Welcome House - The Chestnuts

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 Inadequate. 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 legal regulation in relation to person centred-care and dignity and respect.

This service scored 55 (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 always treat people with kindness, empathy and compassion or respect their privacy and dignity.

Whilst individual interaction by staff members and people were kind, the organisational culture did not always treat people with dignity. People were not supported to have independence or control, or to achieve their goals or aspirations. Some areas of care were undignified, for example a smoking shelter being outside people’s bedrooms meaning noise and smoke would drift in. This had been identified at the last inspection but not addressed. The garden was littered with cigarettes and we observed a staff member pouring a bucket of cigarettes out into the garden.

People fed back that they had good relationships with their care staff, and enjoyed spending time with them. One person told us “It’s very good. They (staff). are very understanding when I get down”. We observed staff singing and dancing along with people during karaoke which brought enjoyment to all involved.

The provider did not always treat people as 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.

Although there had been an increase in activities available to people, these continued to take place primarily as a group rather than considering each person’s wishes holistically and what they may wish to do individually. For example, there had been a recent trip to Margate alongside people who received care from other locations operated by the same provider. The location had been chosen as it was the most popular from all the people living at these services, and had been an annual trip for many years. Whilst it was positive to see people having this opportunity, we saw that several people had expressed wishes to go elsewhere and that they wouldn’t feel comfortable travelling by coach or to busy location. There was no evidence that it had been explored how they could go to these places by themselves, and experiencing the social and emotional benefits of discovering somewhere new or returning to a place that brought them meaning.

There was a heavy reliance on activities such as colouring in sessions as a group, which did not reflect people as adults or that they had abilities to do more challenging and enriching activities. However during our visit we also observed a karaoke session, which was very popular and brought clear enjoyment and joy to people. Some people were supported to do more individualised activities such as religious worship or maintain their personal appearance in a way which was appropriate to their culture.

The provider did not always promote people’s independence

Although several people had expressed goals of living independently in the future, there was no clear structured plan of how staff would work with them to develop the skills they needed to do so. There was limited evidence of people being supported to do tasks for themselves such as assisting with meal preparation or tidying their rooms, despite it being recorded that some people enjoyed doing so. The arrangements at the service didn’t always promote meaningful choice or consider this as an opportunity to develop skills and independence. For instance, lunchtime and evening meals were served from a buffet where service users were called up one at a time to help themselves rather than being directly involved in the preparation. The majority of people we observed would have identical or very similar options, and the menu although developed alongside people was only changed seasonally.

There were some positive opportunities to maintaining people’s independence, such as supporting people to manage their finances safely and shopping trips where people were supported by staff to buy items they required.

The provider did not always take the time to listen to and understand people’s needs, views and wishes.

Whilst we observed staff interacted with people in a way that was kind and compassionate, the majority of these interactions were based on a task such as personal care or asking if people wished to have a drink. There was a lack of evidence of staff taking the time to sit and chat to people about their day, wishes or wellbeing despite the majority of people being described as requiring daily on weekly check in’s. This was especially important given the service supported people with a mental health diagnosis, where such informal conversations are important to monitor people’s mental health as well as bringing wider social and emotional benefits.

However, where people had support needs through their wider health and care needs, this was responded to in a timely way. For example, any deterioration in people’s physical health was quickly identified and a referral made to ensure they received the care they needed. Although most people’s mental health was stable, staff could explain to us how they would respond in a way that was personalised to each person if they were to become anxious or distressed.

The provider cared about and promoted the wellbeing of their staff.

Staff told us they felt supported by leaders, who cared about their welfare and would encourage them to develop professionally including those who aspired to be leaders themselves in the future. One staff member told us “I feel very supported. The provider supported me through my education, and now to do training courses that I have requested to develop my skills. I am happy here”.

All staff received regular opportunities meet with managers, which always started with a discussion about their own welfare, and any factors in their personal life which they could be supported with support their wellbeing and their ability to work. When new staff joined the service, they told us this was a positive process which gave them opportunity shadow other staff and learn the needs of people before they started working with them. One member of staff told inspectors “I enjoy working with the people here and I have no concern. When I joined, I got lots of support and the induction was really good”.