West View

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

The management team and the provider were introducing changes at the home to create an inspiring environment for people living with dementia. There were systems in place to ensure people were assessed before they started using the service; care plans were based on people’s individual assessed needs. Staff understood about risk and how to keep people safe. Risks were assessed and regularly reviewed. The provider had safe recruitment processes. Staff received an induction when they first started working at the service and training relevant to their roles. The provider ensured staffing met the needs of the people living in the home.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Changes were being introduced by the management team and the provider to create an inspiring environment for people living with dementia. People confirmed there were residents’ meetings where the proposed changes had been discussed. A letter had also been sent to explain outlining the future plans for the service. Some people and their families were apprehensive about the changes and the perceived impact this would have on them. However, one person commented, “It was interesting to hear what was going on.” The management team had taken steps to reassure people and had provided information about the planned changes to the building and the additional training being provided to staff.

The leadership team were positive about how the service would be transformed by adopting a more person-centred dementia approach. However, they recognised some people, and staff were anxious so the leadership group said changes had been made gradually.

Staff confirmed they had been informed about the proposed plans and had the option to develop their skills. For example, staff said, “We did have meetings about the Butterfly project and a lot of the staff are happy about that…” and “I feel more positive now than I did a few months ago and when this first started changing, I was going to go but I stayed, and I am glad I did.” Staff acknowledged the changes were being implemented slowly so as not to overwhelm everyone; one commented, “I would say it is a learning curve for staff.”

The leadership team were committed to further improve the service for the benefit of people living at West View, including increased staff knowledge in the Butterfly Approach. Training had been supplied but some staff members felt ‘out of the loop’ so further training sessions were planned to help staff to understand the concept behind the changes.

A visitor spoke positively about their relative’s experience of moving into West View, and two visitors also praised the emotional support staff had given them as a family.

The leadership team were able to explain the assessment process before someone moved to the home. This included liaising with the individual and their family. Staff were aware of this process and confirmed people’s needs had been assessed before moving into the home. Some reported improvements had been made to the quality of handover records to ensure staff were up to date on the needs of new people moving to the home.

Staff from the service worked alongside partners from health and social care to ensure they could meet individual care needs. As part of this assessment, we asked for feedback from the local authority and the integrated care board. No concerns were identified linked to people’s safety.

The leadership team had put systems in place to ensure people were assessed before they started using the service. Care plans reflected people’s individual assessed needs.

People said they felt safe and were checked on regularly by staff, which reassured them. They had access to call bells when they needed additional assistance. Call bell records showed good response times by staff, which helped keep people safe.

Staff understood their safeguarding responsibilities, including reporting to an external agency such as CQC, if they felt their concerns were not addressed. Staff told us they had received appropriate training. For example, one said, “I would have to report it …There is information around the home for staff to see. Abuse can be anything like withholding food from a resident … or telling someone to stay in their bedroom that is abuse, as it is their home...”

We saw staff were attentive and picked up people’s changing moods to ensure they felt safe and reassured. People looked relaxed with one another and the staff team.

There were policies for staff to follow which helped protect people living at the home. Staff confirmed that they knew about the safeguarding policy. The management team showed an understanding of their safeguarding role and responsibilities. They understood the importance of working closely with commissioners, the local authority and relevant health and social care professionals on an on-going basis.

People said staff supported their independence and respected their decision as to how much support they accepted. For example, they said, “I’m allowed to be independent as much as I want to be.” People appreciated staff adapting their approach to suit their confidence or ability, such as leaving them alone in the bath and checking on them or staying with them while they had a shower.

Staff were knowledgeable about the risks to people’s health and welfare. They were aware of people’s individual risks, how this was assessed and how they supported people to remain safe. This included staff with different roles within the home. For example, staff could tell us how food and drinks should be prepared for certain people, due to being at risk of choking or because there was unplanned weight loss. This showed there was good communication between the different staff groups.

