Westbury House

Updated 1 March 2022

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.

As part of CQC’s response to the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 14 February 2022 and was announced. We gave the service one working day notice of the inspection.

Updated 1 March 2022

Westbury House is a residential care home for up to 13 adults with a learning disability. There were nine people living at the service at the time of inspection. People had lived at the service for a long time and the amount of personal care and support they needed had increased. The accommodation was in one building, arranged over two floors. There was a passenger lift for people who could not use the stairs. There was a communal lounge, a smaller lounge, dining room and a garden.

Westbury House 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.

The inspection took place on 19 March 2018 and was unannounced.

At the last inspection, on the 30 December 2015 the service had an overall rating of ‘Good.’ At this inspection we found the evidence continued to support the rating of good. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities using the service can live as ordinary a life as any citizen.

A registered manager continued to be employed at the service. 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.

At this inspection we found the service remained ‘Good’

There continued to be systems in place to keep people safe and to protect people from potential abuse. The registered manager continued to assess and minimise risks. Peoples care and support plans remained up to date and accurately reflected people’s needs. Medicines were managed safely and people received their medicines on time and when they needed them. Staff had undertaken training in safeguarding and understood how to identify and report concerns.

There was sufficient numbers of staff to meet people’s needs. New staff had been recruited safely and pre-employment checks were carried out. Staff training had been consistently updated and staff had the skills and knowledge they needed to support people with learning disabilities.

Staff had regular supervision meetings and annual appraisals.

People’s needs had been assessed and their support was delivered in line with best practice in learning disability services. Peoples support was individualised to them and met their needs. Staff were aware of peoples life story and respected their choices. Activities were planned around people’s known likes and dislikes and people had a choice in the activities they undertook.

People continued to be supported to maintain their health and wellbeing by eating and drink enough and by accessing a balanced diet. People were supported to maintain their health and had access to healthcare services. When people accessed other services such as going in to hospital they were supported by the service staff and there was continuity of care.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; there were policies and systems in the service support this practice.

People were treated with kindness, respect and compassion. Staff took the time to listen to people and engage with them in a meaningful way. Staff knew people well and understood how people communicated. People were supported to communicate with other people and people in the community. People were well known in the community and were supported to maintain relationships with those who were important to them.

People were supported to express their views and had regular access to an advocate. People were supported to remain as independent as possible and make choices and decisions. People’s privacy was respected and they were supported to lead dignified lives.

Support was personalised and person centred. Support plans fully reflected people’s needs, interests and goals. Staff recognised when people were upset or distressed and responded to this. There was a complaints system in place if people of their relatives wished to complain.

People were supported at the end of their lives. There wishes and preferences were recorded and acted upon.

The environment had been adapted to meet people’s individual needs. People who used wheel chairs could move around the service freely and access all areas including the garden. The service was clean and well maintained. Staff were aware of infection control and the appropriate actions had been taken to protect people.

Staff, relatives and community health and social care professionals told us the service was well-led. The registered manager had a clear vision and values for the service. Staff understood the services values and acted in accordance with them. Staff and the registered manager understood their roles and responsibilities. The provider and registered manager regularly audited the service to identify where improvements were needed. There were systems in place to seek feedback from people, relatives and other stakeholders in order to improve the service. Relatives told us that they felt well informed and that communication was positive and proactive.

When things went wrong lessons were learnt and improvements were made. Staff understood their responsibilities to raise concerns and incidents were recorded, investigated and acted upon. Lessons learnt were shared and trends were analysed.

The service worked in partnership with other agencies to develop and share best practice.

Further information is in the detailed findings below.