Quarry Mount

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 changed to requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to good governance.

This service scored 57 (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 have a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not always understand the challenges and the needs of people and their communities.

The provider aimed to provide people living with dementia with a full stimulating life. However, we found activities were not always in line with people’s wishes, and there were some restrictive practices within the home.

People with a learning disability were not always encouraged to be independent and access the community as much as they wished in accordance with best practice guidance.

However, leaders were open and responsive to feedback which demonstrated a positive and open culture. Leaders told us their main goal was making sure people were treated with dignity and respect, and well cared for. They told us their vision was to work towards an ‘outstanding’ service.

Leaders did not always understand the context in which the provider delivered care, treatment and support. However, they embodied the culture and values of their workforce and organisation.

Leaders were not all knowledgeable about best practice guidelines, such as Right Support, Right Care, Right Culture that set out how people with a learning disability needed to be supported. We found shortfalls in relation to person centred care and independence, choice and control indicated some learning and skill development were required. Leaders did not always have oversight of the service, for example in relation to actions from external audits.

However, leaders were kind and compassionate. Staff spoke positively about the support they received from leaders. Comments included, “I feel well supported” and “[Manager] is great.”

People and relatives also spoke positively about the management of the service. Comments included, “I do know that if I had any serious concerns with regard to the care of my [relative] I could approach [managers] and they would be dealt with accordingly” and “The Manageress is understanding, kind and considerate to [people] and ourselves as family.”

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

People told us they felt able to raise any concerns. Comments included, “I would go to [manager] if I had a complaint”. Staff also told us they felt able to raise any concerns. We observed leaders to be approachable and open to feedback.

There was a suggestion box for people to feedback anonymously if they wished.

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 manager told us they promoted workforce equality and diversity. They commented, “We have a diverse range of staff. We treat them all the same and have no preferences. We promote fair recruitment.”

Leaders also told us they celebrated different cultures and enjoy food from different countries.

Staff did not raise any concerns about workforce equality, diversity and inclusion.

The provider did not act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

Quality assurance systems had not identified the concerns found during this inspection, in relation to health and safety, the environment, risk management and person-centred care. Audits took place however these were not always effective as they had not identified these concerns.

Leaders were not aware of the Right Support, Right Care, Right Culture guidance for people with a learning disability, despite supporting a person with these needs. We raised this with leaders who started addressing this during the inspection.

Leaders did not have oversight of all quality and risk concerns in the service. For example, leaders did not have oversight of high-risk actions from their legionella risk assessment, which put people at risk of legionella. Following CQC raising this, these actions were then completed.

Care plan audits had not identified that one person’s care plan contained 3 different recommended food textures, which put the person at risk of choking. Tools used to assess staffing levels and the deployment of staff were not sufficiently effective to ensure people received prompt care that met their needs.

However, leaders were committed to making improvements at the service. Leaders told us they were working from a service improvement plan and we saw a range of recent improvements to quality auditing.

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.

Staff worked well with other partners. The manager told us, “I attend the provider forums, and I used to attend the IPC meetings. We work with the care home liaison team and have a close network. I am also a member of the GCPA [Gloucestershire Care Providers Association]”. Leaders told us they worked well with other care services to collaborate for improvement. Staff worked well with healthcare partners. Relatives told us staff worked in conjunction with them to support the delivery of effective care.

The provider focused on continuous learning, innovation and improvement across the organisation and local system.

Leaders were committed to the development of the service. Leaders told us they had made various improvements at the service such as works on the bungalows, carpet being replaced by hard flooring, bedrooms being refurbished and improved care note documentation. We saw evidence of these improvements. Records had also changed from being paper based to electronic and staff had adjusted to this way of working.

However, ineffective quality monitoring systems meant leaders had not always identified areas for improvement and learning which impacted on the quality-of-care people received.