Westall House

Updated 27 April 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection was carried out by one adult social care inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

This inspection took place on 1 and 2 February and was unannounced.

The provider had completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. Before the inspection we reviewed the information that we had about the service including safeguarding records, complaints, and statutory notifications. Notifications are information about specific important events the service is legally required to send to us.

Some people in the service were living with dementia and were not able to tell us about their experiences. We used a number of different methods such as undertaking observations to help us understand people’s experiences. We spoke with 12 people who used the service and one person’s relative, one health care professional and two volunteers. We also spoke with 12 members of staff. This included the registered manager, the head of care, care staff and ancillary staff.

During the inspection, we looked at four people’s care and support records. We also reviewed records associated with people’s care provision such as medicine records and daily care records relating to food and fluid consumption. We reviewed records relating to the management of the service such as the staffing rotas, policies, incident and accident records, recruitment and training records, meeting minutes and audit reports.

Following the inspection we asked the registered manager to send us some policies and these were all sent within the time frame given.

Updated 27 April 2018

This was an unannounced inspection on 1 and 2 February 2018.

At the last inspection we found there was a breach in Regulation 14 of the Care Quality Commission (Registration) Regulations 2009 because the provider had not notified the Care Quality Commission about the absence of a previous registered manager for over 28 days. At this inspection we found no concerns in relation to notifications.

Westall House is a residential care home for up to 22 older people with a range of needs catered for, including people living with dementia. At the time of the inspection there were 21 people living at the home. On the same site is a sheltered housing service which we do not regulate. There are two floors and a range of communal spaces throughout including a dining room and lounge spaces.

At the last inspection, the service was rated Good.

At this inspection we found the service improved to Outstanding.

Why the service is now rated Outstanding.

Since the last inspection the registered manager and provider had worked hard to ensure there were continual improvements at the home. These had been recognised by the home receiving the ‘house of the year’ award from the provider and an external national nomination for the activities coordinator.

People received exceptionally good care from staff who treated them like part of their extended family and knew them incredibly well. They had found ways to involve people in all decisions about their care and home. Feedback from people, relatives and visitors to the home informed us about how well cared for they felt. Care and support was incredibly personalised to each person, which ensured they were able to make choices about their day to day lives in line with their needs, hobbies and interests. Information about their preferences were gathered in detail by members of staff allocated to help them write their life story.

People’s privacy and dignity was respected by staff and their cultural or religious needs were valued. People, or their representatives, were involved in decisions about the care and support they received. People who had specific end of life wishes had their preferences facilitated by staff to help provide a dignified death.

The service provided to people was responsive to people’s individual needs. There was an activities coordinator who ran the activities in the home with incredible passion. They had listened to every person’s wishes and needs so they could develop bespoke activities to enrich their lives. There was a range of opportunities for people and their families to participate in. Activities always considered people’s hobbies and interests and were personalised as much as possible.

The provider promoted a drive to access pilot schemes and find ways to innovate the support people received. There was a strong emphasis on intergenerational and community working in the home. These provided opportunities for people to reminisce and promoted their well-being by being valued.

There was a high level of volunteers who regularly came and supported the home. They ran activities and felt a valued part of the community which the provider and management were promoting. Complaints were fully investigated and responded to in a timely manner. The registered manager had a strong ethos of valuing any concern a person or their relative raised because they knew how important it was for them.

The home had a provider and management who strove to provide people with excellent care. People, relatives and staff told us the registered manager was excellent and had ensured the best care and support was provided. The registered manager and provider continually monitored the quality of the service and made improvements in accordance with people’s changing needs.

The provider wanted to drive innovation and strive for excellence at all times. They encouraged staff to participate in national pilots to improve the care and support people received. The staff and registered manager had received internal recognition and national recognition for the work they were doing. Staff at all levels felt supported and were proud their work to improve the lives for people had been recognised. They often went above and beyond to enrich people’s experience and value them as people.

There were suitable numbers of staff to meet people’s needs and to spend time socialising with them. Interactions were on a personal level and not just task based. Risk assessments were carried out to enable people to retain their independence and receive care with minimum risk to themselves or others. People received their medicines safely. People were protected from abuse because staff understood how to keep them safe and were sure action would be taken if any concerns were raised.

The home continued to ensure people received effective care. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible. People who required special diets had their needs met and meal times were treated as a social opportunity. Staff had the skills and knowledge required to effectively support people. People told us their healthcare needs were met and staff supported them to attend appointments. One health care visitor was very complimentary about how the home supported the people they saw.

Further information is in the detailed findings below