Welcome House - Leeza Court

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect. At our last assessment we rated this key question Good. At this assessment the rating has changed to Requires Improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

The service was in breach of regulation in relation to person centred care and treating people with dignity and respect

This service scored 40 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not treat people with kindness, empathy and compassion, or respect their privacy and dignity. We observed kind and compassionate interactions between staff and people and received positive feedback in this area. One person told us, “The staff here are very caring and I couldn’t compliment them more. They always ask me what I would like to do”. A relative told us, “Staff are always really good. I’ve never heard any of the staff raise their voice or snap at people”

However, the service as a whole was not always caring. Where people had made allegations of abuse or were self-neglecting, the service had failed to submit appropriate safeguarding referrals. By not ensuring the environment was free from risk or providing adequate guidance in care documents that optimised people’s health and well-being, they did not always receive the support they needed to protect them from avoidable harm or neglect. People were not always supported to have maximum independence or ensured that where restrictions were made, they were clearly documented and done so in people’s best interests.

The provider did not always treat people individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The service did not always clearly document people’s care needs, meaning we could not be assured that people were receiving individualised care reflected their current needs or ensured they would receive the support they needed when they needed it. There was not always clear evidence of people being involved in shaping their own care plans, and there was a lack of clear guidance on what people’s specific wishes were and what they wished to achieve from their care. Restrictions put in place were not always clearly assessed on an individual basis to ensure people were being supported to remain as independent as possible.

Where people had a religious faith, they were supported to express this and to take part in worship either within the service or within the wider community. People were supported to personalise and have control over their own space including having their own keys to be able to come and go as they wished. They were opportunities for people to meet together and make suggestions about the service, and following a recent meeting it had been agreed to start organising regular outside activities and to redesign part of the garden as one person was a keen gardener. One relative told us “My relative has their own room with a sink, private toilet and is allowed to buy their own food. They can help themselves or ask from the kitchen if they want anything, A lot of the time I visit, they bring their friends in, and we sit together.” There needed to be a greater focus on ensuring people’s voice was always used to drive the care they received as meetings had not been held regularly, and key worker meetings did not always clearly evidence how people had been involved in these or if so what their wishes were.

The provider did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing.We found that restrictions put in place were not always clearly assessed to ensure they were the least restrictive option and that there were some blanket restrictions for all people such as around alcohol. These restrictions did not always reflect people as individuals with their own rights and choices.

People were empowered and supported to go out into the community either by themselves or other to take part in things that matter to them. On the day we inspected, we observed people coming and going as they pleased, spending time in communal areas or staying in their own rooms if they wished. People were supported to do tasks such as preparing their own meals or household tasks. Staff could explain how they supported people to be as independent as possible. One staff member said, “I support (person name) in managing their money so they can save up to take part in things they enjoy such as going bowling”. At the time of our visit, the service was creating a new menu which was developed by people and the manager explained would need to be approved at the next service user meeting. However, people had a wide variety of choices and when people wanted to eat something that was not on the menu they would be supported to do so.

The provider did not listen to and understand people’s needs, views and wishes. Staff did not respond to people’s needs in the moment or act to minimise any discomfort, concern or distress. There was insufficient guidance to ensure staff always had clear information to respond appropriately if people were distressed, and staff could not also give a consistent account of how they would support people’s mental health. For example there was no clear crisis plan including for people who were at high risk of coming to harm and were living with significant mental health needs. Conditions such as diabetes, constipation, asthma and COPD (chronic obstructive pulmonary disease) did not have care plans guiding staff on how they should respond if their condition deteriorated, including signs or symptoms of concern and when to contact medical services.

We observed during our inspection that where people requested support, this was responded to rapidly and kindly. One person told us, “Staff are good and encourage me to be independent, sometimes I need to be patient but that is understandable. They support me in getting into and out of bed whenever I need as I can’t do this myself”. However appropriate guidance in place was not in place to do so consistently.

The provider did not always care about and promote the wellbeing of their staff. They did not support or enable staff to deliver person-centred care. We received mainly positive feedback about how management at the service supported staff. One staff member told us “If am worried about anything even a personal matter I could speak to the manager, he is always approachable and available. For example, if I’m worried about a specific person, he would come out and help me support them”. There were regular surveys to gather the experience of staff with clear actions taken following feedback, and regular meetings and opportunities for staff to share any concerns.

However, there was insufficient guidance in place to protect staff against potential verbal or physical aggression. There had not been sufficient action taken to ensure staff were always safe or protected in the roles. One person was at risk of being violent towards people they had not met before and staff were advised to be vigilant, but there was no clear information on how this risk could be managed safely. This posed a greater risk to new or temporary staff who might support this person and be less familiar with them. We were made aware of frequent use of racist language directed at staff by certain people, yet staff largely stated this was part of the role and they would just have to accept this. Although we saw management remind people that racist language was unacceptable, this continued response to sustained racist abuse was not robust. Leaders had not considered the detrimental impact on staff. Staff were not always aware of their rights or the importance of their own wellbeing. Although the majority of staff felt supported if they did receive abuse, there were staff who didn’t feel this was the case.