Westbourne Tower Care Home

Signature at Westbourne is a nursing home providing personal care and nursing care to 108 people at the time of the inspection. The service can support up to 114 people. Signature at Westbourne is a purpose-built building and is accessed over four floors by stairs or a lift. People could access the ground and first floors freely, the second and third floor had restricted access to keep people living with dementia safe.

People’s experience of using this service and what we found

People told us they felt safe and were happy living at Signature at Westbourne. Comments included, “this is my home now and I am very happy”, “the staff are lovely” and, “this is the perfect place for me.”

The design and decoration of the premises did not always follow the best practice guidance for supporting people living with dementia. Plans were in place to redecorate these areas. We have recommended the provider consults good practice guidance around providing a dementia friendly environment for people who use the service.

Peoples needs were assessed before they moved into the service. We found people’s protected characteristics had not always been considered as fully as they could have been. A new electronic care planning system was being introduced that included a more robust system for seeking protected characteristics. We recommended the provide consults good practice guidance to ensure assessments fully explored people’s needs to ensure they could be met before they moved into the service.

Staff had assessed people for risks to their health and well-being and created plan to minimise the likelihood of harm occurring. Clinical and non-clinical risks were discussed daily between staff to ensure people were safe. People told us there was enough staff to meet their needs. Staff had been recruited safely into the service and had received a comprehensive induction followed by regular training to ensure they had the right skills to meet people’s needs. Medicines had been managed safely and people were protected from the spread of infections. Lessons were learned when things went wrong.

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

Staff worked effectively with other agencies to provide consistent, effective and timely care. Staff supported people to access healthcare when required. People were supported to eat a well-balanced diet. Staff told us they felt supported to carry out their job roles.

People told us they were cared for by staff who knew their needs, were kind, respectful and treated them with dignity. One relative said, “[Person] settled in the home immediately which suggests that they must be doing something right.”

Staff provided people with care responsive to their needs. We identified one person was not always being supported to communicate as fully as they could have been. We brought this to the attention of the registered manager and provider who responded quickly and by the next day of our inspection we observed the way the person chose to communicate had been fully supported. This resulted in the person being able to tell staff their likes, dislikes and wishes.

There was a large activities programme in place, one person told us, “the programme of activities is brilliant.” The activity staff told us the plans they had to improve activities for people living with dementia and people who preferred a 1:1 activity.

People knew how to complain and felt they would be listened to. People were supported to have a dignified and respectful end of life when the time came.

People, relatives and staff spoke positively about the registered manager and management team. People and staff felt comfortable to speak open and honestly and felt they would be listened to. Quality assurance systems were in place to monitor the quality of the service and identify areas of improvement. Signature at Westbourne engaged with people, the public and staff to improve the running of the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 10 December 2021 and this is the first inspection.

The last rating for the service under the previous provider was Outstanding, published on 2 February 2019.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Sunrise of Westbourne 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.

Sunrise of Westbourne can accommodate up to 114 older people in purpose-built premises. Nursing care is provided. The home is separated into two communities known as the “Assisted Living Community” and the “Reminiscence Community”. The latter provides specialist care for people who live with dementia. There were 90 people living or staying there when we inspected.

A registered manager was 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 and their visitors were exceptionally positive about the care provided at Sunrise of Westbourne. They were also full of praise for the staff. Many people gave us instances of exceptional care they had received or told us about occasions where staff had gone the extra mile to ensure people continued to live fulfilling, happy lives. Visitors valued the relationships they and their loved ones had with the staff team and told us they always felt welcome. People’s independence was promoted as far as possible and their choices were respected.

Staff at Sunrise of Westbourne were a highly motivated team who demonstrated their commitment to providing high quality, individualised care to meet people’s preferences and needs. There was a very strong emphasis on the provision of activities that were meaningful to the people living in the home. This meant that people were supported to pursue interests and hobbies that were important to them. Activities were continually evaluated to ensure that they remained appropriate to people’s needs and individual preferences. People were able to access the local community either independently or with support. The registered provider encouraged community involvement and invited various local groups into the home on a regular basis.

Staff spoke positively, passionately and with compassion about working at Sunrise of Westbourne. They told us the common aim for everyone was to provide a high-quality service to people in whatever role they undertook. They told us they felt very well supported by the registered manager and the management team and said that they who were always available and willing to lend a hand and work as part of the team.

Staff were well trained and had the skills to meet people’s needs. Regular training and supervision was available for all staff. There were sufficient staff on duty with the right skills and knowledge to provide the care and support people needed. The registered manager explained that staffing levels were based on people’s needs which were kept under constant review and that the number of staff on duty could easily be adjusted for either temporary or permanent reasons. Staff were recruited safely; checks were undertaken before they started work to ensure they were suitable to work in a care setting.

People’s care and support needs were assessed and planned for in detail prior to moving to Sunrise of Westbourne and through an ongoing review process. People and, where appropriate, their relatives, were encouraged to be involved in these processes. Staff knew people very well and understood their care needs and preferences. They spent time with people, both during care tasks and at other times. Care and support was not rushed and we observed staff working at the person’s pace.

Risks were assessed and managed pro-actively. People were supported to take risks to maintain their independence as far as possible, for example, if they could walk they were encouraged to do so.

The home had been purpose built and included special features such as extra wide corridors and door ways. At the time of the inspection, parts of the building were being refurbished. The registered manager had taken this opportunity to change how some areas of the home were used, improve facilities such as the hairdressing salon and staff room and ensure that new understanding about the best environments to support people living with dementia, based on research evidence, had been included.

Staff understood their responsibilities for safeguarding adults, including recognising signs of abuse and how to report any concerns and to whistle blow. Medicines were stored and managed safely, and were administered as prescribed. The premises were well maintained, with regular health and safety checks and up-to-date servicing. People were protected from the risk of infections by staff who ensured that the environment was kept clean and infection control procedures were followed.

People’s rights were protected because the staff acted in accordance with the Mental Capacity Act 2005, including the deprivation of liberty safeguards. Where people could give consent to aspects of their care, staff sought this before providing assistance. If there were concerns that people would not be able to consent to their care, staff assessed their mental capacity. Where they were found to lack mental capacity, a decision was made and recorded regarding the care to be provided in the person’s best interests.

People were supported to maintain a balanced diet and to have plenty to eat and drink. People’s weights were monitored and appropriate action taken if people were identified as being at risk of malnutrition or dehydration. People had access to healthcare services and were supported to manage their health.

Lessons were learned and improvements made when things went wrong. Concerns and complaints were seen as an opportunity to bring about improvement. The registered manager and their team exercised their duty of candour, keeping people and where appropriate their relatives informed about what had happened as the result of an accident or incident.

The service operated openly and transparently, working cooperatively with other organisations to ensure people were safe and received the care and support they needed. The service had a clear management structure, with an established registered manager. They and other members of the management team worked closely with staff, frequently observing and providing care. People, visitors and staff were confident in the leadership of the service.

People and visitors were asked for their feedback about the service they received through regular surveys, meetings in the home and a suggestions box. People told us they felt listened to and that their views did influence how things happened.

There were systems in place to monitor the safety and quality of the service. This included the use of audits and surveying the people who used the service and their representatives.

Further information is in the detailed findings below: