We undertook a comprehensive unannounced inspection of Westwood House on 17 October 2018. Westwood House is a ‘care home’ registered to provide accommodation and support for up to 10 people with learning disabilities. There were 10 people living at Westwood House on the day of the inspection. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

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.

People receiving support from staff at Westwood House received highly individualised person- centred care. Support plans contained detailed and personalised care plans and we saw that many people had been supported to have a full and meaningful life. People benefited from a large range of activities and interests provided, to ensure they were kept occupied, if they chose. There were many excellent opportunities to optimise people's social and stimulation requirements.

There was clear guidance for staff on how to meet people’s individual needs and support them to develop their confidence and have their preferences met. We saw that people were relaxed and staff demonstrated a caring attitude. The service had ensured people’s communication was maximised, which assisted an increased understanding and reduction of distress.

As the values and vision of the organisation and service had been integrated into everyday practice, people living with learning disabilities were able to achieve what they wanted in their lives and overcame obstacles to achieve positive outcomes.

People and their families, where appropriate, were fully involved in the development of their care planning along with health and social care professionals and Westwood House staff.

The service was exceptionally well-led. The service actively promoted a positive, inclusive and open culture. All staff showed a passion and commitment to providing the best support to enable people to have full lives. The registered manager had taken time to look into ways to improve safety and share this practice within the organisation. There were robust quality assurance systems in place, which monitored the service, identifying potential areas for improvement, and actions were taken to improve these.

Staff were highly motivated and worked as a team and shared a common ethos of providing high quality, compassionate care with regard to people's individual wishes and support needs. Staff were valued, well-supported and supervised by the management team.

Staff knew how to keep people safe, and how to report any concerns. There were enough staff to keep people safe. People received their medicines as they had been prescribed.

Risks to people were identified promptly and effective plans were put in place to minimise these risks, involving relevant people, such as relatives and other professionals. Where risks were more complex, comprehensive guidance was in place to guide staff, including the most effective approaches to use, or particular communication methods suited to the individual. Guidance was in place for staff so that they could mitigate risk, and support people to take sensible risks as safely as possible.

People were supported to have maximum choice and control

We undertook an unannounced inspection of Westwood House on 7 March 2016.

Westwood House is a care home without nursing for up to 10 people. On the day of our inspection, nine people were being supported and one person was in hospital. The care home is located in Swindon. The service has been operating at this location since December 2010.

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.

People were safe. Arrangements were in place to protect people who used the service from the risks of abuse and avoidable harm. Staff were knowledgeable about safeguarding and could describe their responsibilities and roles in relation to safeguarding. Staff had received regular training to make sure they stayed up to date with recognising and reporting safety concerns. The service had systems in place to notify the appropriate authorities where concerns were identified.

There were enough staff on duty and they were clear about their responsibilities to protect people who lived at the service. The service had safe and appropriate recruitment processes to ensure staff were suitable to care for people.

People had been assessed for risks, such as drinking too many fluids and assessments were in place to monitor and reduce these risks. Staff were aware of people’s needs and followed guidance to keep them safe. People received their medicine as prescribed.

Staff had received an effective induction before they started working with people. They had received all the relevant training and good support and guidance from the management team. People spoke highly of the staff and described how they felt cared for.

The registered manager and staff understood their responsibilities under the Mental Capacity Act 2005 (MCA). The MCA protects the rights of people who may not be able to make particular decisions themselves. Where restrictions were in place for people these had been legally authorised and people were supported in the least restrictive way. Appropriate guidance had been followed where people’s freedom was restricted.

People told us they were confident they would be listened to and action would be taken if they raised a concern. The service had systems to assess the quality of the service provided. Systems were in place that ensured people were protected against the risks of unsafe or inappropriate care.

People were addressed and supported in a caring and respectful way and staff were kind and friendly towards people in the service. People had enough to eat and drink and were supported by staff to eat food they enjoyed. Mealtimes were flexible to meet people’s individual needs. Activities were tailored to reflect people’s individual preferences. These included activities in the home as well as trips out into the community. People were supported to access health care professionals to ensure their health care needs were met. People’s needs were reviewed on a regular basis and external professionals were involved as necessary.

The service benefitted from good leadership. This was evident across the service with positive feedback from individuals, staff and professionals. There were clear and well-kept records in the service which evidenced that the service supported people safely and effectively by helping people to achieve their goals. Management systems were in place to assess and monitor the quality of the service provided. This included gathering views regularly from people who used the service, their relatives and professionals.

Staff spoke very positively about the support they received from the registered manager. Staff supervisions and meetings were scheduled as were annual appraisals. Staff told us th

At the time of our inspection the provider had two registered managers identified. One of the managers was applying to de-register with the Care Quality Commission. In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at the time of the inspection. Their name appears because they were still a registered manager on our register.

On entering Westwood House we found the atmosphere to be warm and welcoming. We spoke with people who use the service, a visiting family member and staff. We observed staffs understanding of the care and support needed. The people who use the service we spoke with said that staff "look after them well" and a family member said their relative was "really happy."

We looked at people's individual records which incorporated their personal profile, support plans and risk assessments and found they encompassed the safety and well-being of people who use the service. The family member and staff told us that they knew how to raise a concern or complaint and felt confident in doing so. They said if they had any issues they could "talk to the manager."

We looked at the cleanliness of the home and the management of medicines and found the provider had adequate systems in place. We reviewed the provider's quality management system and records and found that people were given the opportunity to provide feedback on the service and staff had received relevant training and supervisions.

We spoke with five people who lived in the home. One person said that they were going out into town independently and they wanted to take the bus. They said that they went out regularly and they had a part-time job. Another person had just come in and told us that they had been out to a cafe for breakfast with a member of staff. A third person told us that they had been out for a meal at a pub. Another person said that they were going out to Bristol with a member of staff to visit a relative. The fifth person returned later in the day and told us that they had a job.

People we met with told us that they enjoyed living at Westwood House. They told us that the staff treated them well and supported them with personal care when required. We saw that people were supported to access the community as and when then wanted. Members of staff understood people’s individual methods of communication. Staff included people in their conversations.

People told us that they received their medicines as prescribed by the doctor. We saw that only trained staff administered medicines to people.

People had the opportunity to raise concerns or make a complaint if they wished to do so. Information was available in easy read formats if required.