The leadership group said work on care plans was on-going to ensure they reflected the principles linked to person centred care.

Staff were attentive, encouraging people to use their mobility equipment and diffusing situations if there had been a misunderstanding. One person’s behaviour had the potential to impact on other people’s well-being. We saw how one of the leadership team picked up on the person’s changing mood and gave clear instructions to staff as to how they supported the person. Staff actions showed they knew the person well; they were careful not to overwhelm the person and provided them with their favourite drink to distract and occupy the individual. For example, staff said, “I just keep things simple and try to make (person) smile. They loves their music from their youth and if you joke with them, they will laugh with you.”

The leadership team had put systems in place to review risks with guidance provided to staff to manage these risks. The leadership team had put risk assessments and care plans in place for everyone which were updated to make them effective documents. Staff said they referred to care plans or the care app, which were accessible, as well as participating in staff handovers to help them meet the care and social needs of people. Charts were used to monitor and review people’s behaviour, if needed, to identify moments when they needed additional support and reassurance.

People told us they felt safe as they moved around the home; for example, commenting on the handrails and handles around the home or in bathrooms, which helped them feel safe.

The leadership team said the safety of the home was monitored through checks including a daily walk around. Staff raised no concerns about the environment or about the availability of equipment to move people safely.

People looked at ease in their surroundings and were relaxed moving around the home. Some chose to spend time in the garden which was accessible and designed to maximize people’s independence. We saw the home was in a good state of repair. Equipment had been tested to ensure it was safe to use, for example moving and handling equipment.

The leadership team had developed processes to identify any concerns with the environment. The maintenance team completed audits on the environment and checks were completed on people’s individual rooms and equipment. The leadership team made changes during the inspection to ensure actions were always recorded when concerns had been identified. The provider completed a risk assessment for a raised pond during the inspection in recognition of the potential risk it posed to the safety of people living with dementia. After the inspection, the provider confirmed the pond had been fitted with an additional safety feature.

People gave mixed feedback on staffing as some worried about what they perceived as a high turnover of staff, which unsettled them. While several people said some staff were less skilled in communicating with older people than others. In contrast, others praised staff, for example saying, “The staff are very kind and respectful. They try to help me; they are very tolerant of older people.” However, despite these variations, people said the staff group knew them well and were caring.

At the time of the inspection, the leadership group were a relatively new team and were still establishing new ways of working in the service. Some staff felt management changes and the move to focus on dementia care had led to a turnover of staff. However, other staff were clear people had left for a variety of reasons and said the team was becoming more stable. New roles were being created within the service to enable staff to progress their careers and responsibilities, which staff appreciated.

We saw the staff group worked well as a team to the benefit of the people living at West View. Some recognised they needed further training in providing support for people living with dementia, which we were told by the management team would be provided as part of the Butterfly project.

There were effective recruitment and selection processes in place. Staff had access to training, which encouraged them to provide safe, compassionate care and identify changes in people’s health. Staff completed training on a range of subjects including, safeguarding vulnerable adults, and moving and handling.

People were positive about the cleanliness of their room and communal areas. For example, they said, “My room is thoroughly cleaned every day” and “It’s clean, there are no smells, it’s spotless.”

The leadership team and staff said infection control was well managed, and the cleanliness of the home regularly monitored. Staff said they had access to infection control equipment.

The home was clean and free from longstanding odours. Infection control equipment, such as gloves and aprons were readily available, which staff wore appropriately.

The leadership team had created systems to audit infection control and prevention (IPC). These included daily walk arounds and monthly reviews and audits. When concerns with the environment had been identified, staff took action to address them.

Staff ensured medicines and treatments were administered and stored safely.

Staff had received relevant training, and their competency was checked to ensure they managed and administered medicines safely.

Systems were in place to ensure regular audits and checks were undertaken, to ensure medicines remained safe at the service. People received their medicines safely and as prescribed. Medicines stocks, balances and records showed people consistently received the medicines prescribed to them.