled that training about keeping people safe had been delivered to staff.  Visiting health care professionals said that staff knew the health care needs of people extremely well and staff were very caring in relation to meeting the medical needs of people.

Relatives of people were complimentary about the care their family member received from staff at the service.  They told us that they felt their family member was safe and staff knew their family member’s likes and dislikes.

People had care and health action plans that ensured their assessed needs would be met.  Relatives of people confirmed that they had been involved with the care plans and would be notified of any changes.   There were risk assessments in place to enable people to take part in activities with minimum risks to themselves or others. 

People received variety of meals that they had chosen.  They took part in the weekly shopping and planning of the menus.  We saw that people could choose to have an alternative meal if they did not like what was on offer.  

Relatives told us they would talk to the manager if they ever had the need to make a complaint.   They told us they were very satisfied with how their family member was cared for by staff at the home and they were confident the manager would address any complaints made.  This service had not received any complaints since the last inspection.

The provider had a clear set of values that included the aims and objectives, principles, values of care and the expected outcomes for people who used the service. 

The service had quality assurance systems in place.  These ensured people continued to receive the care, treatment and support they needed.  The registered manager was present in the service five days a week and more when required.  Staff, relatives and other external health and social care professionals told us that they believed the service was well led by the registered manager.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

The people who use the service were not able to verbally communicate with us, or had very limited ability to do so. Therefore we spent time observing interactions with the staff and the people using the service to determine how their needs were being met and to understand their individual experience of the service. We also observed a number of activities being undertaken and how these activities were carried out.

We saw people’s care records were person centred meaning that they were contained personal and up to date information specifically about the person and their needs and choices about their care. The care records had the information in them that staff required to support the people appropriately.

During the inspection we spoke to all of the staff on duty. We found the staff to be supportive and caring of all of the people and they had a good understanding of their care and support needs. We observed the staff and their interaction with people and saw that they arranged activities to suit each person’s needs. Staff had received the appropriate training to support the people, many of whom could not verbally communicate their wishes.

Staff had knowledge of adult safeguarding procedures and how to report concerns. This meant that they were able to recognise suspected harm or abuse and what action to take to reduce the risk of harm and how to deal with it if it happened.

We saw that there was a variety of activities planned the meet the needs of people using the service and that the people were able to choose whether or not they wanted to take part in the activities. If people chose not to engage then staff helped them to choose other things to do.

We saw that the provider had procedures in place to manage and investigate complaints and concerns about the service. The records we saw confirmed that any complaints and concerns were properly looked into and responded to. Suggestions about how the service could be improved were also dealt with properly.

We inspected Westlands as part of our planned schedule of inspections. The inspection was unannounced, this meant that the manager, staff and people that used the service did not know we were going to visit.

People that used the service who were in the home were not able to communicate verbally with us during our inspection or had a limited ability to do so. So we observed interactions between staff and people that used the service to determine how their needs were met and their experiences.

We saw that people's care records provided good information about how people's care needs should be met. The records we looked at were detailed and provided staff with the information they needed to support people appropriately.

We spoke with all of the staff on duty during our inspection. We found that staff on duty had a good understanding of the care needs of people and observed how they supported them to meet their needs. Staff had been trained in areas relevant to the specific needs of people who used the service.

Staff had knowledge about safeguarding procedures in the home. This meant that they knew and understood how to recognise and report any concerns or suspected abuse.

We saw that the provider had procedures in place for managing and investigating complaints. The records we looked at confirmed that any complaints were properly recorded and looked into.

People using the service at the time of this inspection visit had special communication needs. On this occasion, it was not possible to obtain feedback on their care experience owing to the limited time available for contact with them. In order to obtain this information it would have been necessary to involve staff familiar with their individual methods of communication in discussions with them. There was no opportunity to do this as people and staff were busy getting ready for an imminent pre-arranged community based activity involving the whole group.