Westminster House is a care home run by the local authority, which provides short term respite to people with learning disabilities. The home can accommodate a maximum of 10 people and on the days we visited the home, there were four and five people staying respectively. There were a total of 41 people registered to use the respite service, some of whom used it on a weekly basis and others less frequently. The inspection was unannounced and was carried out on the 02 and 08 December 2015.
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 at risk of receiving unsafe or inappropriate care because care records were not always up to date and did not contain sufficient information to inform staff as to people’s individual needs.
Risks relating to people’s care and welfare were not always managed effectively and risk assessments were not up to date.
There was not an effective system in place to manage short term absences, such as staff sickness. Staff were not always supported to develop through supervisions and appraisals.
The registered manager did not always notify CQC, without delay, of incidents of abuse of allegations of abuse affecting people using the service.
Staff sought verbal consent from people before providing care. Staff were knowledgeable about the people they supported and when appropriate followed legislation designed to protect people’s rights and ensure decisions taken on behalf of people were made in their best interests. However, there were no records in people’s care plans to new enable staff to understand the ability of the person to make specific decisions for themselves. We have made a recommendation in respect of this.
We found the home was meeting the requirements of the Deprivation of Liberty Safeguards.
There were systems in place to monitor quality and safety of the service provided. However, some audits were completed on an informal basis and were not recorded. We have made a recommendation in respect of this.
People were supported by staff who had received the appropriate training to enable them to meet their individual needs. There were suitable systems in place to ensure the safe storage and administration of medicines. Medicines were administered by staff who had received appropriate training.
Staff and the registered manager had received safeguarding training and were able to demonstrate an understanding of the provider’s safeguarding policy and explain the action they would take if they identified any concerns.
Staff developed caring and positive relationships with people and were sensitive to their individual choices and treated them with dignity and respect. People were encouraged to maintain their family relationships. People’s families were involved in discussions about their care planning, which reflected their assessed needs.
People were supported to have enough to eat and drink. Mealtimes were a social event and staff supported people in a patient and friendly manner.
Staff were responsive to people’s communication styles and gave people information and choices in ways that they could understand. They were patient when speaking with people. Staff were able to understand people and respond to what was being said.
There was an opportunity for families, health professionals and regular visitors to become involved in developing the service and they were encouraged to provide feedback on the service provided. They were also supported to raise complaints should they wish to.
Accidents and incidents were monitored, analysed and remedial actions identified to reduce the risk of reoccurrence.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have asked the provider to take at the back of the full version of the report.