Bilton House

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.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 64 (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.

People were complimentary about the culture at Bilton House One person told us, “The atmosphere here is good.” Staff echoed those thoughts. One staff member told us, “Everyone who works here is friendly.”

Leaders and trustees set the tone for the service’s culture. This commitment was reflected in comments from senior figures. A trustee told us, “We should care for the elderly to the utmost.” They went on to explain the importance of investing in the maintenance of the home for the comfort of the residents. This was confirmed by a member of staff who told us they had no trouble obtaining resources when needed.

Management involved people and staff by collecting feedback in meetings. When ideas or suggestions were shared, action was taken.

The provider had compassionate leaders; however, they did not always have the skills, knowledge and experience required to ensure robust systems and processes were in place to provide effective oversight of the service.

The provider and registered manager needed to strengthen their understanding of their regulatory responsibilities, including requirements of submitting DoLS applications and assessing people’s decision‑making capacity. These gaps had already been recognised, and additional training had been arranged. Improvements were also required in how quality monitoring systems were used to provide effective oversight.

Staff told us they would like more engagement from the trustees. Although trustees visited the home regularly, staff were unsure about their role and said they had little to no interaction with them.

Staff did not always feel they could speak up and that their voice would be heard.

Staff felt able to raise issues or concerns with the management team, however, some staff members shared they did not always feel listened to and their concerns were dismissed. There was also a lack of opportunities to discuss concerns, some staff members explained they did not have regular supervisions.

Information about policies to support a culture of speaking up such as whistleblowing and complaints were available within the home. However, one staff member told us they were not aware of their options if they needed to escalate concerns above management.

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 registered manager made efforts to ensure they promoted equality, diversity, and inclusion across the workforce,for example, by ensuring that Christmas celebrations reflected and respected the diverse cultural backgrounds of the staff team.

Staff had received equality and diversity training, and the provider’s policies and procedures promoted equality and diversity.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

Quality monitoring systems were in place, and a range of audits were carried out by the registered manager and senior carers. However, many were not robust enough to accurately monitor the quality of the service. For example, audits did not always fully detail what had been checked and contained limited information on actions that had been taken. This issue had already been identified by the provider prior to our inspection and work was being undertaken to make improvements in this area.

The management structure was unclear. The registered manager was supported by three assistant managers. However, their individual roles and responsibilities were not well defined, which meant they were not always utilised effectively to provide consistent support to the registered manager.

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.

People were supported to maintain important links with families, friends and local communities. For example, one person told us how they attended the local church. External entertainers were welcomed into the home to support activities, such as singers.

Staff worked in partnership with healthcare professionals to support people’s health and wellbeing. A district nurse told us, “They [staff] are on it if they spot any concerns and will contact us. They are always good at taking our advice.”

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.

The provider had been working to strengthen the quality of care and was progressing through an action plan agreed with the local authority. Plans for improvement were also a key topic of discussion in management meetings.

The manager and trustees were open to our feedback and took immediate action to address the issues we identified during our visit.