United Response - 66 & 66a Lemsford Road

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 good. At this assessment the rating has changed to inadequate. This meant the management and leadership was inconsistent. Leaders and the culture they created did not support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to poor governance systems. This meant systems were not robust enough to demonstrate the service was consistently managed well.

This service scored 36 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The management team did not have a clear shared vision and culture which was based on transparency, equality and human rights. There have been significant changes within the management team and senior leadership, including a review of the support services provided to care homes. These changes have presented some challenges, but the provider is clearly on a journey to strengthen its vision and strategy. Staff spoke positively about recent developments and felt more able to approach the current manager. This reflects a growing sense of shared direction and a commitment to building a more cohesive and supportive culture across the service.

We observed staff interactions to be caring, however we found further improvements needed to be made to instil a culture of care in which staff truly promoted people's individuality, protected their rights and enabled them to develop and flourish.

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.

The provider had failed to ensure they had leaders that had the skills to recognise where improvements were required to the culture of the support being provided. At the time of the inspection the Registered Manager was no longer in post, We found that there were failings in the provider oversight of the culture of the service, including ensuring that they met their regulatory requirements.

People’s human rights were not embraced and, in some cases, did not always focus on how to enable people to live their best life and be a part of their community. There has been changes that meant the provider was taking step to improvement the systems. This included new management. A staff member said, “There has been a lot of changed, you get used to one person and then another person comes in. The people that have come have been very welcoming. Hopefully there will be some stable support.”

Relatives gave mixed views on the leadership, most felt that there had been some improvements with the new management. One relative said, “I have spoken online with management, receive a newsletter from United Response and it has been easier to speak with management at the home.” However, another relative said, “We are concerned that United Response as an organisation do have the competency to run Lemsford Road safely and meet the resident’s needs.”

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

Staff felt they were able to speak up about concerns they had, and they were listened to and felt action was taken.

Relatives and people did not always have a forum where they could openly discuss concerns they may have. Relatives felt that this was starting to improve however they were concerned that this improvement may not be maintained. A relative said, “Although we are in dialogue with the homes new management team and they are making the right noises we are still concerned that they are telling us what we want to hear but are slow in delivering.”

At the time of the inspection, the management team had implemented new ways to communicate with relatives with a view to form better relationships.

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 said they felt the leaders and the provider were fair and listened to them.

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. There was evidence that the provider had shown an inability to effectively action in relation to concerns raised by partner agencies and did not take the opportunity to learn lessons in order to improve the service.

The provider lacked oversight of certain aspects of the care and governance systems were not robust enough to capture the significant risks identified during the inspection. Including the culture of the service, and the care records being completed for people using the service. As part of the inspection, we had identified areas of improvement, which had not been found as part of their governance systems. For example, improve staff training and skills, infection prevention control, epilepsy management, restrictive practice and safe management of medicines.

The provider failed to meet best practice guidance set out in Right support, Right care, Right culture. With in the report we have identified examples where people were not respected or had choice and independence over their lives.

Internal audits had identified many of the areas requiring improvement, and there was evidence that actions were being taken to address these. A recent change in management has brought renewed focus on improving the quality of care, and the provider appeared invested in driving positive change across the service

The provider did not always understand their duty to collaborate and work in partnership, so services worked seamlessly for people. They did not always share information and learning with partners or collaborate for improvement.

Relatives felt that communication between the provider and themselves could improve.

The provider understood their duty to collaborate and work in partnership, with the hope that services worked well 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 had previously been a lack of openness within the service, which contributed to a closed culture. For example, incidents relating to financial abuse, infections prevention, medicine management had been appropriately notified to relevant bodies, limiting transparency and oversight However, since changes in management, there has been a clear improvement in information sharing. The management team has taken action to address these concerns, demonstrating a commitment to fostering a more open and accountable culture.