Westwood residential care home is situated close to Chorley town centre. The service is set in a large Edwardian house with a small private car park to the rear. The home offers residential support for up to 20 people who do not require nursing care. The home also offers respite care by arrangement. There is wheelchair access and a lift to all floors.

At the time of the inspection 19 people lived at the home.

The inspection visit took place on 13 September 2018 and was unannounced.

At our last inspection we rated the service Good in all domains. On this inspection, we found the service had remained good in each domain.

We found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There had been a change of registered manager since the last inspection. The new manager had become the registered manager for the home shortly before the inspection. 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 who lived at Westwood residential care home, their relatives and staff were positive about the management support in the home.

People told us they felt safe and looked after by staff. We observed interactions between staff and people. These were positive friendly and supportive. There were procedures in place to protect people from abuse and unsafe care. We saw risk assessments had been developed to minimise the potential risk of harm to people. These had been kept under review and were personalised to meet people’s needs.

Medicines were managed safely. People received their medicines when needed and appropriate records had been completed.

There were sufficient staffing levels in place to provide the support people required and staff responded promptly when people needed assistance. Staff had been recruited safely and received training to develop their skills and knowledge.

We saw people had access to healthcare professionals. People told us staff cared for them in the way they wanted and met their care needs promptly. They referred them to healthcare professionals in a timely way. We saw and people told us staff provided care in a way that respected peoples’ dignity, privacy and independence.

We saw staff were attentive to people’s needs and wellbeing and responded promptly to requests for assistance. They provided care in a personalised way, taking people’s preferences into account. They were aware the importance of upholding people’s rights and diverse needs and treated people with respect and care. People told us they enjoyed a variety of social and leisure activities and staff were welcoming to their families and friends. People said this assisted their well-being.

People had been supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

People told us they enjoyed the food provided and had choice and variety. We observed the lunchtime meal. People received sufficient food and drink and the assistance they needed. The kitchen was clean, organised and stocked with a variety of provisions and staff were trained in food safety.

We looked around the building and found it had been maintained, was clean and hygienic and a safe place for people to live. The design of the building and facilities in the home were appropriate for the care and support provided. We found equipment had been serviced and maintained as required. There were safe inf

This inspection took place on 15 December 2015 and was unannounced. We last inspected Westwood Residential Care Home on 25 July 2014 and the service was judged to be fully compliant with the previous regulatory standards.

Westwood residential home is situated close to Chorley town centre. The service is set in a large Edwardian house with a small private car park to the rear. The home offers residential support for up to 20 people who do not require nursing care. The home also offers respite care by arrangement. There is wheelchair access and a lift to all floors.

There were two vacancies at the home on the day of our inspection visit and these rooms were in the process of being decorated. We were told a waiting list was in place and that once the two rooms had been redecorated then the two vacancies would be filled. The homes lift was not working on the day of our inspection. We were told that the lift would be fully operational by the following day and we were contacted the day after our inspection to confirm this was the case. People who were accommodated on the first and second floor of the home were staying in their rooms and there were enough staff on duty to ensure that people were safe and cared for appropriately.

The home had a registered manager in place who had been with the organisation for a number of years. There was also a deputy manager in place.

People told us they felt safe at the home and with the staff who supported them. They told us that they feel safe from abuse; harassment and their human rights were protected. We observed staff speaking to people and they spoke in a respectful and dignified manner.

The service had procedures in place for dealing with allegations of abuse. Staff were able to describe to us what constituted abuse and the action they would take to escalate concerns. Staff members spoken with said they would not hesitate to report any concerns they had about care practices.

We observed a staff member administering medicines during the inspection. We saw this was done in a competent manner and noted the staff member handled people’s medicines carefully and safely. Careful checks of the records were made each time a medicine was administered and the records were updated accurately at the correct times.

We found the home to be clean and odour free throughout the day of the inspection. Staff we spoke with were knowledgeable about infection control practices and told us they were provided with the necessary protective equipment to carry out their role.

Records and certificates of training showed that a wide range of training was provided for all staff.

We found staff knowledge of MCA and DoLS was sufficient however they needed some additional training to ensure they felt confident in this area. The registered manager told us they were aware of this need and were actively looking for training in this area.

People were approached by the chef to discuss the menu for the next day and to get them to make their choices. We observed the chef taking a lot of time talking to people individually in a warm and caring manner and supporting those who struggled to make choices by describing the meals in detail.

On the day of our inspection, we saw that staff interacted with people without exception in a cheerful and pleasant way. It was clear from talking with staff and observing interactions, that they knew all the people who lived at the home well.

We saw within peoples care plans that referrals were made to other professionals appropriately in order to promote people’s health and wellbeing. Examples included referrals to social workers, district nurses and GP’s.

Information about advocacy and other services was displayed around the service and staff were aware of the need for promoting advocacy and involving next of kin when appropriate.

People we spoke with and their relatives told us they knew how to raise issues or make complaints. They also told us they felt confident that any issues raised would be listened to and addressed. We saw that the home had an up to date complaints policy which was on display in the reception area.

