This inspection took place on 24 and 28 October 2017. The first day of the inspection was unannounced. We informed the registered manager we would be returning to complete the inspection on 28 October 2017.

We carried out an unannounced comprehensive inspection of this service on 21, 22 and 23 June 2016 at which a breach of legal requirements was found in relation to infection control procedures. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach.

At our focused inspection on the 30 March 2017, we found that the provider had followed their plan and implemented improvements and legal requirements had been met in relation to infection control. We stated that the service was safe although further improvements were required to meet optimum levels of hygiene and cleanliness.

Westmead Residential Care Home is registered to provide accommodation and personal care for up to 42 older people, some of whom have dementia. The home is divided over two floors with lift access. People have their own rooms with a hand basin and shared bathroom facilities are available on each floor. At the time of our inspection 39` people were using the service.

The service had 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.

There were systems in place to protect people from abuse and keep people free from harm. The service had policies and procedures in place for safeguarding adults which were available and accessible to members of staff. Staff were able to demonstrate a good understanding of these policies and procedures and how they related to their roles and responsibilities.

People told us they felt safe and secure living in the service. Risks to people were identified and covered areas such as falls and mobility, moving and positioning and personal care needs. Risk assessments were reviewed in line with the provider’s policies and procedures.

Staff had received training on the Deprivation of Liberty Safeguards (DoLS) and the Mental Capacity Act 2005 (MCA). These safeguards are there to make sure that people receiving support are looked after in a way that does not inappropriately restrict their freedom. Services should only deprive someone of their liberty when it is in the best interests of the person and there is no other way to look after them, and it should be done in a safe and correct way. People were consulted with about their care and the service worked to the principles of the Mental Capacity Act 2005.

Family members and health and social care professionals were invited to contribute to the care planning process where appropriate. Care records contained enough information about people for staff to understand their needs and preferences and staff knew people on an individual basis. People told us the staff were kind and caring. However, not all staff members were aware of the levels of privacy people liked to maintain.

There were suitable arrangements in place for the safe storage and disposal of medicines and all medicines were administered by staff who had received the appropriate training to be assessed as competent.

Staff were suitably recruited, inducted, trained, supervised and supported. This enabled them to have the right skills and training to support people effectively. The home had a number of staff vacancies and used bank and agency staff to cover the vacancies. Staff felt the staffing levels were sufficient. Staff were given opportunities to develop and improve upon their skills.

Staff supported people to attend healthcare appointments as required and liaised with people’s family members, GPs and other healthcare professio

We carried out an unannounced comprehensive inspection of this service on 21, 22 and 23 June 2016 at which a breach of legal requirements was found. This was because staff were not always following policies and procedures in line with current relevant national guidance relating to infection control.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. We undertook a focused inspection on the 30 March 2017 to check that they had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Westmead Residential Care Home’ on our website at www.cqc.org.uk’

Westmead Residential Care Home is registered to provide accommodation and personal care for up to 42 older people, some of whom may have dementia. The home is divided over two floors with lift access. Rooms and shared bathroom facilities are wheelchair accessible.

The service had 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.

During our visit we saw that the home was clean and tidy and that staff had access to disposable gloves, hand gels and aprons.

We observed the correct bins being used to dispose of clinical and household waste. Bathrooms were clean and free of personal items.

Over 70% of staff had completed training in infection control policies and procedures.

The provider carried out quality audits on a monthly basis covering infection control and other areas. Audits were detailed in scope, identified shortfalls and set out the action required to improve quality standards.

At our focused inspection on the 30 March 2017, we found that the provider had followed their plan and implemented improvements and legal requirements had been met in relation to infection control.

This inspection took place on 21, 22 and 23 June 2016. This is the first inspection we have carried out since the service registered with the Care Quality Commission (CQC) under a new provider in August 2015. The first day of the inspection was unannounced.

Westmead Residential Care Home is registered to provide accommodation and personal care for up to 42 older people, some of whom may have dementia. The home is divided over two floors with lift access. Rooms and shared bathroom facilities are wheelchair accessible. At the time of our inspection 36 people were using the service.

The service had 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. The registered manager divided his time between this service and another local service run by the same provider.

The provider had infection control policies and procedures in place but staff were not always following these procedures in relation to the prevention and control of infection to ensure that people were protected from avoidable harm.

Some people living in the home told us they wanted to go out more often. The service employed a full time activities coordinator. However , we were told they had been absent for the past three weeks and that staff had been providing some activities in their absence. Due to this and to lifts that were out of order, people’s activity levels were sometimes restricted.

There were systems in place to protect people from abuse and keep people free from harm. The service had policies and procedures in place for safeguarding adults which were available and accessible to members of staff. Staff were able to demonstrate a good understanding of these policies and procedures and how they related to their roles and responsibilities.

Staff had received training on the Deprivation of Liberty Safeguards (DoLS) and the Mental Capacity Act 2005 (MCA). These safeguards are there to make sure that people receiving support are looked after in a way that does not inappropriately restrict their freedom. Services should only deprive someone of their liberty when it is in the best interests of the person and there is no other way to look after them, and it should be done in a safe and correct way. Staff understood what to do if people could not make decisions about their care needs in line with the MCA.

Where possible, people were involved in decisions about their care and how their needs would be met. Family members and health and social care professionals were invited to contribute to the care planning process where appropriate.

Risks to people were identified and staff took action to reduce those risks. Risk assessments were in place and reviewed in line with the provider’s policies and procedures. Risk assessments covered areas such as falls and mobility, moving and positioning and nutritional needs.

There were suitable arrangements in place for the safe storage and disposal of medicines and all medicines were administered by staff who had received the appropriate training to be assessed as competent.

Monthly audits were carried out across various aspects of the service; these included the administration of medicines, fire, health and safety checks.

People were provided with a choice of fresh food and drinks, and were supported to eat when this was required.

Staff were appropriately trained and skilled to care for people. Staff received supervision and guidance where required. Sufficient staff were available and they had the necessary training to meet people's needs.

Staff supported people to attend healthcare appointments as required and liaised with people’s family members, GPs and other healthcare professionals to ensure people’s needs were