Welcome House - Leeza Court

On this page

• 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

Responsive – this means we looked for evidence that the provider met people’s needs. At our last assessment we rated this key question Good. At this assessment the rating has changed to Inadequate. This meant services were not planned or delivered in ways that met people’s needs.

This service scored 36 (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 make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.People’s care records were not always person centred as they did not always reflect people’s current needs, including their mental health and how staff should support people to promote their wellbeing in a proactive manner. Care records did not always reflect people’s complex health conditions. This meant people were being supported by staff who did not have access to clear and up to date information about their current needs and how people should be supported

People had regular key worker meetings to discuss their care, however these appeared largely identical each month, and were written about people rather than with people and their experience, wishes and emotions. There was lack of clear information about what people actually wanted to achieve from their care, and how the service could support people in living independent and healthy life safe from harm. Where people were put at significant risk of harm by their own actions or those of others, these risks had not been appropriately identified or addressed to the provider could work with people to reduce these risks.

We saw some of evidence of the service promoting people to make decisions and ensure choice. One staff member told us “People are able to make their own choices including around food, activities, when to go out and who with. If they want to go out by themselves, they can, or they want to go out with a specific staff member we will make this happen”. We saw this happening in practice and whilst the service encouraged people to attend health care appointments, they were respectful when people stated they did not wish to do so.

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There were shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity. We saw there was a consistent staff team, but knowledge of how to support people was not consistent, and we heard differing accounts from staff around how they would respond if people were to become distressed or how they would protect people from harm. People’s diverse health and care needs were not always consistently recorded or understood, meaning we could not be assured people would receive care and support that was consistent or safe.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Staff had a good understanding of people’s different communication needs, including people with dementia or who needed information explaining to them in an adapted format. One staff member said, “(Person’s name) has a poor memory. They often repeat themselves, so staff encourage them to slow down so they are able to express themselves clearly, and we are able to have a conversation”. When the provider undertook surveys to gather people’s experiences of the service, those who needed additional were supported by staff who assisted them to complete the survey.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff had not always involved people in decisions about their care and told them what had changed as a result.

There were opportunities for people to share feedback on the care they received, however there needed to be a clearer structure to ensure people’s voice was being actively sought and listened to. Although people had key worker meetings, the records were often identical from month to month and did not focus on people’s goals and what they wanted to achieve each month. Although a meeting for people who lived at Leeza Court had just been held, these were infrequent and that last one had taken place in May. There needed to be more opportunity for people to come together as a community to ensure the service was coproducing care alongside people.

There were annual surveys for people and relatives and where any negative feedback was shared, actions were documented on how the service would respond to this. People and their relatives felt confident to raise any concerns. One relative told us, “The manager always communicates with me. Everybody is really nice. If he isn’t available, there is always somebody I can discuss my relatives care with”

The provider did not make sure that people could access the care, support and treatment they needed when they needed it. We observed that the service supported people to attend medical appointments to support their diverse health and care needs, including attending with people where needed. However, some feedback from staff was that the service could be more proactive in doing so. One staff member told us “If somebody tells us they don’t want to go to an appointment, then some staff will just leave it without any attempt to remind people of the importance of attending, as they don’t want to antagonise people”. People with a range of health conditions lacked appropriate guidance around what support they needed, which meant equitable access to careand support could not be guaranteed. This meant they we could not be assured they would receive the support they needed when they needed it.

Staff and leaders did not actively listen to information about people who were most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

The service cared for people with complex mental health needs who are at higher risk of becoming marginalised or a victim of abuse. However, there was a lack of clear guidance on how people would be protected from abuse, both at Leeza Court and in the wider community, and when allegations of abuse were made these were not appropriately acted upon. People had experienced abuse in their personal life prior to coming to the service, and even though some people were alleged to make regular false allegations of abuse this was just accepted rather than any attempt taken to explore why this has happening. One person would contact emergency services on a daily basis requesting help, but there had been no consideration that this could suggest a support need which was not being met or strategies put in place to respond to this.

People were not supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. We found that information about people’s wishes for the future was limited, and there was no record of people being engaged in discussion about end-of-life plans (even if that was to record that they did not wish to talk about it). This was of increased importance as people had life limiting conditions or were assessed to be at risk of attempting to harm themselves, so opportunities were missed for any personal, spiritual or cultural wishes to be recorded around their end of life wishes.