St Bridget's - Care Home Physical Disabilities

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 inspection we rated this key question outstanding. 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. We identified a breach of the legal regulations.

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.

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.

There were opportunities for people to be involved in their local community if they wished. One person had visited a local school and had conversations with the children about diversity and helped them to understand and respect people’s differences. The home worked in line with the provider’s mission statement; one of the aims of which stated, ‘Disabled people feel respected, valued and safe, choose where and how they live and participate freely in social and leisure activities.’

The provider had inclusive leaders at all levels who understood the context in which they delivered care and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Staff spoke highly of the management team and felt they were listened to. We saw the registered manager and deputy manager spent time with people and listened to any concerns. There was a stable workforce with many staff having long service records.

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

Whilst the management team at the home encouraged staff to voice any concerns, some staff felt distanced from the provider. A staff member explained, “We have talked about staffing levels. [Registered manager] would listen, but his hands might be tied because of Leonard Cheshire. Control comes from head office. We are encouraged to speak up but not by head office. You say what they want to hear.”

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.

Staff told us they felt valued, supported and respected by the home’s management team. There was a diverse staff team from different cultural backgrounds. The registered manager said this enabled the home to promote cultural days within the activities offered 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.

Systems were not sufficiently robust to provide effective oversight of the service to drive improvement. Issues found at this inspection had not been identified through the provider’s auditing processes or, if they had, actions had not been taken. For example, risk assessments in relation to people’s risk of choking, or the management and monitoring of seizures, were unsafe. Any patterns or trends in the occurrence of seizures which people experienced were not monitored. Feedback we received from a healthcare professional had identified inconsistencies and errors in several care plans at the time they visited.

A quality audit undertaken by the provider’s compliance team had identified there were no condiments, placemats, serviettes or cutlery on dining room tables. The audit stated action was due by 28 March 2025, but no action on this issue had been taken at the time of this assessment.

Audits relating to the environment, utilities, fire safety, and business continuity had been completed appropriately.

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 received feedback from a healthcare professional. At one of their visits last year, the cleanliness of the home had been discussed and eventually an increase in housekeeping hours was secured. In addition, new flooring had been laid through some parts of the home and some redecoration.

The service worked in partnership with a range of healthcare professionals and with wheelchair services. They had also developed good relationships with neighbours near to the home and assisted with a street party.

A relative told us that in the past there had been opportunities for families to meet up and share their views. They said, “Management work hard, but they could raise standards. There used to be a forum for families but not now; we do receive surveys though.”

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not always actively contribute to safe, effective practice and research.

Issues we found as part of this assessment had not been identified by the provider. These included the management of people’s risks and promoting people’s choices and independence. The home did not align with current best practice guidance in relation to Right support, right care, right culture, to enable people to enjoy a full life.