West Bank Residential Home is located in Ross-on-Wye, Herefordshire. The service provides personal care and accommodation for up to 41 older people. On the day of our inspection, there were 40 people living at the home.

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.

A single inspector carried out this inspection. The focus of the inspection was to answer the five key questions; is the service safe, effective, caring, responsive and well-led?

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.

We saw that staff were kind and caring when they provided care and support to people. People told us, "I'm getting on OK here" and, "they're all nice to me here". We saw that staff were attentive to people's needs and took time to reassure anyone who was anxious.

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.