This inspection took place over a period of two days. Both visits were unannounced.

We previous inspected Westmead Residential Care Home on 20 October 2015 and rated the provider to be Good in all five questions and Good overall.

At this inspection, we found the service remained Good.

Westmead Residential Care Home is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Westmead accommodates a maximum of 35 older people in one adapted building. Care and support was provided for people on both the ground and first floor. On the first day of our inspection there were 31 people living at the home. Some people were living with dementia.

There was a registered manager working at the home 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.

People felt safe living at the home. Staff were aware of the action needed if they were concerned about people and their safety at the home. Staff were aware of how to reduce risks to people’s care and used equipment safely to promote good care. People’s dependency levels were monitored to assess the number of staff required to meet people’s needs. Some people believed staffing levels to be low at times to care for people in their preferred way. People received their medicines as prescribed.

Electronic care plans were in place. The registered manager was aware improvements were needed to ensure information was available to senior staff for them to fully audit them and was working with programme designers to achieve this.

Risks of infection were reduced due to systems and practices in place. Accidents and incidents were reviewed to reduce the risk of reoccurrence and in order for lessons to be learnt to prevent further incidents.

People’s needs were assessed and known to staff before they moved into the home to ensure they could be met. Staff received training and were supported to assist them provide the care people required. There were some mixed comments regarding the food provided from people at the home and whether people enjoyed it. People received support with eating and drinking as required to meet their needs. People were assisted to received support and advice from healthcare professionals to help maintain their wellbeing.

People were supported to have a choice and control of their lives. Staff supported people in the least restrictive way possible.

People liked the staff that provided their care and support and were able to relax and spend time with them. Staff were aware of different means of communicating with people and ensured people received care and support in a dignified way. Staff had knowledge of people’s likes and dislikes as well as their personal life histories. Relatives were confident their family member would receive good end of life care.

People were able to spend time doing things they enjoyed doing and were able to participate in events at the home. People and their relatives were aware of how to raise complaints and were confident these would be addressed.

People, their relatives and staff were complimentary about the registered manager and the senior team. Management systems were in place to ensure checks were undertaken so people would receive quality care and support. People and staff felt listened and to and believed their opinions were taken into account.

This inspection took place on 20 October 2015 and was unannounced. Westmead Residential Care Home provides accommodation and personal care for up to 35 people. There were 28 people living at the home on the day of our inspection. Westmead has 31 single bedrooms and two double rooms. Communal areas of the home consist of lounge areas, a dining room with additional seating areas. Lounge areas are available for people to use when seeing their visitors.

There was a registered manager in place on the day 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.

People we spoke with and their relatives told us they had no concerns about the care provided. People were confident the registered manager would take any worries or concerns about the service seriously. Staff we spoke with showed awareness and recognition of abuse and the actions they would need to take in the event of abuse taking place.

Staff were knowledgeable about people’s care needs and the individual risks associated with their care. We saw action was taken following incidents within the home to prevent future similar occurrences. Meetings took place whereby staff were able to share information to ensure they were up dated and aware of people’s changing needs and any risks.

People were protected against the risks associated with medicines because systems were in place to ensure they were administered as prescribed. Regular audits were carried out to ensure people had received their medicines.

Staff felt supported by the registered manager and received training to provide them with the knowledge to support people in meeting their individual care needs. We saw staff treat people with dignity and respect while supporting them. People’s consent was obtained prior to the provision of care and support. The registered manager was aware of their responsibility in assessing people’s capacity were needed and obtaining authorisation from the local authority if people’s liberty was restricted.

Staff knew people well and took people’s individual preferences as well as their likes and dislikes into account. People were able to maintain their hobbies and interests within the home or by attending clubs within the wider community. Staff had an awareness of people’s life histories which assisted them provide care specific to each individual.

People told us they liked the food available and were provided with a choice. People were supported where needed in a discreet and dignified way. People told us they had access to healthcare professionals as needed to maintain their wellbeing.

People and their relatives were involved in care plans to ensure these were kept up to date. People were involved in the running of the home and were able to express their views which were taken into account by the registered manager and acted upon.

The registered provider and the registered manager had effective systems in place to monitor and review the quality of the service provided.

At this inspection we spent time with people who lived at the home to gain their experiences of life in the home. We spoke with four people who lived at the home, four staff and the manager. We also looked at some records.

All the people that we spoke with were positive about the care and support provided. One person said: “If I need anything at all they (staff) will help me at any time” and “They (staff) are all so kind to me.” Another person said: “Lovely dinner today” and “The care is of a very high standard here.”

It was clear from what we saw on the day of our inspection that staff knew people’s social and health care needs. This was demonstrated in the individual support people received from staff. What we saw matched the care plans that were personal to each person and written with and for people who lived at the home.

We saw positive interactions between staff and people with lots of chatter and laughter during the day with staff helping people make simple everyday decisions. There were arrangements in place where required to help people with the bigger decisions so that their best interests were upheld.

We saw that people who lived at the home had their medicines as prescribed at the right time and in the right way. This made sure people’s health needs were effectively met.

We saw that the provider had effective systems in place that made sure staff training was planned and delivered including dementia awareness. This meant staff knew how to provide care and support to people with dementia care needs.

The provider had responsive systems in place to monitor and review people’s experiences and complaints to ensure improvements were made where necessary.

There were 34 people living at Westmead on the day of our inspection. We spoke with four people who lived at the home, three staff and the registered manager to find out their views about the service provided. People who lived at Westmead told us positive things about the care and support that they received. One person said, “Always help when I need it but they (staff) let me do what I can for myself.”

The atmosphere in the home was relaxed and homely. We observed positive and respectful interactions between people that lived at the home and staff throughout our inspection. We found that people were supported with their care and to follow their choices of daily activities in leading a full a life as possible.

We found that everyone living at the home had care and risk plans. These held details of people’s current needs so that these could be met effectively by staff. We saw that people's needs had been assessed by a range of health and social care professionals which meant their range of needs had been monitored and met.

Staff knew how to safeguard people from harm and felt confident that if they had to report any abuse, action would be taken to protect people. People told us that they, “felt safe” living at the home.

The planning of staff ensured that there was enough staff, with the right skills and experience, to meet the needs of people. At different times during our visit, we observed staff fully engaged with providing support to people.

We carried out this review to check on the care and welfare of people. When we visited the home we spoke with seven people who lived there and one relative. People were pleased with the care that they or their relative received.

We saw that staff interacted with people who used the service in a friendly, courteous and respectful manner. People told us that the staff were nice and were kind and respectful towards them. People told us that they felt safe and secure living at Westmead Care Home.

We pathway tracked the care of two people and looked at how their care was provided and managed. We found that people received effective and appropriate care, treatment and support to meet their personal needs. However, we found that some care records needed improving to make sure that they accurately reflected peoples care needs at all times.

We looked at how the registered manager monitored the quality of the service and found that there were effective auditing and monitoring systems in place to assess that the care, treatment and support being given was appropriate.