Westhope Place

Westhope Place is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The care 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 and autism using the service can live as ordinary a life as any citizen.

This location is registered to provide accommodation and personal care to up to seven people with physical or learning disabilities. At the time of our inspection seven people living in Westhope Place. Not everybody was able to tell their experience but our observations during the inspection told us that people felt comfortable with staff and were content in their home. We saw that interactions both verbal and non-verbal were positive and that people trusted staff to keep them safe.

This comprehensive inspection took place on 7 March 2018 and was unannounced. Due to a significant delay in the inspection process, we undertook a second day of inspection which was announced with the provider on the 29 August 2018.

There was a registered manager in place. '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 received a safe service. The provider ensured that people were supported by sufficient staff who knew how to protect people from the risk of harm or abuse. The provider's procedures for staff recruitment helped to ensure people were only supported by staff who were suitable to work with the people who lived at Westhope Place. People could live their lives with reduced risks to themselves. Staff followed safe procedures for the management and administration of people's medicines. Staff followed the provider's health and safety procedures which helped to ensure people lived in a safe and well-maintained environment. There were procedures to deal with foreseeable emergencies and these were understood and followed by staff. People were protected from the risks associated with the spread of infection because staff had received training and followed appropriate procedures.

People received effective care and support from staff who had the skills, training and knowledge to meet their individual needs. Staff understood the importance of ensuring people's rights were respected. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. People were supported to eat well in accordance with their needs and preferences. People's health and well-being were regularly monitored.

People were supported by staff who were kind, compassionate and who took time to get to know what was important to people. Staff treated people with respect and ensured people could spend time alone whenever they wanted. People were supported to plan their day in accordance with their needs and preferences. Staff communicated with people in accordance with their needs and abilities which helped people make an informed decision. People were supported to maintain contact with the important people in their lives.

People continued to receive a service which was based on their needs and preferences and there was an emphasis on enabling people to be as involved in the planning and review of the support they received. People enjoyed a variety of activities and social events within the service and the local community. Trips out to their favourite places were arranged such as ‘Monkey World and the zoo. The service had not received any complaints however systems were in place to enable people to raise concerns in a format that was suitable for example, pictorial. People were supported to practice their faith and attend religious services if and when they wanted. People's care plans detailed their preferences following death which helped staff to ensure their wishes were respected.

People benefitted from a provider and registered manager who promoted an open and honest culture,

learned from mistakes and continually looked at how the quality of the service could be improved. People were supported by a staff team who embraced the provider's ethos and who felt valued and well supported. People's views were valued and responded to and people were enabled to be part of the wider community.

This inspection took place on 8 February 2016 and was unannounced.

At the time of this inspection the service did not have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 day-to-day management of the service was being overseen by a manager who is referred to as the acting manager throughout this report and the provider had given us assurances that the process for submitting a registered manager’s application had been initiated.

Whilst the provider had completed identity and security checks for new staff the character references obtained had not always been provided by the staff member’s previous employer. Full work histories had not always been obtained and gaps in the employment history of some staff had not been accounted for. Therefore the provider could not be assured these staff were suitable to work with adults at risk.

People’s independence was promoted and they participated in a range of activities of their choice such as going to the pub or a café for lunch and going shopping. One person told us “I like colouring and I like going on holiday. In the summer we go on day trips to Eastbourne, London, Brighton and Worthing. On Thursday I’m going shopping and going to the Gateway Club”.

People were supported by kind, caring staff that knew them well and understood their individual needs. One person told us “The staff are very nice and kind. I’m happy with the staff”. People’s relatives and representatives reported that their loved ones were supported by caring staff. One relative told us “It’s a peaceful, friendly home. I feel at home there and feel very happy she is there. They are doing the best for her as far as I can see”.

People could choose their own meal and drinks. One person told us “We have nice food for breakfast and lunch and nice tea. We have all sorts of things. Sometimes we have meetings about what we have to eat”. People were supported to maintain relationships with people that mattered to them and visitors were welcomed. One person's relative told us "I visit at all times of day, they never know I’m coming, I just pop in when I’m in the area". People's relatives and representatives were kept informed of their loved one’s wellbeing and any changes in their needs. One person's representative told us they had been "very impressed" with the support their loved one had received through a period of ill health.

People’s needs had been assessed and planned for. Plans took into account people’s preferences, likes and dislikes and were reviewed on a regular basis. Staff worked in accordance with the Mental Capacity Act (MCA) and associated legislation ensuring consent to care and treatment was obtained. People were supported to make their own decisions and where people lacked the capacity to do so, their relatives and relevant professionals were involved in making decisions in their best interest.

Medicines were ordered, administered, stored and disposed of safely by staff who were trained to do so. Referrals were made to relevant health care professionals when needed and each person had a health action plan in place.

Staff received the training and support they needed to undertake their role and were skilled in supporting people. A staff member told us, “I did shadow shifts when I first started. I didn’t work on my own until I had been shown what to do and had got to know people”. Staff had a good understanding of each person’s communication needs and of how some people communicated their feelings through their facial expressions or their actions. They were able to recognise when a people were feeling anxious and took appropriate action to minimise these anxieties.

Staff knew what action to take if they suspected abuse had taken place and felt confident in raising concerns. Risks to people were identified and managed appropriately and people had personal emergency evacuation plans in place in the event of an emergency. Staffing levels were sufficient to meet people’s assessed needs and for staff to spend one to one time with people.

The management of the service were open and transparent and a culture of continuous learning and improvement was promoted. The provider had ensured processes in place for auditing and monitoring the quality of the service were followed and complaints were responded to appropriately.

We found one area where the provider was not meeting the requirements of the law. You can find what action we have told the provider to take at the back of the full version of the report.

The staff we spoke with said that they were pleased to be working in a 'small and friendly' care home. They said that they felt well trained and supported for their work and that they were 'lucky to be part of a good professional team'. They felt that they had time to provide a high standard of care and to perform the 'key worker' role.

Staff told us that each person had an allocated key worker and key working sessions were held monthly. We saw records which supported this. One person told us they were able to maintain their independence. Two people said that 'the staff sits with me and tells me about my care.''

We found there was enough qualified and experienced staff to meet people's needs. People told us the staff were nice. One person said 'it was nice to go out to lunch or have a coffee' Staff reported that there was enough time to involve people in their care and that they had enough time to give the people the attention needed.

We found evidence that learning from incidents took place and appropriate changes implemented.

During the visit we observed staff engaged in a professional and caring manner to people.The atmosphere was pleasant and people appeared relaxed.