Care Home for Special Needs

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 as requires improvement. At this assessment, the rating remains the same.

This meant the service management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care. For example, staff did not complete full application forms and information regarding conduct in previous roles was not available. A lack of audits and quality checks meant issues identified at this assessment had not been identified by the provider.

The registered manager did not maintain effective oversight of Deprivation of Liberty Safeguards (DoLS) by monitoring applications to the authorising body. Environmental safety risks were not always assessed, mitigated or monitored.

Staff were not recruited according to the provider’s own policies., Accurate and complete records of the care and treatment provided to service users were not always in place.

At our last inspection of this service, we identified similar shortfalls in good governance. The service was in continued breach of the legal regulation in relation to the governance of the service.

This has resulted in a repeated breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

This service scored 62 (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 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 registered manager was open to make changes where gaps had been identified during our assessment. There was a willingness to improve. The provider did welcome and support an open culture which was supported by staff feedback to us. Staff were confident to identify poor practice and told us concerns when raised would be acted on. People told us staff were kind and compassionate. Staff and management fed back passionately about the care being delivered to people and spoke fondly of the people they were supporting. Staff were able to share positive examples of where they had gone above their role to do things for people. This included supporting people to attend places they wished. We saw an example of how a person loved going to coffee shops. The registered manager would ensure that they visited a coffee shop regularly, sometimes on a daily basis.

The service had an inclusive leader who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. People told us that the registered manager arranged regular holistic therapy including massage. They told us that the therapy was very inclusive and positive.

There was a stable management and staff team. People, their families and staff knew who the management were, and how to contact them. People and relatives told us the registered manager was caring and approachable. One person said, “Definitely recommend the home.” Staff knew their roles, responsibilities and how to support each other. They told us they felt valued by the management team.

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

Staff told us they felt confident to speak up if they had any concerns. One staff member told us, “If I had any concerns, I would raise them. I believe the concerns would be acted upon.”

There was a whistle blowing policy in place. Staff were informed about this as part of their induction.

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. Policies and procedures to promote diversity and equality were in place.

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.

A lack of quality checks or audits meant the provider did not identify the issues we found during our assessment.

Environmental risks had not always been assessed or mitigated and there was a lack of oversight of records relating to the care people received and staff employed. Candles had been used without risk assessments to mitigate potential fire risks.Daily care records to document the care and treatment people received were not completed by staff.

Systems to recruit safely had failed and did not follow the provider’s policy. This posed a risk that staff employed may not be suitable or lack the skills and competence needed for their roles.

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.

We saw evidence of collaboration with a ‘holistic massage therapist’, to help a person who was living with dementia. Feedback from the person’s family was that these sessions greatly helped in achieving a better mood.

The provider encouraged creative ways of delivering equality of experience, outcome and quality of life for people. However, the registered manager had not completed any analysis for changes and improvement. There was no service improvement plan or discussions in staff meetings regarding improvement. The registered manager told us that this was due to the fact that there were only 2 people at the home, and that they had the opportunity to discuss matters day to day.