Archived: Westoe Grange Care Home

This inspection took place on 31 May and 1 June 2016 and was unannounced. We last inspected this service in August 2014, at which time we found them to be meeting all of the regulations that we inspected.

The service had a registered manager in post. 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 told us they felt safe living at Westoe Grange. Staff understood their responsibilities with regards to protecting people from harm and improper treatment. Records showed there were enough staff employed at the service and staff confirmed this. People told us the staff responded to them promptly and medicines were given on time.

Policies and procedures were in place to ensure the smooth running of the service. Care needs were thoroughly assessed and person-centred care plans were drafted. Risk assessments were regularly reviewed and preventative methods were recorded to reduce the likelihood of a repeat event.

Accidents and incidents were recorded, investigated, analysed and monitored for trends. Action plans were in place to address shortfalls and drive improvements through the service. The manager recorded all incidents and escalated them to external bodies such as the local authority and CQC as necessary.

Checks on the safety of the home were carried out regularly by on-site maintenance staff as well as by external professionals where necessary. Personal emergency evacuation plans were in place.

Medicines were managed in line with safe working practices. They were administered safely and hygienically and medicine administration records were maintained and up to date.

The manager and staff had an understanding of the Mental Capacity Act 2005 (MCA) and their own responsibilities. Staff worked in people’s best interests and we saw these were documented in line with MCA principals.

Staff supported people to maintain a healthy, well balanced diet. People told us the food was lovely and they enjoyed a variety of meals. The chef catered for people’s likes and dislikes.

Staff received an induction upon commencement of their employment and they were trained in topics specific to their role. Formal supervision and appraisals were carried out routinely.

Staff interacted well with people and demonstrated genuine, kind and caring attitudes. We saw staff offered people choices and encouraged them to make decisions about aspects of daily life. People were respected by staff and their privacy and dignity was maintained.

People engaged in a variety of organised activities. They were supported by staff to maintain links with their family and the community by encouraging visitors into the home without restrictions. Group activities and one to one sessions took place and the service sometimes hired a minibus to facilitate day trips.

People and their relatives knew how to complain and told us they would feel confident to approach the staff or manager if something was wrong. Resident and relative meetings were held and a quarterly survey was used to gather feedback and opinions about the home and the service.

The manager held a comprehensive set of records, audits and action plans which demonstrated they monitored the quality and safety of the service. The provider had oversight of the service.

Staff told us they were happy to work for the provider and enjoyed a good relationship with the people who lived at Westoe Grange.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

Below is a summary of what we found.

Is the service safe?

We contacted the local authority safeguarding team who told us the provider was always 'spot on' where concerns needed to be reported to the local authority. They said that investigations carried out by the provider had been thorough.

During our inspection, we checked how people using the service were cared for and whether they felt safe. We spoke with ten people and two visitors. We saw that people were treated well and that there were warm, friendly relationships between people and the staff team. People told us, "I wouldn't be here, if I wasn't content. I don't miss my home here. I have got used to being here. They're very good."

We spoke with two visitors to find out whether they considered their relatives were safe using the service. They made complimentary comments about the service. Their comments included, 'They treat (my relative) and other people very good.'

We found that staff had training about safeguarding people from abuse. When we spoke with staff, we found that they understood the types of abuse that could occur in a care home environment, and they were clear about the action they had to take if they had any concerns. Staff were confident that any concerns they raised would be taken seriously by management and also understood that they could report any concerns to other bodies if they felt they were not being listened to.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLs) which applies to care homes. We found the provider had made applications under these safeguards where appropriate and notified CQC about this.

We saw that risks to people's safety had been identified and assessed to ensure that appropriate care and support was provided to keep people safe. For instance, some people, who were at risk of falling, were using sensory mats which alerted staff when they needed help to move about the home.

Is the service effective?

We considered that there were clear processes for obtaining people's consent and ensuring people could make informed decisions where appropriate.

We found that people received the care and support they needed. The staff we spoke with had a good understanding of people's care needs. People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People told us they were happy with their care. They told us, 'It's better here than being at home alone. The staff are marvellous' and 'I like it here. They're good. It's just like home.'

Visitors told us they were happy with their relative's care. Their comments included, 'It's excellent. I've no qualms about it. They looked after (my relative) like I couldn't.'

Is the service caring?

One person told us, "It's lovely. I've settled in. The staff are fantastic. You couldn't want anything more. I would recommend it to anyone." Another person commented, "They're very friendly. I would recommend it to anyone. I'm very nervous and when I'm here, I don't feel nervous."

We saw that people were treated with dignity and respect by staff, who were friendly and considerate. People's comments included, "I wanted to come here. It's very good. I can't complain,' and "The staff are not bad at all. They're all very nice. They never grumble or pull a face."

Is the service responsive?

People were pleased with the care they received. One commented, "They're here in the night if you need them."

We found that the service identified people's care needs before they moved into the service so that they could be sure staff could provide the support people needed.

We found that staff acted on any changes in people's well-being and sought advice and guidance from other health and social care professionals when appropriate.

Is the service well led?

A manager was in place who was registered with CQC. Staff felt supported by her and people we spoke with felt the service was managed effectively. One person told us, 'The manager is on the alert all the time. She's excellent. She's a lovely lady."

People and relatives told us the management and staff were open and friendly and they felt confident about any raising any issues or concerns with them.

There were effective quality assurance systems in place. Audits were carried out to check people were cared for appropriately, for instance, to make sure there were effective infection control measures in place.

One relative said 'The manager is really helpful; she has time for you and listens to you if you have any issues.' Another relative said the care home was 'Homely, the staff know my relative's needs and the care home is always very clean'.

We spoke to a visiting health care professional who told us they found the care home to be 'Very good'. They said 'The staff are good at making people feel welcome when they first come to live at the home'.

We saw that people who used the service, staff and visitors were protected against the risks of unsafe or unsuitable premises. People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard and the provider had systems in place to identify risks and monitor the quality of service provided. There was an effective complaints system in operation.