Archived: Westwood Court

Westwood court is a care home with nursing located in the town of Winsford, which is situated in Cheshire. The service provides nursing support and accommodation to people living with dementia, and people with mental health needs.

There was a manager in post within the service, who was registered with the CQC. 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 were protected from the risk of abuse. Staff had received training in safeguarding vulnerable people, and were aware of how to report their concerns. The registered provider had a whistleblowing policy in place, which staff were familiar with. Whistleblowing is where staff are able to report any concerns, either to the registered provider or to an external agency, without fear of reprisals.

People told us that they felt their finances were safe. The registered manager had a robust system in place for monitoring people’s finances and ensuring that it was kept secure. Where people were supported to go shopping by staff, a record of itemised receipts was kept, which were signed by staff so there was a clear audit trail to follow up on any identified discrepancies. A detailed log of money taken out and returned was also maintained as part of this process.

There were sufficient numbers of staff on duty to meet the needs of people using the service. Rotas indicated that staffing numbers were consistent, and people told us that they did not have to wait long to be supported by staff. Staff told us that they did not feel rushed, and we observed staff spending time chatting with people.

People were supported to take their medication as prescribed. Medication review records (MAR) were signed by staff to indicate that people had taken their medication. Medicines were appropriately stored in a secure room, and those medicines that needed to be kept chilled were kept in a designated medication fridge. Room and fridge temperatures were monitored to ensure that medication remained at the correct temperature.

Staff had been supported to undertake the training they needed to enable them to carry out their role effectively. Training records indicated that staff had completed training in areas such as safe administration of medication, the Mental Capacity Act 2005, infection control and moving and handling. New staff were required to complete the care certificate as part of their induction. The care certificate outlines a national set of minimum standards for care and support staff.

People received the support they needed to protect them from the risk of malnutrition. People told us that they enjoyed the food that was available, and we saw examples of staff helping people to eat their food where they needed support. Appropriate options were available to people who required a special diet, for example pureed or diabetic options. There was a menu on display in the dining area which used photographs of the food options available, to help people who could not read to make a visual choice.

Staff treated people with dignity and respect. Staff ensured that people’s doors were closed whilst they were being supported to attend to their personal care needs. Some people had also been supported to put locks on their doors to ensure that their privacy was maintained. The registered manager had ensured that there was a process in place to access their room if required, for example in the event of ill health or an emergency.

People had been able to choose the décor for their rooms, or where appropriate had been supported by their relatives to do so. One relative told us that they had been given the money to choose some wall paper and a new blind. People’s rooms were clean and people told us that they were comfortable.

Care records contained personalised information about people’s likes, dislikes and their preferences. Records also contained detailed and up-to-date information around their physical and mental health needs. This enabled staff to get to know people they were supporting, and offer support that was appropriate to meet their needs.

People told us that they knew how to make a complaint and would feel confident in doing so. The registered manager kept a record of complaints and compliments that had been received, which evidenced that he had responded to these in a timely manner.

People, their relatives and staff told us that they knew and liked the registered manager and felt that he was approachable. The registered manager was visible and spent time talking to people using the service to ascertain their views. The registered provider had sought feedback from people and their relatives, the results of which suggested that people were happy with the service being provided.

Quality audits were carried out by the registered manager to ensure that the quality of the service was being maintained. These focussed on areas such as care records, staff conduct and people’s medicines. Action was taken to follow up on areas that required attention.

This is a summary of what we found;

Is the service safe?

The service was safe.

People told us they felt safe at the home and staff had received the required training in order to protect people from the risk of abuse.

The provider had regard for the Mental Capacity Act 2005 and the manager had submitted 55 Depravation of Liberty Safeguards applications to the local authority. 11 of which had been authorised. Staff were knowledgeable of the restrictions placed on people and we saw no other restrictions had been imposed on people during our visit.

Is the service effective?

The service was effective.

It was clear from our observations and discussions with staff that they had a good understanding of people's care and support needs and that they knew people well.

Staff told us that they felt well supported by the new management team and they had the information they needed for their roles. A rolling training programme was in place.

Is the service caring?

The service was caring.

People were supported by kind and attentive staff. Staff spoke to people in a caring and compassionate manner. When people became confused and upset, staff dealt with the situation calmly and were attentive to people's needs.

People told us they were well cared for and had no concerns.

Is the service responsive?

The service was responsive.

People's needs had been assessed before they moved into the home. People had access to activities that were important to them.

Records and discussions with staff showed that where there was a concern about a person's health needs the advice and support of various health professionals had been sought.

Is the service well-led?

The service was well-led.

A manager was in place at the home and was registered with the Commission shortly after our visit.

Staff had a good understanding of the ethos of the home and quality assurance processes were in place. Staff understood their roles and responsibility to maintain people's safety. All of them spoke highly of the new manager and felt they were listened to.

Systems were in place for obtaining the views of people who used the service and their relatives. People spoken with during our visit said they had no concerns about the services provided.

Where people were able to speak to us, they told us they enjoyed the food at Westwood Court and they had plenty of choice. We saw that both dining areas had weekly menu boards and pictorial menus were also available in the dementia unit to help people make a choice.

We found that staff were knowledgeable about the different types of abuse that could occur. Staff confirmed that training had been completed recently in relation to safeguarding people from the risk of abuse.

Relatives and staff spoken with told us they thought there was enough staff who worked at Westwood Court. Comments from them included: "There are so many staff here compared to other homes (my relative) has been in! I think it is very well staffed. They are never on their own in the lounge. Whenever I come I am always aware of staff sitting and talking to someone.'

We found that people who used the service and/or their representatives were asked for their views about the care and treatment that was received. In addition to this surveys had also been completed by staff and visiting professionals.

We spoke with four people who used the service. All said they felt cared for and respected by the staff team. We spoke with seven family members. All said they were happy with the care and support provided to their relatives and had been involved in the planning and reviewing of the care and supported offered.

During our observations of care and support being provided we noted that there was a constant staff presence in communal areas. This meant people's health and safety was being monitored at regular intervals.

Relatives spoken with told us they felt their relatives were safe living at Westwood Court and that a good standard of care was provided.

We looked at three staff files and found there were effective recruitment and selection processes in place. This meant there were systems in place to safeguard people who used the service from receiving care from people unsuitable to work with vulnerable adults.

Information held in daily records and the accident/incident records showed there was evidence that learning from incidents / investigations took place and appropriate changes were implemented.