We carried out a review of the data available to us about Westbury House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Westbury House, you can give feedback on this service.
We found the following examples of good practice.
The provider had effective systems in place to support and monitor the service. There helped ensure there were sufficient levels of personal protection equipment (PPE) and that staff complied with testing and vaccination requirements.
Staff wore PPE as required and followed safe infection prevention control practices when changing and disposing of PPE.
People were supported to spend time with those who were important to them and go out in the community. Risk assessments were in place to support this.
We undertook this inspection at the same time as CQC inspected a range of urgent and emergency care services in Kent and Medway. To understand the experience of social care providers and people who use social care services, we asked a range of questions in relation to accessing urgent and emergency care. The responses we received have been used to inform and support system wide feedback.
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.
This inspection took place on 30 December 2015, was unannounced and was carried out by two inspectors.
Westbury House provides accommodation and personal care for up to 13 adults with a learning disability. People also had communication and mobility needs. There were 11 people living at the service at the time of inspection. People had lived at the service for a long time and some were becoming increasingly frail and elderly. The amount of personal care and support they needed had increased.
The accommodation was over three 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. Hallways were wide and accessible so people in wheel chairs could move around the service freely and independently.
There was a registered manager working at the service and they were supported by a deputy manager. They were also the registered manager of another service in the same road. 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, deputy manager and staff supported us throughout the inspection.
The registered manager had been in charge at the service for a long time. They knew people and staff well and had good oversight of everything that happened at the service. The registered manager was enthusiastic, energetic and led by example. Their energy and enthusiasm was passed on to the staff team who were encouraged and supported to look at different ways of improving the life’s of people and improving the service. They promoted the ethos of the service which was to give personalised care and support to people and support them to achieve their full potential to be as independent as possible.
Risks to people’s safety were assessed and managed appropriately. Assessments identified people’s specific needs, and showed how risks could be minimised. The registered manager also carried out regular environmental and health and safety checks to ensure that the environment was safe and that equipment was in good working order. There were systems in place to review accidents and incidents and make any relevant improvements as a result.
The provider had taken steps to make sure that people were safeguarded from abuse and protected from the risk of harm. Staff had been trained in safeguarding adults and knew what action to take in the event of any suspicion of abuse. Visiting professionals told us that people were cared for in a way that ensured their safety and promoted their independence.
Emergency plans were in place so if an emergency happened, like a fire, the staff knew what to do. Safety checks were carried out regularly throughout the building and there were regular fire drills so people knew how to leave the building safely.
People felt comfortable in complaining and when they did complain they were taken seriously and their complaints were looked into and action was taken to resolve them.
Before people decided to move into the service their support needs were assessed by the registered manager to make sure the service would be able to offer them the care that they needed. People indicated that they were satisfied and happy with the care and support they received. People received care that was personalised. The care plan folders and health care plans contained a large amount of information. Some of the information and guidance was duplicated, inaccurate and was difficult to find. The manager agreed to address this.
The dedication and attitude of the managers and staff was ‘over and beyond the call of duty’. People received care that was personal to them. Staff understood their specific needs well and had good relationships with them. People were settled, happy and contented. Visiting professionals told us they only had positive experiences and praise. Throughout the inspection people were treated with dignity and kindness. People privacy was respected and they were able to make choices about their day to day lives. People had an allocated key worker. Key workers were members of staff who took a key role in co-ordinating a person’s care and support and promoted continuity of support between the staff team. The service was planned around people’s individual preferences and care needs.
Staff were familiar with people’s life stories and were very knowledgeable about people’s likes, dislikes, preferences and care needs. They approached people using a calm, friendly manner which people responded to positively. This continuity of support had resulted in the building of people’s confidence to enable them to make more choices and decisions themselves and become more independent. Staff asked people if they were happy to do something before they took any action. They explained to people what they were going to do and waited for them to respond.
The registered manager was effective in monitoring people’s health needs and seeking professing advice when it was required. Health care professionals said that staff always followed the advice that they gave. Assessments were made to identify people at risk of poor nutrition, skin breakdown and for other medical conditions that affected their health.
People received their medicines safely and when they needed them. They were monitored for any side effects. If people were unwell or their health was deteriorating the staff contacted their doctors or specialist services. People’s medicines were reviewed regularly by their doctor to make sure they were still suitable.
People were supported to have a nutritious diet. Care and consideration was taken by staff to make sure that people had enough time to enjoy their meals. Meal times were managed effectively to make sure that people received the support and attention they needed.
The registered manager and staff understood how the Mental Capacity Act (MCA) 2005 was applied to ensure decisions made for people without capacity were only made in their best interests. CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. These safeguards protect the rights of people using services by ensuring that if there are any restrictions to their freedom and liberty, these have been agreed by the local authority as being required to protect the person from harm. DoLs applications had been made to the relevant supervisory body in line with guidance.
The management team made sure the staff were supported and guided to provide care and support to people enabling them to live fulfilled and meaningful lives. New staff received a comprehensive induction, which included shadowing more senior staff. Staff had regular training and additional specialist training to make sure that they had the right knowledge and skills to meet people’s needs effectively. Staff said they could go to the registered manager at any time and they would be listened to. Staff fully understood their roles and responsibilities as well as the values of the service.
A system to recruit new staff was in place. This was to make sure that the staff employed to support people were fit to do so. There were sufficient numbers of staff on duty throughout the day and night to make sure people were safe and received the care and support that they needed. There was enough staff to take people out to do the things they wanted to.
The registered manager had sought feedback from people, their relatives and other stakeholders about the service. Their opinions had been captured, and analysed to promote and drive improvements within the service. Informal feedback from people, their relatives and healthcare professionals was encouraged and acted on wherever possible. Staff told us that the service was well led and that the management team were supportive. The registered manager was aware of had submitting notifications to CQC in an appropriate and timely manner in line with CQC guidelines.