About the service:

Westfield House is a residential care home that provides care and support for up to 12 people with learning disabilities and specialises in the care of those with Autistic Spectrum Disorder. Nine people were living in the home at the time of this inspection.

People’s experience of using this service:

¿ The service was safe and people were protected from harm. Staff were knowledgeable about safeguarding adults from abuse and knew what to do if they had any concerns and how to report them. Risks to people who used the service were assessed and their safety was monitored and managed, with minimal restrictions on their freedom. Risk assessments were thorough and personalised.

¿ The service ensured there were sufficient numbers of suitable staff to meet people’s needs and support them to stay safe. The registered manager confirmed that robust recruitment procedures were followed.

¿ Medicines were stored, managed and administered safely. Staff were trained, and their competency checked, in respect of administering and managing medicines.

¿ People who used the service took part in the recruitment of new staff and volunteers and had a strong influence on the outcome.

¿ Staff training was developed and delivered around people’s individual needs.

¿ The service placed a strong emphasis on the importance of eating and drinking well. Wholesome and nutritious food was provided, with a variety of different options to choose from each day. People who used the service were fully involved and helped to plan their meals with staff.

¿ Links with health and social care services were excellent.

¿ There were different areas for people to use for their preferred activities, and private space to spend time with their families or visitors, or to have time alone. People who used the service were encouraged to help with decorating or furnishing the premises.

¿ The service was skilled in how it obtained people’s consent for care and treatment and involved them in related decisions and assessing capacity when needed. Staff were fully educated and trained and had a comprehensive understanding of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.

¿ Staff treated people with kindness, respect and compassion. People also received emotional support when needed. People were involved in planning the care and support they received and were supported to make choices and decisions and maintain their independence as much as possible. Information was provided to people in formats they could understand.

¿ Care plans were personalised and described the holistic care and support each person required, together with details of their strengths and aspirations. Information also explained how people could be supported to maintain and enhance their independence and what could help ensure they consistently had a good quality of life. People’s comments and concerns were listened to and taken seriously. The service also used any comments or complaints to help drive improvement within the service.

Rating at last inspection:

At our last inspection (report published 26 August 2016) all the key questions were rated Good and the service was rated as Good overall. The overall rating has not changed and the service remains Good. However, the rating for the key question of Effective has improved to Outstanding.

Why we inspected:

This was a planned inspection based on the date and the rating of the last inspection.

Follow up:

We will continue to monitor the service through the information that we receive.

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

This inspection took place on 1 September 2016 and was announced. Westfield House is registered to provide accommodation and personal care for up to twelve people who have a learning disability. It opened in May 2016 as a service for people who have a learning disability. We gave the service 24 hours’ notice of the inspection because it is small and we needed to be sure that people would be in. On the day of the inspection, there were two people living at the service.

There was a registered manager in post. 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.

The service had sufficient staff to meet the needs of the people living there. Staff were recruited only after completing the necessary checks to make sure they were suitable to work at the service. There were systems in place to reduce the risk of people experiencing abuse.

People were cared for by staff who were kind, caring and compassionate. People were also treated with dignity and respect.

Staff had received appropriate training to enable them to support people effectively and to keep them safe. Staff received regular supervision and were supported in their roles. Good leadership was demonstrated and senior staff were always available to staff so they could seek advice and guidance if needed.

People were asked for their consent before care was provided. The provider followed relevant legal guidance when making decisions on behalf of people who were unable to make and consent to them themselves.

The care was being delivered to meet people’s individual preferences and people were supported to maintain good health as they had access to relevant healthcare professionals when they needed them.

Relatives were complimentary about the service and the support their family member was receiving. There was information available if people or their relatives wanted to complain.

The management team assessed and monitored the quality of the service. and improvements were made when they were identified.

Throughout this this inspection we noted that people were cared for appropriately. They were treated courteously and we found that people appeared to be content in this home.

The majority of people were not able to answer direct questions but did let us know they were "OK". One person, who was unable to tell us about the home, did say "She's kind" pointing to a staff member. We were also told about the food, "I love the food" was stated by another person.

We did spend time observing people and noted that they were dressed appropriately. Clothes were clean and pressed and gentlemen had been assisted to shave. The care plans we looked through gave us a clear picture of the individual needs people required. Through observations during the inspection we saw this care and support being delivered.

We did find that the home needed to be more vigilant on the safe keeping of prescribed creams stored in people's bedrooms. Other procedures for recording, storing, administration and controlled drugs management were safe.

We did not find any concerns to show the home did not have enough staff who were skilled and able to offer the care and support to people living with dementia. We found skilled and trained staff working in the home with people appearing to be understood and their complex needs met.

A complaint that we were aware of had been dealt with appropriately. The home had a complaints procedure available if people had a concern or complaint.

The majority the people living at Westfield House were unable to answer our questions due to their complex needs which meant they were unable to relay their experience of the service to us.

We did however spend time observing the people and their interactions with the staff on duty. We noted appropriate encouragement being given by staff when being offered choices such as drinks or where they would like to sit. There were plenty of smiles and recognition of staff who spoke to people at eye level and who used appropriate conversations to encourage people to interact.

One person told us that staff were kind and that they could choose what they wanted. We saw another person holding the hand of a staff member and interacting in a manner that they both recognised and which assisted with communication. There were plenty of smiles and contented sounds to replace words.

We saw that a person responded well when asked a question and watched staff give the time for that person to answer in their own way.

People who use this service have difficulty understanding and responding to verbal communication. Only one person was able to tell us about their experiences of living in the home. A few other people made comments about specific issues, such as the meals. Most of the information about people's experiences of Westfield House was gathered through our observations and from speaking with family carers.

People told us they liked the home, the care staff and the food. Our observations were that people generally looked well cared for and happy. The staff were attentive, they gave people choices and showed them respect.