Archived: OSJCT Buckland Court

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• 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

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.

This service scored 54 (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 clear shared vision and strategy which was based on transparency, equity, equality and human rights, diversity and inclusion. However, this was not being fully implemented by some leaders. People shared they were not involved in decisions about the service and what they would like to do. People were not encouraged by leaders to make choices about how they wanted to live their lives.

Not all leaders understood the context in which the provider delivered care, treatment and support. They did not always embody the culture and values of their workforce and organisation. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively, or they did not always do so with integrity, openness and honesty. Staff shared leaders had not always been approachable in relation to workplace concerns. However, we received feedback to demonstrate this had changed between our 2 onsite visits ,as staff told us they now felt more able to approach their leaders.

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

Several members of staff told us they were not encouraged to make suggestions to the registered manager, and that if they did, they were ignored. However, during our second onsite visit, when a change in leadership at the service had occurred, they said since the interim manager had been in post, they were confident they would be listened to and appropriate action would be taken.

The provider had systems to support people to speak up including a speaking up policy. Staff were encouraged to share their views by the interim manager.

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. There was a diverse workforce within the service on both days of the inspection. Staff felt supported by leaders if they needed to discuss or amend their working hours or roles and responsibilities.

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 systems in relation to governance and oversight, but these failed to identify or act upon issues. For example, the registered manager completed daily checks of the service and included a review of cleanliness. However, the service was noted to be visibly dirty on our first onsite visit. Whilst there had been some improvements made by the time of our second onsite visit, there were still areas that were unclean despite managers checking the quality of cleaning. When shortfalls had been identified, the registered manager had not always acted to address them, for example, an external fire risk assessment had been completed in October 2023 but it had taken a year to implement all the recommendations. Due to the change in the leadership at the service during our inspection the acting manager could demonstrate they had immediately implemented an improvement plan aimed at addressing the issues found.

Daily care notes were reviewed by the management team; however, it was identified in 1 person’s notes that they struggled to go to bed and regularly did not sleep for more than a couple of hours a night. Staff had recorded actions to support the person to try to sleep but these had not helped. However, the registered manager had not liaised with the local GP in relation to this person to see if they could get more support to enable them to get a better sleep pattern. The interim manager confirmed they would speak to the doctor in relation to this issue on their visit the following day.

Other audits such as legionella, infection protection and mattress audits were being completed safely with actions being identified and recorded a completed.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They usually shared information and learning with partners and collaborated for improvement.

Leaders told us they worked well with other professionals in health and social care. One professional told us they were in regular contact with leaders. They said they communicated well and shared important information.

There was a visit from a petting service on the first day of the inspection, however opportunities to integrate outside the service were limited. People were not supported to engage with their local community in the community.

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.

When the service had completed their yearly feedback to the CQC about their service development, they had recorded “none”. This was evidenced in the lack of engagement and creative support provided to people particularly relating to community engagement, however there were regular visits to the service by various groups.

Staff had received appropriate and comprehensive training in relation to supporting people in an inclusive way that enabled choices; however, the registered manager had not focussed on improvement and innovation within the service.