The inspection took place on 1 and 6 July and was unannounced on the first day. We last inspected the service in October 2013 when it was found to be meeting the regulations we assessed.
Westfield House is a care home for people with a mental health diagnosis. It comprises of 13 single rooms with en-suites and nine self-contained flats. It is situated in Parkgate close to Rotherham town centre.
There was a registered manager 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. The registered manager was registered at a number of locations and there was a general manager at this service who also had management responsibilities.
People who used the service who we spoke with told us the service was very good, staff were excellent and they felt safe living at Westfield House. However, we identified a number of concerns. Our observations and the records we looked at did not always match the positive descriptions people gave us. We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We identified that people did not always receive safe care and treatment that was person centred, infection control measures were not satisfactory, there were not always enough staff on duty to meet people’s needs and the quality monitoring of the service was not always effective
During our inspection we saw staff encouraged people to be as independent as possible while taking into consideration their wishes and any risks associated with their care. People’s comments and our observations indicated they received the care and support they needed from staff who knew about their individual needs and helped them meet them. However, risks had not always been identified or documented in people’s plans of care. We also identified that people’s physical health was not always monitored as required.
There were not always enough staff to meet people’s needs. People who lived at the home told us they did not think there was always enough staff on duty to meet their needs. One person said, “I would like to go out but need staff to support me, so I don’t get out much.” The provider has addressed this since our visit.
People were not always protected against the risks associated with infection prevention and control. The systems in place were not effective in ensuring the service maintained standards.
People were protected against the risks associated with the unsafe use and management of medicines. Appropriate arrangements were in place for the recording, safe keeping and safe administration of medicines.
We found that staff we spoke with had a good understanding of the legal requirements as required under the Mental Capacity Act (2005) Code of Practice. The Mental Capacity Act 2005 sets out how to act to support people who do not have the capacity to make some or all decisions about their care.
People were supported with their dietary requirements. We found a varied, nutritious diet was provided.
We found staff approached people in a kind and caring way which encouraged them to express how and when they needed support. People we spoke with told us that they were able to make decisions about their care and how staff were to support them to meet their needs.
There were robust recruitment procedures in place. Staff had received formal supervision and annual appraisals had been completed. These ensured development and training to support staff to fulfil their roles and responsibilities was identified.
Staff told us they felt supported and they could raise any concerns with the general and registered managers, and felt that they were listened to. People told us they were aware of the complaints procedure and said staff would assist them if they needed to use it
The provider had a system to monitor the quality of the service provided. However, some of these were not fit for purpose and were therefore not always effective.