We carried out a review of the data available to us about Westall 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 Westall House, you can give feedback on this service.
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
Westall House is registered to accommodate up to 21 people, they specialise in supporting older people whose primary need is assistance with personal care. There were 18 people living at the service at the time of our inspection. The property is a detached house situated in a rural setting on the outskirts of the village of Horstead Keynes. There is a communal lounge, library and dining room and all bedrooms have en-suite facilities. All areas are easily accessible including the garden and grounds.
The service had a registered manager. 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 person is legally obliged to inform the Care Quality Commission (CQC) if the registered manager will be absent from work for more than 28 days and what the arrangements for managing the home will be whilst they are away, but had failed to do so. We also found providers’ processes and systems had not identified that the registered manager and staff employed at the home were not aware of the full implications of the recent changes in legislation and how this affected their responsibilities. Accidents and incidents had been recorded but we were not assured that the provider had analysed the information to identify whether any emerging themes, patterns or trends had been identified. These are areas that we identified as requiring improvement.
People were supported to be as independent as possible and live the lifestyle of their choice. They could choose for themselves when to get up, how to spend their time and where to eat their meals. People led active lives and were supported to participate in a range of activities provided by the activity organiser volunteers and staff which they enjoyed. They were supported and encouraged to maintain relationships with people that mattered to them and their visitors were welcomed into the home. People were able to bring their own furniture and belongings to furnish their rooms and had a say in the way the home was run for example what food was on the menu.
Staff knew the people well and were aware of their personal preferences, likes and dislikes. Person centred care plans were in place detailing how people wished to be supported, and people were involved in making decisions about their care. A member of staff said “Its people’s own choice to do what they want and we do whatever we can to help them”. People were supported with their healthcare needs and staff liaised with their GP and other health care professionals as required. Two visiting health care professionals and a social care professional told us they had no concerns about the home and gave positive feedback about the care people received.
Feedback about the registered manager and staff was positive. One person referred to them as being “Warm and kind”. Staff were aware of their responsibility to protect people from harm or abuse. They knew the action to take if they were concerned about the safety or welfare of an individual. They told us they would be confident reporting any concerns to the registered manager or the person on call. A relative felt their loved one was safe and was confident their family member would speak out if something was wrong. The registered manager had responded appropriately when concerns had been raised and the relevant people had been informed. Systems for recruiting new staff made sure they were suitable to work at the home. They included security and identity checks and references from previous employers.
Staff felt supported and received regular training. They had obtained or were working towards obtaining a nationally recognised qualification in care. They were knowledgeable about their roles and responsibilities and had the skills, knowledge and experience required to support people with their care and support needs.
Accidents and incidents were recorded appropriately and steps taken to minimise the risk of similar events happening in the future. Risks associated with the environment and equipment had been identified and managed and emergency procedures were in place in the event of fire.
The provider had quality assurance and monitoring systems in place to measure and monitor the standard of the service. Areas identified as in need of improvement had been detailed in an action plan with planned dates for completion.
We found one area where the provider was not meeting the requirements of the law. You can see what action we have told the provider to take in the back of the full version of this report.
We looked round the home which was clean and free of unpleasant odours. The rooms were on the ground and first floor and where single occupancy. All of the rooms offered ensuite facilities, with nineteen of the rooms with showers which had special adaptations. The rooms were personalised with individual own furnishings, photographs, TV's and pictures. All the door ways and corridors were wide enough for wheel chair access and there was a lift so people could access the first and ground floors which enabled people to move around independently.
During our visit we spoke with four people who used the service, and a visitor. We also spoke with five staff including the registered manager. We spent time observing how staff interacted and supported people. We saw staff treat people in a sensitive, respectful and professional manner.
All the people we saw looked happy and individuals we spoke with told us they liked being at Westall House. One person told us that they were 'very happy here' and that the 'staff couldn't do enough'. Another individual told us that they 'thought the home was excellent' and that 'everybody was lovely'. One of the relative's we spoke with told us that their relative 'was very happy and I am happy she is here'.
We found that people were treated with dignity and respect. Staff supported people to make choices about their care and daily activities. People were encouraged to engage in stimulating activities of their choice.
People's care and treatment was planned and delivered in line with their individual needs and preferences. We found that people were involved in developing their care plans. Care plans were reviewed regularly with people to ensure their needs were being met. A daily record of care was maintained to document how care and support was delivered and to monitor any changes. Staff told us they felt care plans were robust and helped them to understand people.
People told us they felt safe living at Westall House. People felt comfortable to raise concerns and were confident that any comments would be investigated. Staff were trained to understanding safeguarding and how to keep people safe.
We found that staff received appropriate training and supervision which enable them to carry out their work in a safe and effective way. Staff told us they felt supported.
Records were maintained and stored securely.