Westfield House

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

People told us they felt safe at the service and there were systems and processes in place to protect people from the risk of abuse. Risks to people and environment were assessed and monitored and medicines were managed safely. There were enough staff to support people and staff received appropriate supervision and training. People's feedback indicated there had been a lot of changes in staff and managers, which had a negative impact on people who use the service. However, people said this improved recently and things were much better. There was a learning culture at the service and care delivery was improved following changes to people's needs.

This service scored 56 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us they felt there was a learning culture at the service. People confirmed they were able to make decisions regarding the delivery of their care, and were able to discuss key events with their support team.

Staff explained the importance of embedding a learning culture at the service. They told us how they held regular debrief sessions following accidents and incidents, as well as having reflective practice sessions to determine where improvements could be made. A staff member said, "We all participate in reflective practices and talk about the good and the bad, as well as looking for improvements and getting feedback." People were also invited to attend debriefs following incidents so they could give feedback and ideas for improvement.

People's care was reviewed on a monthly basis to determine if learning could be implemented to improve people's care. People contributed to setting goals and targets so staff could learn what was valuable and important to people. Staff worked with people to achieve positive outcomes to help people to learn and develop key skills and personal interests.

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 at the service. A person said, "I feel safe in the house". A relative told us, "I feel I can trust the new manager and I have faith. The manager is always approachable and will always respond to me."

Staff knew how to escalate concerns should they need to and felt confident in doing so. A staff member told us, "I feel 100% protected. There is a whistleblowing process, but I have never had to use it.” Another commented, "It's very open and is a breath of fresh air here. The staff are fantastic and the night staff are fully involved and feel part of the one big team. Things are communicated extremely well."

During the assessment, no safeguarding concerns were observed. The atmosphere of the service was friendly and welcoming, and people were supported to make choices and speak freely.

Safeguarding referrals were made to the local authority where required. There was a safeguarding and whistleblowing policy and staff knew how to access this and who to contact if they had safeguarding concerns. There was a 'freedom to speak up' champion at the service and accidents and incidents were reported appropriately.

People and their relatives told us they were involved to manage risks safely. A person told us, "“The therapy, the nurses are great. My risk has decreased massively”. A relative told us they were fully involved in decision making regarding their loved one's care. People were involved to manage risk by contributing directly to their own support plans. A person told us, “I am involved in my support plans. I wrote them."

Leaders understood the importance of involving people to manage risks. They were working with people, their families and the local authority to manage current and anticipated risks. Staff told us they received training around therapeutic risk, and were 'key workers' to certain people. This meant they knew the people they supported well and could contribute towards supporting people to manage risk safely. Staff told us they read people's care plans regularly and received email updates to make them aware of any changes to people's needs or support.

During the assessment, we observed people discussing wellbeing and therapies to manage risk with healthcare professionals in a positive and constructive way.

Care plans were detailed and people contributed to the risk elements of their plan. People had recorded how they prefer to be supported to maintain their mental wellbeing. People's 'triggers' were recorded clearly, so staff could support them in a way that reduced potential risks from occurring. There was a therapeutic risk policy to guide staff in how to support people safely, and there were numerous emergency procedures in place for staff to follow so they could mitigate risk when incidents did occur.

People told us they enjoyed staying at the service and didn't raise any environmental concerns. People also told us that faults with the home environment were fixed promptly by the maintenance team.

Staff and leaders did not raise any concerns regarding the home environment. Staff praised the maintenance team who were described as, "Great" and "Responsive". Staff told us they escalated concerns regarding the environment to the maintenance team who responded promptly.

We did not identify any concerns with the environment when visiting the location. The home appeared comfortable, clean and had adequate facilities. There were private spaces available for therapies and sensory areas in the house and garden.

All health and safety checks and certificates were in place and up to date. There were emergency grab bags for staff to utilise in the event of an emergency.

Some people raised concerns regarding there being lots of changes to the staff team and managers of the service. However, people told us this had improved recently and the staff team and management were much more stable. A relative said, "The last 5 weeks have been fabulous and there are some really good staff." A person told us things were much better now, as they needed staff who knew them well for consistency.

Staff told us there had been a high turnover of staff and that progress was being made with recruitment but this was proving difficult. Staff told us they received appropriate training but they would benefit from more refresher sessions. The service had previously used agency staff to cover support shifts but things had improved and this was no longer the case. The service utilised bank staff to cover shifts to ensure people were supported by consistent staff. Leaders told us that due to the location of the service, recruitment had been difficult. However, there were long term plans to move to a different location. Staff told us they received adequate supervision from the management team, who were described as "Supportive."

At the time of the assessment, there were 3 support staff on duty. From our observations, we noted there appeared to be sufficient staff to meet people's needs, and they responded to people's needs in a considerate and timely way.

Staff were recruited to the service safely and all relevant checks had been undertaken. Staff received adequate support through regular supervisions and appraisals and had received the relevant training to enable them to support people safely. Where people had individual needs, staff received additional training in these areas. People received the correct amount of support in line with their commissioned hours from the local authority.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

People told us they had no concerns regarding the safe management of medicines, and people received their medicines as prescribed. People told us staff supported them to take their medicines safely, and were working to support and empower people to develop their skills so they could self-administer their medicines in the near future.

Staff told us they received medicines training and a subsequent competency assessment of their ability to administer safely. Staff understood how to escalate concerns relating to medicines. Medicine administration records (MARs) were completed accurately. Staff had a good understanding of the different types of medicines they were administering and their purpose. Staff told us what they would do should someone refuse their medicine, and outlined the medicines return process clearly.  

Medicines were stored securely and the medicines room temperature was monitored. People's care plans outlined how they were working towards becoming independent in self-administrating their medicines. People were involved in discussions around their medicines, which were reviewed by health practitioners regularly. Where people were at risk from medicines, there was clear guidance and risk assessments in place. Controlled drugs were stored safely and record keeping relating to medicines were up to date and accurate.