Archived: Westwinds - Care Home Learning Disabilities

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We identified three breaches of the legal regulations. The provider did not ensure that there was an inclusive and positive culture of continuous improvement at the service. The management of the service lacked the understanding of their responsibilities and oversight of the service. The governance systems in place were ineffective in making the required improvements. People’s care had been impacted by the lack of coordination and partnerships with external agencies, such as community healthcare professionals. Staff did not always support people in a person-centred way and did not always know the values of the organisation. Staff told us they did not feel involved in the day-to-day running of the service and felt that their concerns would not be listened to. Leaders and staff did not always collaborate with partners to deliver care that was safe, person-centred and reduced inequalities. The provider had policies and networks in place which championed equality, diversity and inclusion. The provider told us about the systems that were already in place such as the employee assistance programme and various employee networks. There were also future plans in place, such as to re-launch a staff association. The lack of a consistently positive culture and lack of direction was not in line with RSRCRC because people had been impacted by the atmosphere in the service and staff did not understand their responsibilities in creating a welcoming environment for people.

This service scored 29 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff and leaders did not share the provider’s values and vision. Staff were unable to tell us what the values of the provider were and the expectations of them. Several staff had started working at the service recently and completed their induction. They told us that they were unable to recall the values of the organisation and did not always know where they would check to locate them.

There were processes in place at an organisational level but these had not been translated into the service. Staff lacked a fundamental understanding of the values and philosophy of care provided by the organisation. Staff told us that they were unaware of the plans following the departure of the interim manager and did not feel included in conversations with the provider. Organisational values were not discussed at supervisions and team meetings and staff did not have the knowledge in order to apply these to the day-to-day running of the service. There was a culture of acceptance amongst the staff team and we were told that this was partially because they had raised concerns numerous times in the past with no action having been taken in response. Staff struggled to explain the shared direction because they did not feel that there were systems in place to retain a service manager for long enough to embed improvements that they implement in the service.

Staff told us they did not feel heard by the provider and did not feel included in the day-to-day running of the service. However, staff told us they generally felt supported by the interim manager. The interim manager told us that they did not have experience in working with people with learning disabilities and/or autistic people. This meant that they felt unable to prioritise in a way that consistently improved people’s quality of life. They felt they were unable to access appropriate support including for people’s healthcare needs, and that there was an expectation on them to run the service without opportunities for development in areas that they were not confident in.

Whilst the provider’s auditing processes had identified some of the institutionalised practises we found, they did not ensure that appropriate action was taken in response to their findings, such as ensuring that people did not have to wait for a hot drink with potentially unsafe milk. This showed the provider was aware of the practices but did not follow these up adequately as we continued to find the issues they had identified. This was not in line with RSRCRC because issues around the culture in the service were not addressed proactively and we found that these were still happening.

The interim manager had encouraged people to speak up about areas of improvement and concerns. However, staff told us that they did not know who to escalate concerns to in the absence of the interim manager and they did not feel that their voices were heard when they had suggestions about areas of improvement. There was a culture of staff not speaking up because there was a culture of acceptance and newer staff could not see why some of their attitudes towards people were undignified.

The provider had a whistleblowing policy and procedure in place, and staff had undertaken relevant training. However, staff told us they did not have confidence that their concerns would be listened to and 2 members of staff told us they did not know how to escalate concerns externally.

Staff told us they did not always feel valued and respected in their roles by the provider. Staff made a distinction between the interim manager, whom they found supportive, but they did not always feel that the provider was supportive of the service and valued the staff working at the service.

The provider had policies and plans in place which championed equality, diversity and inclusion. The provider told us about the processes that were already in place such as a dedicated health and safety department and an employee assistance programme. There were also future plans in place, such as to re-launch a staff association. However, we found there to be a culture of blame at the service and staff did not always acknowledge their differences by being kind to each other. Staff were talking over each other and arguing loudly in the presence of people and did not understand why this may make their colleagues feel not appreciated and valued.

Staff told us they felt supported by the interim manager but that they did not feel supported by the provider. Staff told us they had raised issues several times with the provider but, partly, due to the changes at provider-level and a lack of a clearly communicated structure, they did not know who to approach in order to escalate concerns which had not been addressed. When we spoke to the provider about this, they told us there had been some recent changes and that there was a new structure in place. However, these need to become embedded in the service.

The governance systems in place were not effective. Consecutive provider audits in July 2023 and October 2023 in relation to the culture at the service found that staff were task-orientated, that they did not spend meaningful time with people throughout the day, and that people were not involved in decisions relating to their care. We found the same issues had still not been addressed adequately by the time of our site visit and showed that whilst the systems in place highlighted issues, there was insufficient follow-up from the provider to ensure these had been addressed.

Relatives told us that people were not always able to access the community because the service often lacked staff who were able to drive. People’s care had been impacted by the lack of coordination and partnerships with external agencies, such as community healthcare professionals.

The interim manager and staff explained the challenges they had faced in relation to one person’s healthcare and another person’s social needs. Staff told us the impact this had on people and themselves. This included feeling that they were not supporting people appropriately and that this had affected morale.

The leadership of the service did not always ensure that they worked well together with partners and feedback from partners was not always acted on. As we have reported under the key question of Effective, feedback from partners was mixed. Feedback included that staff did not always work well with partners. Several partners told us they found the service to be uncoordinated and unorganised with staff often lacking the basic understanding of people’s needs and when to approach partners. Other feedback we received included that staff and managers were welcoming and friendly when they visited.

The processes in place to ensure specialist services were accessible were not robust. Staff did not always record outcomes of visits with healthcare professionals appropriately. This meant it was challenging to understand the level of input a person had received. Systems in place to check that healthcare entries were appropriately made were not effective and there was no evidence that staff had looked at lessons learnt when healthcare professionals raised concerns.

Staff told us they did not discuss people’s outcomes and how to improve these. Staff told us that they had not discussed people’s goals and how to help people reach these. Staff told us they were not offered time to develop their skills outside of the provider’s mandatory training schedule. When we asked staff about RSRCRC, they did not know how this would impact their work. Staff told us that they did not discuss accidents and incidents in a formal way and they did not feel included when looking at lessons learnt and how to make improvements to the service. They told us that they felt listened to by the interim manager and the previous manager if they had ideas but that these would not materialise. Staff told us that this had affected morale and resulted in them becoming disengaged.

The provider’s systems in place to ensure continuous learning and improvement were not effective. Whilst audits identified some of the shortfalls, the provider did not ensure that a clear timeline was followed to ensure these were addressed. The action taken by the provider in response to their own audits were not adequate and had impacted people’s quality of life.