The West Gate

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

We found the management and oversight of the service had deteriorated and there was a breach of regulation. There were systems in place to monitor the service, but these had not always been effective in identifying shortfalls. When shortfalls had been identified, action had not been taken quickly to rectify them. The management had not driven improvement and learnt lessons from incidents. Quality assurance had not been completed in line with the provider’s policy. People, relatives, and staff had not had the opportunity to attend regular meetings to give their opinions of the service. Staff had not received all the training required to complete their roles. They had not received regular supervision to discuss their practice and training needs. Staff told us, they were confident to raise concerns with the management team and they were supported. The management team supported an inclusive and diverse staff team.

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.

Staff told us, there was a positive culture within the service. They described how the management was visible around the service and understood people's needs. Staff told us the management team supported them and made changes when needed.

The provider had processes in place to obtain feedback from people, relatives, and staff, however, these had not been followed. Quality assurance surveys had not been sent to people, staff and relatives for over a year. There had been several given out, but this was done following our on site assessment. There had been some meetings for people, staff and relatives but these were not being held regularly.

Staff we spoke with had mixed views about how they were supported to develop and use their skills to support people. Some staff told us, they had not received guidance about how to support a person using oxygen until they had complained. Other staff expressed disappointment they did not use their mental health skills as much as they would like as they were required to provide more physical support.

There were processes in place to provide training and supervision, however, these processes had not always been effective. New staff had received direct observation to check their skills, but this had not been a continuous process and established staff had not been part of the process. Staff had not always received training to support people and had not always had the opportunity to discuss their training needs and development.

Staff told us they were comfortable and confident to raise concerns. Staff gave examples of how they had spoken up and the action taken by the management team.

There were policies and procedures in place to support staff and people to raise concerns. Staff were protected by the provider's whistle blowing policy to encourage and support them to raise any concerns.

Staff told us they were supported to work in the way which suited them, they described how they had shift patterns around their caring responsibilities.

There were policies and procedures in place to make sure there was equality in the recruitment process. The policies protected staff once they were employed to ensure equality.

Staff told us about the new structure within the service has had a strong positive impact on them. They were clear of the reporting structure and who supervised them to support them in their role. "I love my job; I love the variety. It's a fantastic job to have. I am very passionate. New management team are so supportive and most of all they are approachable." Staff told us they were supported and felt valued. There were clear governance responsibilities from support worker up to the registered managers. However, staff and the management team had not always undertaken their responsibilities.

The management of the service had changed since the last inspection, there were now 2 registered managers in post. There were systems in place to monitor the quality of the service, these had either not been followed or not been effective in identifying shortfalls found at this assessment. The management team had completed audits, issues had been identified but these had not been acted on. For example, an audit of people's dining room experience had identified kitchen staff were not all compliant with wearing correct personal protective equipment this continued at the next audit, some kitchen staff were still not compliant. The provider had completed a 'mock inspection' and had identified concerns and shortfalls such as a fire drill not being completed. There was an action plan in place where the required actions were added, however, not all actions had been completed, for example the fire drill and sending out quality assurance surveys had not been completed after 8 months. The management team had not always acted quickly when risk had been identified to mitigate the risk.

People and relatives told us they had access to other healthcare professionals, and they received support which was relevant. They were satisfied with the way staff worked with partners to provide support following guidance.

Staff explained how they referred people to healthcare professionals when required. They described why it was important to work with partners and request advice to improve people's care and support.

Partners told us they were satisfied with the way staff provided them with information and acted on their advice to support people.

The registered managers kept up to date by receiving information from outside groups including local managers groups.

Staff thought the service had continued to improve, they felt the new management team had improved their working environment. The registered manager told us they had made improvements to staff morale and the support people received.

The registered managers had not consistently promoted a culture of learning and improvement. They had not acted quickly when things went wrong and when shortfalls had been identified during audits. Incidents had continued to happen and action had not been taken to improve the quality of the service.