Westerley Residential Care Home for the Elderly - Woodhall Spa

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

The provider and manager had made improvements at the service. Risks to people’s safety were assessed and mitigated both on a personal level and on an environmental level. Staff training had improved and staff felt well supported. There were enough staff to ensure people’s safety and meet their needs. There were safe recruitment processes in place. The manager and staff had a good understanding of how to manage any safeguarding concerns and people trusted the staff to support them.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People told us they felt safe with the staff who supported them. All the people we spoke with felt able to talk to staff about any concerns they may have. One relative said, “My [Relative] has always been safe here and there is absolutely nowhere else we would want them to be living.”

Staff showed good knowledge of what abuse people in care homes may be exposed to and what actions they should take if they suspected any form of abuse had taken place. All the staff we spoke with told us they would be able to go to the management team including the nominated individual if they had any concerns. They felt confident the manager would act on any concerns they raise to them.

Throughout the inspection we saw positive interaction between people and staff. Our discussion with the manager showed their understanding of how to deal with safeguarding issues for the people in their care.

Policies and procedures were available to guide staff about how to protect people from the risks of abuse or harm. People’s capacity to make decisions was assessed and where necessary decisions made in the individual’s best interests were recorded via best interest meetings. These meetings involved relatives, and health professionals when needed, the potential decisions were discussed and the outcomes recorded. If needed, appropriate legal authorisations were in place to restrict people. The manager had oversight of Deprivation of Liberty Safeguards (DoLS) authorisations and monitored these to ensure they remained up to date and proportionate.

People felt improvements at the service meant staff supported them well and helped them to manage risks to their safety. They were involved in managing their own risk assessments. For example, one person who was at risk of choking, had worked with staff to ensure their preferences on what and how they ate their food was considered and managed in a safe and positive way. Relatives were positive about the way staff managed the risks to their family member’s safety. One relative told us, “[Family member] now has a pressure pad (sensor mat) so it is an extra level of safety for them, and us.”

There were improvements in staff’s knowledge of the risks to people’s safety. Staff were able to discuss the different areas of care where individuals needed support. This included who needed a specialist diet or support when eating, who needed walking aids or was at risk of skin pressure damage.

Throughout our visit we saw people had the aids they needed to support them in their daily lives. This included good fitting footwear, or if people were at risk of falls, sensor mats were in place. For example, one person liked to spend time in their room but was at risk of falls. Staff had ensured the person had a call bell beside them, a walking frame within reach, and sensor mat in place to alert them to the person’s movements to allow them to safely support the person.

There were improvements in people's care plans. Their plans now contained up to date risk assessments which both reflected people's needs and the measures we saw in place. Where people needed bed rails as well as an assessment there was information to show people had consented to have a bed rail in place, or a best interest meeting had been undertaken to support the decision to use bed rails.

People told us there had been improvements in the environment. They felt the service was cleaner and well maintained. One relative said, “The new manager has changed so many things - ones I noticed were cleanliness, radiator protectors, health and safety and lots of notices. Food, outings, newsletter etc all improvements to an already good service.”

There were improvements in staff knowledge and a sense of ownership of their responsibilities in relation to maintaining a safe environment. Throughout the assessment we spoke with kitchen, housekeeping staff and care staff. All the staff we spoke with were clear about their different responsibilities. This included ensuring areas such as the kitchen and laundry were locked.

We saw improvements in the environment during our inspection. Coded locks on doors leading to staircases, retractable stair gates on open staircases, window restrictors on window and radiator covers were now in place.

Since our last visit the provider had made improvements to the environment and now had clear processes in place to ensure the environment was monitored and well maintained. There were now regular fire drills for staff to ensure they all knew how to support people should there be a fire related incident. Records showed that there were now regular environmental checks such as water temperatures and flushing of water outlet to prevent the risk of Legionella disease.

People were happy with the level of support they received from staff. We spoke with a group of people who told us there was always enough staff even now when the staff have been reduced in line with the decline in resident numbers. Relatives told us staffing levels had changed but there were still enough staff throughout the day. When they had been visiting there was the same quick response to call bells as when there were more staff. They also told us now the bells were always placed next to the resident or on a lanyard so they could call for staff if they needed them.

Staff we spoke with told us they were busy, but there was enough staff to support people. Staff told us they felt supported in their roles. A member of the housekeeping team said, “The changes (at the service) are good, I know what I need to do and the paperwork tells me what to do.” They went on to say they were supported with regular supervision from the deputy manager. The manager had worked to improve the level of training and supervision staff received. We saw from the training matrix improvements in the level of staff undertaking key training modules. The manager also continued to work with staff to further improve their training and keep up to date with mandatory training.

Throughout our visit we saw staff working in a confident and competent way. They engaged with people well and responded to their needs in a timely manner.

We reviewed the recruitment processes and found improvements had been made in the way staff were recruited. Disclosure and barring service (DBS) checks were in place. This service highlights if potential staff have had criminal records and helps leaders make safer recruitment decisions. Staff records were complete. We reviewed staff rosters during our assessment and saw allocated staff numbers matched the established needs of people at the service.

People were positive about the level of cleanliness at the service. One person said, “The home is very clean now and carpets get cleaned as well, it certainly smells of polish too!” A further person said, “Our room is deep cleaned every month and we both have to vacate the room for half a day-this is new and means our special place together is lovely and fresh.” A relative we spoke with said, “Yes the home is clean, tidy and organised now, much better than what is was. There is no odour now which is better. It was not horrid before, just in the background but now it is all gone. “

Staff were clear about their roles in reducing the risk of spreading infection. They understood the importance of hand hygiene, wearing personal protective equipment and how to dispose of it.

The environment was clean and well maintained. We saw staff undertaking safe infection prevention practices in their daily work routine.

There had been a significant improvement in the way the staff monitored the environment. We reviewed cleaning records of both equipment and the environment which showed areas were monitored on a regular basis.

People told us they received their medicine in a timely manner. If they needed any as required medicines these were administered when they needed them.

Staff who administered medicines told us there had been improvements in the way the medicines were managed and how errors were reported and dealt with.

Our observations of staff showed they were administering medicines safely. There was a medicines policy in place and staff who administered medicines had received training in the safe handling of medicines. The audits we reviewed showed where errors had been identified these had been managed well to facilitate learning for staff.