30 January 2023
During a routine inspection
Signature at Westbourne is a nursing home providing personal care and nursing care to 108 people at the time of the inspection. The service can support up to 114 people. Signature at Westbourne is a purpose-built building and is accessed over four floors by stairs or a lift. People could access the ground and first floors freely, the second and third floor had restricted access to keep people living with dementia safe.
People’s experience of using this service and what we found
People told us they felt safe and were happy living at Signature at Westbourne. Comments included, “this is my home now and I am very happy”, “the staff are lovely” and, “this is the perfect place for me.”
The design and decoration of the premises did not always follow the best practice guidance for supporting people living with dementia. Plans were in place to redecorate these areas. We have recommended the provider consults good practice guidance around providing a dementia friendly environment for people who use the service.
Peoples needs were assessed before they moved into the service. We found people’s protected characteristics had not always been considered as fully as they could have been. A new electronic care planning system was being introduced that included a more robust system for seeking protected characteristics. We recommended the provide consults good practice guidance to ensure assessments fully explored people’s needs to ensure they could be met before they moved into the service.
Staff had assessed people for risks to their health and well-being and created plan to minimise the likelihood of harm occurring. Clinical and non-clinical risks were discussed daily between staff to ensure people were safe. People told us there was enough staff to meet their needs. Staff had been recruited safely into the service and had received a comprehensive induction followed by regular training to ensure they had the right skills to meet people’s needs. Medicines had been managed safely and people were protected from the spread of infections. Lessons were learned when things went wrong.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Staff worked effectively with other agencies to provide consistent, effective and timely care. Staff supported people to access healthcare when required. People were supported to eat a well-balanced diet. Staff told us they felt supported to carry out their job roles.
People told us they were cared for by staff who knew their needs, were kind, respectful and treated them with dignity. One relative said, “[Person] settled in the home immediately which suggests that they must be doing something right.”
Staff provided people with care responsive to their needs. We identified one person was not always being supported to communicate as fully as they could have been. We brought this to the attention of the registered manager and provider who responded quickly and by the next day of our inspection we observed the way the person chose to communicate had been fully supported. This resulted in the person being able to tell staff their likes, dislikes and wishes.
There was a large activities programme in place, one person told us, “the programme of activities is brilliant.” The activity staff told us the plans they had to improve activities for people living with dementia and people who preferred a 1:1 activity.
People knew how to complain and felt they would be listened to. People were supported to have a dignified and respectful end of life when the time came.
People, relatives and staff spoke positively about the registered manager and management team. People and staff felt comfortable to speak open and honestly and felt they would be listened to. Quality assurance systems were in place to monitor the quality of the service and identify areas of improvement. Signature at Westbourne engaged with people, the public and staff to improve the running of the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 10 December 2021 and this is the first inspection.
The last rating for the service under the previous provider was Outstanding, published on 2 February 2019.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.