Westhope Care Limited - 11 Kings Court

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

There was a lack of effective oversight and governance to ensure people received care and treatment which met their assessed needs. Oversight systems and processes had failed to identify shortfalls in staff practice or consider risk mitigation measures. We found a breach of regulation relating to good governance.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Some staff and managers spoke of concerns around the lack of leadership and guidance from previous senior leaders. We were told this was now recognised by the provider and interim local manager support had been put in place. A new manager had been appointed but had not yet started in post at the time of the assessment. We found issues relating to people’s rights and lack of shared knowledge to enable staff to carry out their roles effectively. The new regional management team had created an action plan aimed at addressing issues identified at the assessment visit. They have demonstrated openness and a willingness to improve.

The provider did not have effective systems which assessed or monitored the day-to-day culture of the service, and this meant they had not identified the warning signs of a closed culture following significant concerns found at another local service. Recent improvements have been made ensuring staff have opportunities to freely raise concerns and reviews for people with the local authority are underway to ascertain if their needs and wishes are being met.

Staff, relatives, and people provided positive feedback about the interim management team. However, the changes were recent and temporary and have changed again following our assessment visit. We found although local managers acted with integrity, they lacked knowledge in some areas of support practice. For example, risk assessment and support planning around behaviours of concern, understanding their roles with MCA and the differences between a shared supported living house and a residential care home, were all areas for improvement.

The providers processes had not effectively measured the skills and competence of leaders and as a result had failed to ensure they received support to lead effectively, team with limited guidance and support. At the time of our assessment visit the interim support to had begun to improve the support to the staff. A new manager has been recruited and had plans to start following our assessment visit.

Staff felt able to share their concerns with the local manager. Staff said, “I can talk privately to [Names of managers] if I want to. And “Yes I am supported.” Another said “[Name of manager] is very helpful,” “I am happy to work here.” Managers told us there had been recent recruitment of staff and a core team was being developed.

Senior managers confirmed formal systems designed to gather feedback from relatives and staff had failed to be effectively used. For example, surveys of staff and relatives were not carried out. This was a missed opportunity to hear from relatives and staff which may have identified issues with the previous senior management of the service. People and staff meeting were being held; staff commented they appreciated the team meetings. One staff said, “I have had 3 meetings in the 3 months I have been working here.”

Staff told us they felt working at Westhope care supported living shared house was positive.

There were processes now in place to support staff, such as 1:1 supervision, and team meetings.

Managers and staff did not always have a clear understanding of their roles and responsibilities with safety risks, particularly in relation to MCA including DoLs and least restrictive practices, behavioural support, some health conditions and people’s rights as tenants. Staff told us they requested more training to understand people’s communication needs, and this had not been supported. Managers were not able to effectively differentiate between supported living and residential care.

Governance processes were not always effective and did not always keep people safe, protect their human rights and provide good quality care and support. The provider was aware people did not have real tenancies and were open in telling us there was no separation between the landlord and care provider. This meant people did not have the right to change their care provider without having to move from their home. The provider told us they were working to link with a registered social landlord to create a real tenancy. We were first told this in March 2024. In August 2024 we have been informed negotiations have now started. The providers own systems had failed to identify people had not had assessments about making decisions about care they received or where they lived. Audits had not been carried out or failed to ensured managers and staff had the knowledge to identify the scale of shortfalls and risks to prioritise action.

People told us staff and managers worked with health professionals and supported them with appointments. We saw records of health appointments and referrals taking place. Relatives were confidant people’s health needs were met.

Health & social care professionals who gave feedback, were positive about health support. Comments included, “I felt staff took on-board the guidelines. “Their care plans did reflect staff reading them by asking for a dated signature.”

Systems were in place to record health appointments and actions required.

Staff told us they had limited training around communication and sensory needs and limited knowledge of positive behaviour support (PBS). Staff and managers were not able to demonstrate a working knowledge of their roles under the mental capacity act. This increased the risk of people not receiving safe, effective care. Newly appointed senior managers have given CQC assurances they are focusing on these training and learning needs.

Opportunities to learn from concerns raised at the providers other local services were missed. For example, CQC raised concerns in the providers other local services around understanding and implementing of the mental capacity act. The provider did not always have effective quality monitoring systems in place to monitor staff practice that would have identified the need to ensure staff practice was in line with their training. Steps have been taken by new management recently to start to address the previous lack of learning.