Boston West Care

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

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

This is the first assessment for this newly registered service. This key question has been rated Requires Improvement. This meant the management and leadership were inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

This service scored 61 (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 had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The provider’s vision and values were shared with staff. Staff meeting records confirmed the new manager had reinforced the provider’s strategic vision and values. These principles were also clearly outlined in the service user guide, helping people understand what they could expect from the service.

Staff were positive about working for the provider. Our observations of staff’s practice and engagement with people confirmed the provider’s vision and value principles were known, understood and practised by staff.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty. However, changes within the management structure during 2025 had a negative impact on the service. These disruptions affected continuity and oversight, highlighting the importance of stable leadership in maintaining quality and consistency across the organisation. Further time was required for the management team to be fully complemented, and for newly implemented systems and processes to be embedded effectively.

In July 2025, a new experienced manager was appointed. The manager, who had submitted their registered manager application, also held responsibility for the provider’s second registered location in Leeds. They provided written assurance outlining how they managed their time across both services, including oversight, leadership, and on-call arrangements.

At the time of inspection, the service had been without a clinical lead since August 2025. While the position had been advertised, interim clinical supervision, oversight and leadership were being provided by the clinical lead from the provider’s other registered service. Written confirmation of these interim arrangements was received, and the information provided offered assurance of a temporary structure. We will continue to monitor this.

The deputy manager had worked at the service for many years and was well respected by people, relatives, staff and external professionals and provided some consistency and continuity to the service.

The provider worked closely with the manager and deputy in overseeing the service and providing leadership

Staff spoke positively about the support from the manager, deputy and the provider. Staff consistently described leaders as being “approachable and supportive.”

Relatives and external health professionals told us they were not aware of who the new manager was or what the clinical leadership arrangements were. The manager told us how they had attended a resident and relative meeting to introduce themselves, but there was no attendance; however, they were arranging another meeting. They also advised how they had recently written to external professionals introducing themselves.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff told us they felt well supported. Staff were enabled and encouraged to share any concerns and/or make suggestions during staff meetings, staff handovers, and supervision meetings. The manager told us they had an open-door policy and made themselves available to staff, this was confirmed by the staff. However, we were concerned not all staff may be aware of when the manager and or clinical lead was onsite. The manager agreed to add these details to the staff rota.

Staff confirmed they had access to the provider’s whistleblowing policy and would not hesitate to use it. This policy allows employees to report suspected wrongdoing or illegal acts within an organisation in a protective and confidential manner.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The provider had policies and procedures that protected staff’s human rights and working conditions.

The provider valued diversity within the staff team and demonstrated a commitment in supporting and valuing the staff. The staff team reflected the diverse needs of people using the service.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate. However, changes within the management team and challenges in leadership had a noticeable impact on the service. These disruptions affected consistency and oversight, highlighting the importance of stable governance in maintaining service quality and continuity.

The provider was transparent about internal challenges experienced under the previous management team, including the misplacement of important documentation. The provider completed an audit in June 2025, which showed significant improvements needed in care plan and risk assessment documentation. Staff guidance lacked sufficient detail, and reviews had not been completed at the expected frequency. Although the provider had identified the necessary improvements, we noted the time for these extended to a four-month target for completion and the absence of clear prioritisation.

In July 2025, a new experienced manager was appointed, and during the inspection, shared an action plan dated September 2025. Improvements to care plans and risk assessments were actively underway, supported by the implementation of enhanced systems for staff communication and care plan review procedures. The manager was also reviewing audit processes to ensure they were more meaningful and effective.

During the inspection, concerns were noted regarding the reporting of notifiable incidents to us. The manager apologised and advised that this was an oversight and submitted these records.

New and improved systems and processes required further time to become embedded and sustained.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement. However, further development was needed to strengthen the effectiveness and consistency of partnership working.

Engagement with external communities was limited. The manager reported that efforts were underway to explore how local religious groups could support people’s religious, cultural, and spiritual needs.

Feedback from external healthcare professionals indicated that communication with the service could be improved. This highlighted the need for clearer, more responsive channels to support collaborative working.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people.

However, the manager acknowledged the need to further develop and establish local links. They showed a commitment to enhancing collaboration, to support the service to further develop in how people’s individual care and treatment needs were met. The manager said, “I’m a great believer in partnership working and I’m trying hard to engage with other professionals and the local community.”