This unannounced inspection took place on the 23 May 2017. Westlands Care Home provides accommodation for up to 28 people who require residential care for a range of personal care needs. There were 16 people in residence at the time of this inspection.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People were safeguarded from harm as the provider had systems in place to prevent, recognise and report concerns to the relevant authorities. All staff knew their responsibilities as defined by the Mental Capacity Act 2005 (MCA 2005) and Deprivation of Liberty Safeguards (DoLS) and had applied that knowledge appropriately.

There were sufficient numbers of experienced staff that were supported to carry out their roles to meet the assessed needs of people living at the home. Staff received training in areas that enabled them to understand and meet the care needs of each person. Recruitment procedures protected people from receiving unsafe care from staff unsuited to the role.

People’s care and support needs were continually monitored and reviewed to ensure that care was provided in the way that they needed. People had been involved in planning and reviewing their care.

People were supported to have sufficient amounts to eat and drink to maintain a balanced diet. Staff monitored people’s health and well-being and ensured people had access to healthcare professionals when required.

Staff understood the importance of obtaining people’s consent when supporting them with their daily living needs. People experienced caring relationships with staff, who provided good interaction by taking the time to listen and understand what people needed.

People’s needs were met in line with their individual care plans and assessed needs. Staff took time to get to know people and ensured that people’s care was tailored to their individual needs.

People had the information they needed to make a complaint and the service had processes in place to respond to any complaints.

People were supported by a team of staff that had the managerial guidance and support they needed to carry out their roles. The quality of the service was monitored by the audits regularly carried out by the manager and by the provider.

This inspection took place on 13 April 2016. It was unannounced.

Westlands Care Home provides a service for up to 28 people who have a range of care needs including dementia, mental health, sensory impairment and physical disabilities. There were 18 people living in the home on the day of this inspection. The service is also registered to provide a domiciliary care service to people in their own homes, but this was not happening at the time of this inspection.

At our last comprehensive inspection on 19 February 2015, we found that the service was in breach of legal requirements in a number of areas. We followed up on these areas at another inspection on 29 September 2015 and found improvements had been made. Although we found that the service was no longer in breach of legal requirements at that time, we did not change the overall rating for the service because to do so would require consistent good practice over a sustained period of time.

We therefore checked all the areas where legal breaches had occurred previously during this inspection, and found that the improvements had been sustained.

Although we did identify some new areas for improvement during this inspection, the area manager was able to demonstrate that she had already identified these through a recent internal audit, and confirmed she had a plan in place to address these.

A registered manager was not 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. A new manager had been appointed who was planning to take up their post the following month. Appropriate managerial support and oversight was being provided by the area manager in the interim.

Risks were managed so that people’s freedom, choice and control were not restricted more than necessary. We did find some anomalies in terms of how risks were managed and reviewed however, which meant people were at risk of not having identified risks managed in a consistent way.

There were sufficient numbers of suitable staff but improvements were needed to ensure people got the right support at key times of the day such as meal times.

The provider carried out robust checks on new staff to make sure they were suitable to work at the service. However, not all legally required checks were in place.

Systems were in place to ensure people’s daily medicines were managed in a safe way and that they got their medication when they needed it. Improvements were required however regarding the recording of PRN (as required) medication.

People received personalised care that was responsive to their needs. However, some care records needed reviewing; to ensure the care and support being provided to people was still appropriate for them.

People felt safe living at the service. Staff had been trained to recognise signs of potential abuse and keep people safe.

People received effective care from staff that had the right skills and knowledge to meet their needs.

We found that the service worked to the Mental Capacity Act 2005 key principles, which meant that people’s consent was sought in line with legislation and guidance.

People had enough to eat and drink. Support was provided to those who needed help with eating and drinking, in a discreet and helpful manner.

People’s healthcare needs were met.

Staff were motivated and provided care and support in a caring and meaningful way. They treated people with kindness and compassion and respected their privacy and dignity at all times.

People’s social needs were provided for and they were given opportunities to participate in meaningful activities.

People were given opportunities to be involved in making decisions about their care and support.

People received personalised care that was responsive to their needs.

Westlands Care Home provides a service for up to 28 people, who may have a range of care needs including dementia, mental health, sensory impairment and physical disabilities. There were 20 people living in the home on the day of this inspection.

We carried out an unannounced comprehensive inspection of this service on 19 February 2015 and found legal requirements had been breached. We also reported that the home had been operating under an administration company since May 2012, along with 16 other services, due to the financial difficulties of the previous provider.

After the February 2015 inspection, we were informed that a new manager had registered with the Care Quality Commission to manage the service. Like registered providers, 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.

In addition, we were informed that a new owner had acquired the home, but had kept the same provider name (legal entity).

A representative for the new owner wrote to us to say what they would do to meet legal requirements, to ensure people using the service had their needs met by staff who had the right skills and training. They also told us that they would improve systems used to assess and monitor the quality of the service provided to people living in the home.

We undertook this focused inspection to check they had followed their plan and to confirm that they now met the legal requirements.

This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Westlands Care Home on our website at www.cqc.org.uk.

