West Bank Residential Home

West Bank Residential Home is a care home providing personal care for up to 42 people. The service provides support to older people, people living with dementia, people with physical disabilities and younger adults. At the time of our inspection there were 39 people using the service.

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

People, their relatives and staff gave positive feedback about the care provided. The provider had effective safeguarding systems in place and staff knew what actions to take to help ensure people were protected from harm or abuse. People received their medicines as prescribed. The premises were clean with no malodours. People were supported to have maximum choice and control of their lives and staff provided them with care in the least restrictive way possible; the policies and systems in the service promoted this practice. Staff worked within the principles of the MCA and sought people's consent before providing personal care and assistance.

The provider had comprehensive quality assurance systems to monitor the quality of the service. People, relatives and staff were regularly asked for feedback. The culture of the home promoted positive outcomes for people. The registered manager understood their responsibilities under the duty of candour. Relatives were kept informed of any changes in people's needs or incidents that occurred. The registered manager and staff worked closely with local health and social care professionals to meet people's needs.

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

Rating at last inspection

The last rating for this service was good (published 26 June 2019).

Why we inspected

We received concerns in relation to falls management, pressure care, communication with families and leadership of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained good based on the findings of this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for West Bank Residential Home on our website at www.cqc.org.uk.

Recommendations

We have made a recommendation about submitting statutory notifications.

Follow up

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

West Bank Residential Home is located in Ross-on-Wye, Herefordshire. The service provides personal care and accommodation for up to 41 older people. At the time of our inspection, there were 38 people living at the home.

People’s experience of using this service:

People who lived at the home, relatives, staff and healthcare professionals told us West Bank had a homely atmosphere and a strong emphasis on the importance of family and community connections.

There was a positive atmosphere within the home. People and their relatives were enabled to be involved in the care and staff were motivated in ensuring people were treated as individuals and had an enjoyable life.

Staff had developed positive, respectful relationships with people and were extremely kind and caring in their approach. People’s privacy and dignity were respected by staff who worked to a set of values around providing care centred on each person. People were supported and encouraged to be as independent as possible in all aspects of their lives.

People told us staff concentrated on what was most important to them and made sure they received the care they needed and preferred. People were supported to take part in a rich programme of planned and spontaneous activities which they found interesting and fulfilling. The staff team including the chef had been creative in supporting people to eat and drink enough which helped people to remain well.

Staff anticipated people’s care needs and responded to people swiftly, respectfully and with warmth. People were valued for who they were and supported with compassionate care at the end of their lives in ways they preferred.

Staff felt a strong sense of ownership and pride in the service and felt well supported by the management team. There were sufficient staff to meet people's care and support needs. Staff had been recruited safely and many of the staff team had worked at the home for several years which was valued by people living there.

Plans of care had been developed and reviewed with people and their relatives, and the staff team knew people they were supporting well. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

Risks associated with people's care and support had been appropriately assessed and managed. People told us they felt safe living at the service and with the staff team who supported them. The staff team were aware of their responsibilities for keeping people safe and had received the relevant safeguarding training.

Medicines were stored, administered and disposed of safely. Staff followed the providers policies in reducing the risk of cross infections and regularly checks were undertaken to make sure people lived in a clean environment.

The registered manager was a positive role model and together with their staff team they had a passion to learn about and aim for best practice with people at the heart of their care. People who lived at the home and all staff were actively encouraged to contribute to the evaluation of the care provided and recommendations of where they could aim higher to drive through improvements. Regular quality audits and checks were completed so improvements were continually recognised and there was effective follow up action which made sure people received a high-quality service.

More Information about the inspection is in the full report.

Rating at last inspection:

At our inspection the service was rated Good in all areas and overall. The report was published on 03 October 2016.

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received and assess if improvements have been made.

Follow up:

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

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

The inspection took place on 31 August 2016 and was unannounced.

There was a registered manager at this home. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered providers and registered managers 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 were supported by staff who knew how to keep them safe and how to respond to any concerns about their safety. Staffing levels were determined by the needs of the people living at West Bank.

People were supported to have as much freedom as possible, whilst keeping them safe. People received their medicines safely, and as prescribed by the GP.

People had access to a range of health professionals and were supported to maintain their health. People received the support they needed with eating and drinking, and with maintaining a healthy weight.

People's individual choices and preferences were respected.

People were involved in decisions about their care. People's religious beliefs were respected and they were given opportunity to continue to practise their faiths. People had access to independent advocacy services, where required.

People's changing health and wellbeing needs were responded to and appropriate medical attention sought. People enjoyed their individual hobbies and interests, as well as various group social events and opportunities.

People and relatives knew how to make or complaint, provide feedback or raise a concern. Where complaints or concerns had been raised, these had been investigated, responded to and action taken to prevent a re-occurrence.

People and their relatives were positive about the running of the home. The registered manager involved people, relatives and staff in the running of the home. The provider, registered manager and staff were clear of the values of the home, and worked together to ensure people were as happy as possible.

Below is a summary of what we found. The summary describe what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found

Is the service safe?

The people who lived in the home and their relatives told us they were pleased with the care provided. They felt that their views were respected and listened to.

People told us they felt safe. We saw that people were free to go about their daily routine. People told us, 'The staff are very happy and kind' and, 'It's very nice here'.

We found that people's medication was managed in a safe and effective way. This ensured that people received the right medication in the right quantities at the right times.

Staff understood about the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and how they would be put this into practice. No DoLs applications had been submitted.

Is the service effective?

People told us that they were happy with the care they received. They told us that the registered manager and the staff had asked them what their needs were and how they would like them met. A relative said, 'My mum is well looked after'. One person said, 'They are always asking me'.

Care records we looked at showed people's needs and preferences had been recorded and care and support had been provided in accordance with their wishes. One person said, 'They do a good job of looking after me'.

People and their relatives were involved in the assessment of their needs. One person said, 'We talk about what mum would like and they look at arranging things for her'.

People and their relatives told us they were happy to discuss their personal preferences with staff. They said that staff obtained help for them if they were unwell. This meant people were supported to have access to health care services and received ongoing support.

Is the service caring?

The people we talked with told us they felt that their wishes were respected and they were helped to live their lives as they wished. Staff took the time to find out about people's past. Staff we talked with knew people's needs well and how they wished to be cared for. This meant that staff cared about the person as an individual and showed concerned about their well-being.

People and their relatives were encouraged to make their views known about their care. People that we talked with told us that they found the registered manager and the staff easy to approach about any issues they had. This meant that people were listened to and they felt that their views mattered.

Is the service responsive?

People had been assessed before they moved into the home so that arrangements could be made to meet their needs.

People and their relatives told us they talked with the staff about what was important to them. They talked about the activities they took part in and how they liked their meals prepared. They told us that staff had changed their care packages as a result.

Is the service well led?

The registered manager and staff demonstrated values that included involvement, compassion, dignity, respect and independence. Staff we spoke with showed they understood those values as they discussed their role and responsibilities in their work. This meant the service promoted the individual to help them manage their life as much as they were able.

People we talked with told us that their concerns were listened to. People told us, 'I would go to see (manager) if anything was wrong'.

The provider had systems in place to assess and monitor the home. This meant that that they could identify any potential improvements needed to continue to meet people's care.

Some people were not able to make decisions about their care and support. Records clearly explained that decisions made on behalf of people had been taken in their best interests.

The home was kept clean and tidy. Regular safety and maintenance checks were being carried out to make sure that the premises were safe and suitable for people's needs.

The provider's representative was visiting the home regularly and had produced written reports of these visits. Any actions arising from the visits were followed up by means of action plans.