Records we saw reflected people’s needs accurately and we observed written instructions from community professionals being followed in day to day practice.

We found the service had good staff retention. Staff we spoke with had been with the service for a minimum of 6 years up to 30 years with the home.

All the staff we spoke with told us they had a commitment to providing a good quality service for people who lived at the home. Staff confirmed that they had handover meetings at the start and end of each shift, so they were aware of any issues during the previous shift.

We saw evidence of a wide range of audits being undertaken by the home manager as part of the quality assurance process in place. These included; medication, care plan, health and safety and kitchen audits.

We considered our inspection findings to answer questions we always ask;

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well-led?

This is a summary of what we found -

Is the service safe?

We undertook a tour of the premises during our inspection and viewed a number of people's private rooms, toilets and all communal areas of the home. The environment was very clean and hygienic and there were no unpleasant odours.

We found evidence that monthly infection prevention and control checks were carried out that looked at details of any outbreaks (none were identified), audits undertaken, staff training and monitoring activity and reviews of relevant policies. We saw that individual members of staff had been observed whilst carrying out their duties to ensure that they followed correct procedures. Eight observations had been carried out during 2014 at the time of our inspection. No issues had been identified.

Is the service effective?

We looked at care plans for three people living at the home. People's needs were assessed and care and support was delivered in line with their individual needs. We saw that care assessments had been carried out and daily monitoring records were in place. Care plans were easy to follow and it was evident that regular reviews of people's needs were carried out. Risk assessments were in place covering areas such as moving and handling, falls and nutrition. Evidence was in place showing that monthly reviews of all risk assessments were carried out. At the time of our inspection the home were in the process of transferring some of the care plans to an electronic system. Staff training was taking place to ensure that all staff were familiar with the system and felt confident using the system.

Is the service caring?

We spoke with four people who lived at the home, one visiting relative and another visitor to the home. All the people

we spoke with were happy with the care they or their relatives were receiving at Westwood Residential Care Home. One person who lived at the home told us, "I'm happy here, staff treat me well". Another person who lived at the home said, "I can't grumble, I'm comfortable, the staff are good, I'm alright". A visitor to the home who also went into other local care homes said, "It's a lovely atmosphere here. The staff are great and always very helpful. Their attitude is second to none".

Is the service responsive?

All the people we spoke with who lived at the home felt comfortable raising any issues with staff and said they knew how to make a compliant if they needed to. One person told us, "I think I would know how to make a complaint, I'd just ask a member of staff". Another person said, "If we have any issues we talk to staff, they couldn't be more helpful".

We spoke with two members of staff who were able to talk us through what would happen if a person living at the home wanted to make a complaint or raise any issues. We also saw that the subject of complaints was discussed at the latest residents meeting held on 30 May 2014.

Is the service well-led?

There was evidence that the home carried out a number of audits including medication, care planning and infection control.

The home had a comprehensive quality assurance policy in place that covered a range of issues including internal reviews, staff and management meetings, residents meetings, annual satisfaction surveys, care plan reviews and risk management.

At the time of our inspection there were twenty people living at Westwood Residential Care Home which meant that the home was fully occupied. We spoke to a number of residents and relatives who visited on the day. People who lived at the home were positive about their experiences and the comments received reflected this. One person living at the home stated, "I feel very comfortable and very happy here. You would have to go a long way to to find somewhere as good as this". Another person told us, "I think there are enough staff, I never want for anything".

Care plans showed that people's care was delivered in a person centred way and that their likes and dislikes were noted and recognised by staff. From speaking to staff, looking at their personnel files and staff training files it was apparent that staff felt supported and had the opportunity to develop.

The premises were clean and tidy and the design, layout and security of the premises were fit for purpose to meet the needs of the residents.

People living in the home that we spoke with said that staff always treated them with respect. Relatives of people living in the home generally agreed and one said, “I am so relieved as to how well (person living in the home) is looked after.”

People living in the home that we spoke with said they were pleased with the home and felt supported. One said, “When we were looking for somewhere this one kept coming up and I am delighted.”

People we spoke with who lived in the home, all said they were kept safe. One person said, “If ever I want to go downstairs I always find someone to help me with the lift.”

People we spoke with who lived in the home said that staff were able to provide the support required to meet their individual needs. One person said, “Staff go above and beyond to make sure everything is ok.”

Confidential information policies were available and security of this information was acknowledged. Staff files were kept secure and archive records were locked away.

People told us they were satisfied with the quality of care and support they received. We were told the staffing levels were sufficient to meet the needs of people living in the home and that the staff were professional, caring and friendly.

Care staff received regular supervision from the senior staff and were trained in the tasks they are required to complete.

People were provided with person centred care plans which were reviewed regularly and updated when required and were involved in the planning and reviewing of care when appropriate.

People said they felt safe living in the home and were able to discuss concerns or issues

with the staff if they wished to. We were told that the service provided enjoyable and varied activities for people.

There were comprehensive auditing and reviewing procedures in place to identify any

areas where improvements could be made.