Welcome House - The Chestnuts

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 Requires Improvement. At this assessment the rating has remained Requires Improvement. This meant people’s needs were not always met.

The service was in breach of legal regulation in relation to person-centred care

This service scored 50 (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 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.

We saw some examples of person-centred care being undertaken, however there were further opportunities missed to ensure the care people received fully reflected them as an individual. For example, one person had a religious faith and were being supported to attend their place of worship regularly. However, there was no written guidance to help staff who were unfamiliar with their faith understand what it meant to them, or how they wished to be supported. We identified that certain staff had refused to enter their place of worship with them because of their own religion, which the provider hadn’t fully explored with staff as to why they might be uncomfortable doing. There was no reference to if they wanted to be supported to attend local religious festivals, and we noted they were largely eating the same food as their peers despite it being recorded they would like more food from their culture.

Likewise, another person was from a different culture and was supported to have their hair cut in a specialist hairdressers to reflect their heritage. However, there was no other guidance on their culture and how they may wish to express this, or consideration of how they could be supported to participate in their own community.

There were some 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.

People were supported by a consistent staff team, who were kind and knowledgeable about their health needs. However, they did not all have the same understanding of what people wanted to achieve from living at The Chestnuts, or a coherent plan to help them to achieve these goals. People came from diverse backgrounds and cultures, however these were not always clearly reflected in their care or understood by leaders and staff.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

We saw information was provided in easy read formats where required including activities timetables, minutes of meetings and copies of their keyworker reports to ensure people were able to process information in a way that was personalised to them. Staff communicated patiently with people, and would repeat things if needed and give people time to respond to ensure they had time to process information and make decisions for themselves.

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 did not always involve people in decisions about their care or tell them what had changed as a result.

Opportunities were not always taken to involve people in their own care, to ensure it continued to be shaped around the wishes and preferences. Although there were service user meetings which were well attended and discussed matters such as activities and food, these were not taking place frequently. There had only been 3 meetings between March 2026 and the date of our inspection, and 1 of these had been a very brief meeting to discuss the location of the summer trip. People had monthly keyworker meetings, however the records from these were largely identical each month and were primarily written about people rather than with them. There was also no clear evidence that people had been involved in writing their own care plan.

The provider did undertake annual surveys to gather the feedback of people, relatives and professionals who worked with the home. This feedback was mostly positive and where areas for improvement were identified, these were implemented in practice. All those we spoke with told us that any concerns they raised would be listen to by leaders, although there had been few complaints within the last year. One person told us “I could speak to (Manager name). She is nice”.

The provider did not always made sure that people could access the care, support and treatment they needed when they needed it.

People were not able to access regular person-centred engagement, activity or support that was tailored to them to allow them like empowered lives focused on their skills and abilities. However, people were able to access health support when required. For people who might be reluctant or less able to leave the home, this included access home visits from health care professionals whilst those who could attend in person were supported by staff to do so. If people’s health and care needs deteriorated, this was responded to appropriately, so people received the support they needed.

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

The provider had not fully considered barriers faced by people with a mental health diagnosis in wider society, and how people could be supported to overcome these. For instance, people had goals around living independently, getting paid or voluntary employment or forming a relationship but there was no clear plan of how this would be achieved. We saw some consideration had been given to how people from diverse cultures could be supported to access care that promoted their culture and heritage, but again this had not been fully considered or demonstrated in practice.

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.

There was no consistent or personalised plan setting out how staff should work with people to support them to achieve any future goals, such as living independently once more. There were multiple people who were described in their care plans as having aspirations to live in their own home in the future, however there was no detailed plan setting out how the service would work with them to equip them with the skills to do so. The majority of staff we spoke with stated there was either nobody who could live independently, or gave us the names of other service users where their care plan did not contain any references to independent living. One staff member told us “Everybody is fine here. Nobody has a goal to live by themselves”. Some people living at the service were in romantic relationships, however there was no guidance of any sort to describe how they may wish to be supported to maintain or develop these relationships or to ensure they were safe for both partners.

However we identified people had been supported to put in place end of life care plans in case their health were to deteriorate, which included references to spiritual or religious wishes and people they would like to be involved on their behalf.