Anchor House - Doncaster

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 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 requires improvement. At this assessment the rating has changed to inadequate. This meant there were widespread and significant shortfalls in leadership. Leaders and the culture they created did not assure the delivery of high-quality care.

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

This service scored 32 (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 shared vision, strategy and culture based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not understand the challenges and the needs of people and their communities. We did not see evidence of a shared culture in the service which supported the provision of good quality care and support to people. Members of staff ignored instructions from the management team about the wearing of uniform, hanging washing on lines outside and spending time in the care environment with people. Members of staff did not appear to work with the new management team.

The provider did not have inclusive leaders at all levels who understood the context in which they delivered care, treatment and support, or who embodied an appropriate organisational culture and values. Leaders did not have the skills, knowledge, experience and credibility to lead effectively, and they did not do so with integrity, openness and honesty. The provider did not support the new management team and members of staff effectively. The provider had tasked the new management team with increasing the number of people placed into the care home but without sufficient resources or support to enable this to happen safely. The new management team did not have access to previous governance records and reports and had made a start on creating new reporting and recording processes from scratch. The provider had engaged with an external consultancy to support improvement, but this contractual relationship was terminated by the external consultancy due to a breakdown in the professional working relationship.

People did not always feel they could speak up and their voice would be heard. There was a staff handbook in place with information about how to speak up. Feedback from members of staff indicated they would be happy to speak up if they saw poor care and they could speak to a member of the new management team. However, no concerns about the quality of care were shared by members of staff either anonymously with CQC or directly with the new management team. We were not assured members of staff were able to speak up about the quality of care provided at Anchor House – Doncaster.

The provider did not always value diversity in their workforce. They did not always work towards an inclusive and fair culture by improving equality and equity for people who worked for them. Although there was a diverse workforce in place, robust systems were not in place to support safe, person-centred and well-led care and support. Members of staff were employed on a range of different arrangements which did not always provide confidence of employment in the long-term. We were not assured members of staff were supported effectively to deliver good quality care and support to people.

The provider did not have clear responsibilities, roles, systems of accountability and good governance. They did not act on the best information about risk, performance and outcomes, or share this securely with others when appropriate. The provider had limited oversight of quality and improvement throughout the service. Concerns and failings identified by inspectors had not been identified by the provider or the management team. A recent daily walkaround carried out by the management team did not identify any concerns. A visit by the Local Authority contracts team and the infection prevention and control clinical team took place 4 days before CQC inspected the service. No changes or improvements had been made and there was not an action plan in place to address the concerns. The failings around safety, person-centred care and leadership identified at this inspection were the result of poor leadership and governance at the service. Improvements identified at the previous inspection had not been sustained or embedded and the service had regressed to inadequate provision of care and support. Leaders did not work well together and clear roles and responsibilities were not established. For example, the registered manager and the deputy manager did not have clear lines of accountability and did not work together with the provider as an effective management team.

The provider did not understand their duty to collaborate and work in partnership, so services work seamlessly for people. They did not share information and learning with partners or collaborate for improvement. The provider, management team and members of staff did not consistently engage with people, communities and partners to share identify and learning therefore continuous service improvement had not taken place. This meant networks to identify new or innovative ideas were not identified which led to poor outcomes for people.

The provider did not focus on continuous learning, innovation and improvement across the organisation and local system. They did not encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not actively contribute to safe, effective practice and research. There was llimited evidence of embedding and sustaining learning and improvement identified at the previous inspection of the service. The regulatory compliance history for Anchor House - Doncaster was poor and showed the provider had not learned lessons and made improvements to the service. There was limited focus on improvement and a lack of innovation which led to people receiving poor quality care where their outcomes and equity of experience were not met.