The inspection took place on the 29 November 2016 and was unannounced.

Westlake provides nursing care and accommodation for up to 61 people. On the day of our inspection there were 52 older people at the home, some who were living with dementia. The home is spread over two floors with a passenger lift, communal lounges, dining room and gardens.

Westlake has a registered manager who has been in post for many years. However at the time of the inspection the registered manager was on long term leave. 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 provider had ensured that suitable management arrangements were in place during the absence of the registered manager. The person in charge was the care manager who had worked at the home for many years and was also a registered nurse.

People told us they felt safe living at the home. Comments from people included “Safe, why wouldn’t I feel safe. There is always someone around to help me if I need it and I can call my bell in my room and they come to me”, “I feel safe, I’ve no reason not to. Actually safer than in my own home”. People were protected from the risk of abuse because staff understood how to identify and report it. Staff had access to guidance to help them identify abuse and respond in line with the providers policy and procedures if it occurred. One member of staff told us “Anything I notice which is untoward I would report straight away and know it would be dealt with”.

The provider had arrangements in place for the safe ordering, administration, storage and disposal of medicines. People were supported to get their medicine when they needed it. People were supported to maintain good health and had access to health care services.

Staff considered peoples capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. Staff observed the key principles of the MCA in their day to day work checking with people that they were happy for them to undertake care tasks before they proceeded. One person told us “They don’t do anything without consent. Flu injections, we had a choice about whether to have it or not”. The provider was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS).

Staff supported people to eat and drink and they were given time to eat at their own pace. People’s nutritional needs were met and people reported that they had a good choice of food and drink. One person told us “We have three courses, it really is wonderful food”. Staff were patient and polite, supported people to maintain their dignity and were respectful of their right to privacy. People had access to and could choose suitable leisure and social activities.

People and relatives found staff to be kind and caring and the care they received was good. Comments included “The staff are very nice. They listen to you and attend to you. What more can you ask” and “Yes they are caring, they are very respectful”.

People were encouraged to express their views and had completed surveys. Feedback received showed people were satisfied overall, and felt staff were friendly and helpful. People and relatives also said they felt listened to and any concerns or issues they raised were addressed. One person told us “We have an administrator and the general manager. There’s always someone to go to”.

Staff felt fully supported by management to undertake their roles. Staff were given training updates, supervision and development opportunities. For example staff were offered the opportunity to undertake additional training and development courses to increase their understanding of the needs of people. One member of staff told us “Yes we get offered

People we spoke with told us that their decisions were respected by staff and they were given choices and encouraged to express their views. Where people required another person to act on their behalf their consent was sought appropriately. A person's relative told us "staff contact me as required, as my relative is unable to make some decisions - it's been excellent".

We found that people's care was based on an individual needs assessment and planned and delivered to ensure their safety and welfare. A person told us "they are very good and really look after us very well". We found that staff demonstrated a good understanding of people's needs and preferences.

Records showed that people's medicines were safely managed in the home. We saw that people were given information about their medicines and we found that staff administering medication were competent to do so.

A visiting GP told us "there is a very high standard of care - this is a good team". We found that the provider carried out the relevant checks when they employed staff and staff we spoke with had the relevant knowledge, qualifications, skills and experience to carry out their role effectively.

We found that the provider had an effective system in place to deal with comments and complaints and this was monitored. Staff demonstrated that they understood how to support people in making complaints and people told us they were able to raise their concerns and they were listened to.

When we spoke to people they told us they were happy at the home. We gathered evidence of people’s experiences by reviewing their care records and speaking with relatives of people living at the home.

We found people views were taken into account in the way in which they were cared for. A relative told us ‘’ I can’t say anything bad about this place, dad is well looked after.’’ We found staff respected people’s privacy and dignity.

The provider told us people were assessed prior to coming to the home to live. Information from the assessment was used to develop people’s care plans. We reviewed the care records and saw care and treatment was delivered and planned in relation to peoples care plans. We saw evidence of the multi disciplinary approach to the care people received.

Staff told us they were supported and received appropriate training to deliver care to meet people's needs.

The provider told us people were protected from the risk of abuse as staff were trained to recognise abuse and could raise an alert if they needed to. We noticed safety information was prominently displayed around the home. People had access to safeguarding information if there were concerns

The provider told us that feedback from the people and their representatives was used to assess and monitor the quality of the service delivered.