Westgate Court

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulation in relation to consent to care and person centred care.

This service scored 54 (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’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

People had care plans in place to help assess their needs and make staff aware of their preferences. However, care plans were missing in key areas so we could not be assured people’s needs had been fully assessed. For example, a person who had a learning disability did not have a care plan in place to evidence their needs. Care plans which were in place needed more detail and lacked person centred information. For example, care plans reflected that people’s daily routines were important to them however the care plan did not record what these daily routines were. Communication plans were missing for people so we could not be assured staff were aware of people’s preferences when it came to communicating. People’s personal care plans did not fully detail staff expectation within this care area.Due to the inconsistencies within care records and person-centred information a breach of regulation was identified.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

People told us they were involved in planning their care and that they had reviews with the staff to discuss their care. However, due to the concerns raised during the inspection, we could not be assured that the service always effectively considered legislation and current evidence-based good practice and standards. For example, people who were at risk of poor skin integrity did not have nationally recognised assessment tools in place to help manage this. We found shortfalls in the services understanding of the MCA and best practice regarding medication management.

People’s nutritional needs had been assessed and people worked with staff to create menus to suit their preferences. However, people’s hydration needs were not always accurately recorded or monitored. More work was needed to ensure considerations were in place for people with diabetes which was being managed through diet and exercise.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Systems were in place to ensure information about people was shared appropriately with other services when needed. Hospital emergency plans had been developed to ensure easy information sharing, and good relationships had been developed with partner organisations. Staff worked well together and completed handovers to ensure all staff were updated on people’s care and health. One staff member said, “The team are amazing, we all help each other and are supportive.”

The provider supported people to manage their health and wellbeing. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.People were supported to access a range of health care professionals and staff monitored people’s well-being daily. There were regular visits from health care professionals including GPs and support from district nurses was in place when people needed it. Staff supported people to their health care appointments. One person said, “I went to the dentist with staff, they have to come because I forget things.”

The provider routinely monitored people’s care and treatment. However, they did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.Staff monitored health and collaborated to review changing needs. However, some care areas lacked effective checks; for instance, catheter care records were inconsistent, and gaps went unnoticed and unreviewed.

Although staff reported that they supported individuals in becoming more independent, there was insufficient evidence showing how staff enhanced outcomes or fulfilled expectations related to social and aspirational goals. For instance, care plans lacked information about people's objectives for gaining independence. Additionally, records did not demonstrate how staff assisted people in achieving their goals or responded to requests made by individuals during resident meetings.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.We found an inconsistent approach to ensuring the principles of the MCA had been followed. Some people had not been appropriately assessed when they lacked capacity to consent to aspects of their care.

We found that people were not always supported to make decisions about their lives, care and treatment in line with the Mental Capacity Act 2005 (MCA). For example, people had lap belts on their wheelchairs to keep them safe, however this could be a form of restraint if used inappropriately. The provider had not completed the appropriate mental capacity assessments or best interest decisions for people who lacked capacity to give consent to the use of this equipment. People who were lacking capacity to consent to the use of monitoring equipment, such as falls monitors and epilepsy equipment also did not have the correct assessments and best interest decisions in place. The need for these assessments had not been identified by the staff; therefore, we cannot be assured staff and leaders had a good understanding of the principles of the MCA. A breach of regulation was identified in relation to lack of consent to care.