Archived: Westwinds - Care Home Learning Disabilities

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We identified two breaches of the legal regulations. People were not always at the centre of how care was planned and delivered. Information, including the complaints procedure and opportunities for feedback, were not always available in a format that suited all people. We identified shortfalls in the continuity of care provisions as people were not always able to access healthcare services when they needed them by taking into account their personal circumstances. People had care plans in place but these were not always being followed by staff and staff told us they did not always have the time to read care plans. Care delivered was not in line with RSRCRC as it was not person-centred and did not involve people in making decisions about their lives.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People did not always receive person-centred care. People’s needs and preferences were not always taken into account by staff and people spent large proportions of their day in the lounge sitting down or walking repetitively along the corridor due to a lack of stimulation.

Staff did not understand the importance of providing care which was person-centred. Staff chose to undertake activities which were convenient for them rather than person-centred around the individual’s needs and interests. This meant people did not always engage in activities and daily notes showed that people spent the majority of time sitting in the service rather than going out and undertaking activities they enjoyed.

We reviewed daily notes relating to the care that staff provided to people and found that these were not detailed, were task-orientated and parts were illegible. This meant it was not clear what other activities had taken place and there was a lack of basic information which failed to reflect what people had done throughout the day and at night. Daily notes completed by staff showed that choices people had made were not recorded in their daily notes. During our assessment, we observed people were not offered a choice of meals or whether they wished to have a drink alongside their meals. There were no meaningful activities being undertaken on the day of the assessment.

As we have highlighted in other quality statements, the measures in place for care provision and continuity were insufficient. They did not ensure people’s care was delivered smoothly across services and did not take into account people’s diversity of needs. The care provided was inconsistent and depended on the experience of the carers on shift.

Staff did not always know how to ensure continuity of care. The interim manager was able to explain how care should be provided in a way which ensured good outcomes to people, but staff did not know how they could do this. They told us they had raised concerns in relation to care provisions but that these had not been addressed. They told us that they had raised concerns in relation to activities available, maintenance of the premises and the lack of transport.

We were told by some professionals who visited the service that the care provisions depended on the staff working on that particular day. They said that staff did not always understand their responsibilities in ensuring there was continuity of care. Comments from other partners included that staff were friendly and polite when greeting them and welcomed them into the service.

People’s care records we reviewed during the assessment showed how people’s care was planned but this was not always delivered with continuity, inclusion and a holistic approach to meet people’s needs. Care plans were not regularly reviewed when people’s needs changed, and there was no evidence that people had been involved in the decisions that were made in care records.

People did not always have access to information and advice about health, care and support in a format that was accessible for them despite the care plans stating that they could benefit from communication aids. This meant staff made decisions on people’s behalf without their consent including the clothes people wore and the meals people ate. This was not in line with RSRCRC as people were not being provided information in a format accessible to them in order to make decisions and be actively involved in their care.

Staff we spoke with were not always aware of people’s communication and sensory needs. Staff did not communicate well with people consistently throughout the assessment and there were times when staff did not engage with people for several hours.

People’s communication needs were not always met. For example, care plans guided staff to use aids and short sentences. We found that staff were not following this. When we asked staff about communication, they told us that people are unable to communicate verbally and that there was no further way of communicating, such as Makaton or pictorial aids.

Relatives told us they did not always feel listened to and involved in the care being provided. Several of the people living at the service were unable to communicate verbally but they had not received information in a way that was accessible, such as the complaints procedure, despite their care plans stating that they could benefit from this in order to make daily choices. This was not in line with RSRCRC as it did not involve people and did not always consider their views.

Staff did not support people to voice their opinions. Staff told us they did not always feel listened to when they raised complaints, particularly in relation to environmental works. The interim manager told us that they had raised concerns several times with the provider in relation to the environmental shortfalls but that these had not been addressed.

Whilst there was a complaints procedure in place, no complaints had been recorded or analysed to see if there was a pattern and whether any lessons could be learnt. Meaningful feedback from people and their relatives had not been sought for over a year. Relatives told us they had not received surveys asking them for feedback. Since our site visit, the provider told us that they have sent out surveys to people and their relatives.

People did not always have equity in accessing care provided. For example, one person was restricted in terms of their mobility and they were unable to leave the garden without a transport vehicle. As the service did not have a designated driver working every day, the person was unable to leave the premises. This had impacted on the person’s wellbeing and they became more withdrawn.

Staff did not seek people’s or relatives’ feedback to actively to improve access for people more likely to experience barriers or delays in accessing their care. Staff did not understand their responsibilities in ensuring the provider complied with legal equality and human rights requirements. Whilst staff understood that it was a fundamental right to be able to leave the premises if an individual wished to, they did not feel that it was their responsibility as they told us they had reported concerns to the interim manager and previous managers.

We did not look at this evidence category during this assessment. The score for this evidence category is based on the previous rating for Responsive.

People’s care records included information around people’s sensory and communication needs although these were not followed by staff. The provider had procedures and policies in place for people to have equity in accessing care and treatment but this was not always being followed by staff. For example, the provider had built a sensory room in the premises and whilst this was being used by people, staff supported people to sit there and then left them to sit in the darkened room on their own for long periods.

Feedback from relatives was mixed with some commenting that they had no concerns in relation to equality and diversity, however others told us they felt that staff did not always advocate for people’s rights such as to go out of the service and visit the local community.

Staff told us they knew how to ensure people’s rights were protected and that there was generally an inclusive atmosphere at the service. However, we found that staff did not always champion people’s rights and we observed staff interactions which showed a lack of respect and dignity towards people and each other.

People’s care records showed that people’s human rights and protected characteristics were included in the planning. The information was not always accessed by staff and they did not always know the steps they needed to take but the provider had plans in place to re-establish networks such as Pride and Cultural Diversity Inclusion (CDI).

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.