During this inspection on 29 September 2015, we found that improvements had been made.

Improvements had been made to enhance staff knowledge in terms of understanding the different types of abuse, and what to do in the event of suspected abuse taking place.

The level of training provided to staff working in the home overall had increased; to ensure people received effective care from staff with the right knowledge and skills.

Systems for dealing with people’s complaints were much clearer, and showed people were listened to and any concerns responded to appropriately.

Progress had also been made regarding the systems for monitoring the overall quality of the service and driving continuous improvement.

Although we found that the service was no longer in breach of legal requirements, we have not changed the overall rating for the service on this occasion, because to do this this would require consistent good practice over a sustained period of time. We therefore plan to check these areas again during our next planned comprehensive inspection.

This inspection took place on 19 February 2015 and was unannounced.

Westlands Care Home provides a service for up to 28 people, who may have a range of care needs including dementia, mental health, sensory impairment and physical disabilities. There were 22 people living in the home on the day of the inspection.

The service is also registered to provide care and support to people in their own homes, as part of an agreed care package. However, this was not being provided at the time of this inspection.

Since May 2012, the home, along with 16 other services, has been operating under an administration company due to the financial difficulties of the previous providers. We were informed during this inspection that there were no formal updates in respect of this arrangement but that it was the intention of the administration company to sell the home as an ongoing concern. A senior member of staff told us they hoped to have more news on this soon and that people, their families and staff were being kept informed.

The home did not have a registered manager. 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. A new manager had been appointed shortly before this inspection, who informed us they were in the process of applying for registration.

We found that systems were in place to protect people from abuse and avoidable harm but improvements were required to enhance staff knowledge in reporting suspected abuse and managing identifiable risks within the service.

Improvements were also required to ensure staff have the right training and support; to ensure there are sufficient numbers of staff with the right skills and knowledge to meet people’s needs, at all times.

Systems were in place to ensure people’s medicines were managed in a safe way.

We found that the service worked to the Mental Capacity Act 2005 key principles, which state that a person's capacity should always be assumed, and assessments of capacity must be undertaken where it is believed that a person cannot make decisions about their care and support. However, improvements were required to ensure people’s liberty is not deprived without proper authorisation.

People had enough to eat and drink. Assistance was provided to those who needed help with eating and drinking, in a discreet and helpful manner.

We found that overall people’s healthcare needs were met. However, minor improvements were required to ensure people’s healthcare conditions are properly monitored and managed.

Staff treated people with kindness and compassion. They spent time with people and encouraged them to make their own choices in respect of day to day decisions. We also saw that people’s privacy and dignity was respected at all times.

A new activity coordinator had been appointed who was looking at the activities provided by the home and looking at ways to improve these; to ensure people’s individual social interests are met.

A complaints procedure had been developed to let people know how to raise concerns about the service if they needed to. Improvements were required to ensure people’s concerns and complaints are recorded properly and a clear audit trail maintained; to show that these are listened to and responded to appropriately.

There were concerns about the effectiveness of the existing quality monitoring systems in place. This is because we found a number of areas during this inspection that required improvement, but these had not yet been addressed. The new manager showed us that she had begun her own audits of the service and had started to identify where improvements were required.

We spoke with four people who all told us they were happy with their care. One person told us “It’s one of the best homes, I’m very happy here.” We saw that staff treated people with respect and gave explanations when assisting people. We spoke with three members of staff who all had a good knowledge of people's care needs. We saw that staff had a good relationship with people living in the home. We saw people enjoying activities and chatting with staff.

We received positive feedback about the home from a visiting health professional.

The provider is registered to provide the regulated activity "personal care" to people who live in their own homes as well as providing “Accommodation for persons who require nursing or personal care” from Westlands Care Home. At the time of our visit the manager confirmed that the regulated activity personal care was not currently being provided so it did not form part of the inspection.

We spoke with seven people about the service they received. They were happy with their care and told us that staff treated them with respect. One person told us they were “quite satisfied and happy” and another said staff were "always polite and helpful”.

We spoke with a visiting health professional and three relatives of people living in the home. They all spoke highly of the care people receive. One relative explained that the staff communicate well and that the manager deals with any issues raised very promptly.

We found that people’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We saw that people using the service and their relatives had been able to give feedback about the service through quarterly satisfaction surveys. We looked at a selection of these and saw the feedback from people living in the home and their relatives was positive.

We spoke with five people who used the service. All spoke highly of the staff describing them as “lovely” and “helpful”.

We saw that new staff received an induction when they started working in the home and that this was followed up with an ongoing programme of training. We saw that the training included areas such as moving and handling and dementia care which were relevant to the care that staff provided.

Staff told us that they received regular supervision sessions. We looked at the records for a selection of these and saw that the manager had given staff feedback on their performance, discussed their training needs and given them an opportunity to discuss any issues that they wished to talk about. We saw that staff were also able to give feedback via a six monthly staff survey.

We spoke with three members of staff who told us that they felt supported to do their jobs. They all told us that they found the manager approachable and could go to her for support and advice.