Westerleigh Nursing Home

We found the following examples of good practice.

The home facilitated visiting in line with the government guidelines. There was a visiting procedure and charter that had been shared with relatives and people’s representatives. There was a designated area of the home where visiting took place. This was facilitated by a staff member who had robust systems to ensure safe practice was followed. This included an appointment system and COVID-19 testing.

Attention had been given to promoting social distancing for staff and people in the home. The environment had been reviewed and occupancy had been reduced to accommodate changes in the environment to support social distancing. For example, communal areas had been re-arranged to allow people to form bubbles and have separate lounge and dining facilities. Other rooms had been designated as the staff testing room and visiting room.

The home was clean and there was a team of regular domestic staff who completed a cleaning programme. The cleaning products had been reviewed and updated to ensure suitability for cleaning during a pandemic.

There was an allocated infection control lead who had established effective systems and processes for IPC. There was a good supply of personal protective equipment (PPE) and staff had received specific COVID-19 training. Staff competencies had been assessed and staff received regular updates on IPC. Staff were supported with regular discussions and recognition of their hard work. For example, staff were given hand cream and lip balm to help with the side effects of using PPE.

Regular testing for people and staff was taking place, in accordance with government guidelines.

Westerleigh is registered to provide nursing, care and accommodation for up to 30 people. There were 28 people living in the service when we visited. People cared for were mainly older people who were living with a range of care needs, including arthritis, diabetes and heart conditions. Some people were also living with dementia. Most people needed support with their personal care, eating, drinking or mobility. Accommodation was provided over two floors.

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

Although regular quality audits were completed to manage oversight of the service, we found improvements were needed for the management of pressure relieving equipment to ensure they were always correctly set and for medicine record keeping. For both these concerns, we considered the risk and impact on people to be mitigated. The manager acknowledged these were areas for improvement and immediately rectified these shortfalls.

People told us they experienced safe care. People told us, “It’s safe here, it’s clean and I love the garden.” Another person said, “Everything is okay, my family know I’m safe and get the care that I need, but I would like to be closer to them.” A relative said, “The staff are all very good, I know my mother is safe and looked after. Staff will always make time to talk to us.”

Training, policy guidance and safe systems of work minimised the risk of people being exposed to harm. Staff understood how to safeguard people at risk and how to report any concerns they may have. Medicines were administered safely by competent staff. Safe recruitment practices had been followed before staff started working at the service. Staff were deployed with the correct training, skills and experience to meet people’s needs. Nursing staff received clinical supervision and training. The premises were clean and infection control measures followed. People told us the home was clean and tidy. Relatives spoken with had no concerns about the cleanliness of the service. People’s needs and the individual risks they may face were assessed and recorded. Incidents and accidents were recorded and checked or investigated by the registered manager to see what steps could be taken to prevent these happening again. This ensured lessons were learnt.

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 supported this practice. The care offered was inclusive and based on policies about Equality, Diversity and Human Rights. Care plans had been developed to assist staff to meet people’s needs in an effective way. Staff applied best practice principles, which led to effective outcomes for people and supported a good quality of life. The care plans were reviewed and updated. Referrals were made appropriately to outside agencies when required. For example, GPs, community nurses and speech and language therapists (SALT). People’s nutritional needs were monitored and reviewed. People had a choice of meals provided and staff knew people’s likes and dislikes.

Staff treated people with respect and kindness and were passionate about providing a quality service that was person centred. Confidential information was held securely. People had received an updated privacy policy and policy statements following changes to data protection legislation in May 2018.

The care was designed to ensure people's independence was encouraged and maintained. Staff supported people with their mobility and encouraged them to remain active. Activities were provided and were under review as it was known that improvements were needed. People were involved in their care planning. End of life care planning and documentation guided staff in providing care at this important stage of people’s lives. End of life care was delivered professionally and with compassion.

People, their relatives and health care professionals had the opportunity to share their views about the service. Complaints made by people or their relatives were taken seriously and thoroughly investigated.

Rating at last inspection:

Good. (Report published on 22 November 2016.)

Why we inspected:

This inspection took place as part of our planned programme of inspections.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

The service is registered to provide accommodation for up to 31 older people who require nursing care. At the time of our inspection there were 27 people staying there.

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.

People received care from staff that knew them and were kind, compassionate and respectful. Their needs were assessed prior to coming to the home and care plans were in place and were kept under review.

There were appropriate recruitment processes in place and people felt safe in the home. Staff understood their responsibilities to safeguard people and knew how to respond if they had any concerns.

There were sufficient staff to meet the needs of the people; staffing levels were kept under review.

Staff were supported through regular supervisions and undertook training which helped them to understand the needs of the people they were supporting. People were involved in decisions about the way in which their care and support was provided. Staff understood the need to undertake specific assessments where people lacked capacity to consent to their care and / or their day to day routines. People’s health care and nutritional needs were carefully considered and relevant health care professionals were appropriately involved in people’s care.

People were cared for by staff who were respectful of their dignity and who demonstrated an understanding of each person’s needs. This was evident in the way staff spoke to people and the activities they engaged in with individuals. Relatives spoke positively about the care their relative received and felt that they could approach management and staff to discuss any issues or concerns they had.

There were a variety of audits in place and action was taken to address any shortfalls. Management was visible and open to feedback, actively looking at ways to improve the service.

During our visit to Westerleigh we spoke with five people who used the service, two relatives and five workers. The people we spoke to told us they were happy living at the home and that the staff were attentive to their needs. One person told us "staff are wonderful, I'm very happy," another told us "I have no complaints, they look after me very well."

Twenty eight people were living at Westerleigh Nursing Home during our inspection. We saw people being cared for by workers who understood the needs of people who were living at Westerleigh and we observed workers interacting with people in an attentive, friendly manner. Staff we spoke with had a good understanding of the needs of people using the service and told us they felt supported in their work.

We saw that people were cared for in individual rooms, some with en suite bathrooms. Communal areas included a television room, quiet area and dining room.

The people we spoke with told us they were happy with the care they had received and with the staff team. One person who used the service told us 'This is a very nice place, I like it here'. Another person who used the service told us 'I'm quite happy here and I am looked after well'. Staff we spoke with had a good understanding of the support needs of the people who used the service. One member of staff we spoke with told us 'We provide a very good level of care. We try and meet all the residents' needs in every way'.

We saw that the service had systems in place to gain and review consent to care and treatment from people who used the service. The overall appearance of the service was clean and we saw that they had appropriate systems and policies in place in respect to cleanliness and infection control.

We spoke with three care workers during our visit and were told that they felt valued and supported and that their training needs had been met. We also saw that care plans, staff records and other records relevant to the management of the home were accurate and fit for purpose.