Wall Hill Care Home Limited

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 inadequate. 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 provider was previously in breach of the legal regulation relating to overall governance, but not enough improvements were not found at this assessment, and the provider remained in breach of this regulation

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 established a shared vision and strategy, with a person-centred approach at its core. Improvements had been made across several areas of care, reflecting the provider’s commitment to improving the care provided. However, further progress was needed to embed a culture of accountability, particularly regarding how care records were updated and how guidance from visiting professionals was implemented consistently across the staff team.

The manager recognised these areas for development and introduced measures to address them. They shared a new auditing systems aimed at improving oversight and consistency.

Staff described a more positive working environment. One team member said, “The culture is so much better. There is a real emphasis on people's wellbeing and happiness, everyone just wants people to be happy.”

During our visit, we observed a noticeable shift in the service’s culture compared to the previous inspection. The atmosphere was calm and welcoming, with staff taking time to support people in a relaxed and engaging manner.

The provider had a statement of purpose which included a commitment to protecting people’s privacy, promoting choice, and delivering care that was tailored to each person.

Leaders showed a strong commitment to improving care and listening to feedback. The manager responded to concerns raised during the previous inspection and made several improvements across the service. However, internal monitoring still needed further development to help leaders keep full oversight of care delivery and record-keeping.

The manager took on board our feedback and acted appropriately. Care documentation was updated, and new systems were introduced to improve oversight. We plan to review how well these systems are working during our next inspection.

Relatives and friends told us they had faith in the managers ability to bring about change. One friend said, “The management has changed, and we are pleased to see that there has now been a vast improvement in the quality-of-care people are receiving. It is plain to see the new care home manager has made significant changes in how the home is run.”

Staff said they felt supported and described leadership as visible and approachable. One staff member told us, “[Name of manager] is a brilliant manager. They follow up on everything you tell them. All the staff look up to [manager], they are a great leader.”

The manager showed an understanding of the duty of candour and offered apologies to people and their relatives when things went wrong.

The provider promoted a positive culture where staff felt confident their voice would be heard. Staff told us they felt able to raise concerns and trusted these would be taken seriously. One staff member described raising concerns about staff practice early in their employment, saying, “The manager listened and acted quickly, they put in further staff development opportunities, and it was resolved.”

A whistleblowing policy was in place and accessible to the team, supporting an open and transparent environment.

The provider valued diversity within the workforce and worked towards creating an inclusive and fair culture. Efforts were made to improve equality and equity for staff, supporting a respectful and supportive working environment. For example, where staff disclosed health conditions that could affect their role, the provider carried out risk assessments to identify how best to support them in their work.

Staff told us they felt included and described a workplace where diversity was recognised and celebrated. The team reflected a range of backgrounds, and it was positive to see culturally significant events being acknowledged and celebrated within the home, such as a party to celebrate Diwali, which is the Hindu festival of lights, with variations celebrated in other religions such as Jainism and Sikhism.

The provider did not always have clearly defined responsibilities, roles or systems of accountability. Governance arrangements were in place but did not consistently support effective oversight. Risks were not always identified using the best available information, and relevant details were not always shared securely with others when needed.

Systems to monitor the quality and safety of care had been introduced, and improvements had been made since the last inspection. Governance supported oversight of key areas such as person-centred care, communication and access to health services. However, care plans did not consistently reflect people’s current needs, and there were inconsistencies in decisions around end-of-life care. This showed governance systems were not always effective in identifying and updating inaccurate or incomplete information. Oversight of catheter care and weight monitoring also needed strengthening to ensure gaps were addressed.

In response to feedback, the manager introduced new auditing processes to improve care plan accuracy and ensure vital information was recorded consistently. Staff told us systems had improved and described a more confident and positive working environment. One staff member said, “There has been a massive turnaround. Staff are much happier in their roles and have much more confidence.”

The manager understood their regulatory responsibilities and submitted required notifications appropriately.

The provider worked with external partners to share information and learning and collaborated to improve care. However, advice from a visiting professional regarding methods to address weight loss was not consistently followed or monitored, which impacted the effectiveness of partnership working.

Visiting professionals shared examples of significant improvements and described the provider as receptive to feedback. One professional said, “The provider appears to engage and listen to the advice given at the time.” Another commented, “We have seen improvements, they come to us for advice and share concerns with us.” However, professionals also told us how they sometimes needed to follow up on advice and felt communication between staff and management could be strengthened.

Staff told us they welcomed input from visiting professionals and valued the support offered.

The provider focused on continuous learning and improvement across the organisation and within the local system. At the previous inspection, serious concerns were identified, and enforcement action was taken. During this inspection, significant progress had been made. People received support from a kind and caring staff team, and the environment had undergone renovation. Improvements were also seen in the range of activities offered, incident management, and moving and handling practices.

However, despite these positive changes, some concerns remained. For example, care plans continued to contain inconsistent information, and monitoring of oral health required further oversight. In response to our feedback, the provider introduced new systems to strengthen care monitoring and improve the accuracy of records.

New initiatives had also been launched, including a nationally recognised dementia audit and an oral care improvement programme. These developments reflected a renewed commitment to innovation and learning. We will review the impact of these initiatives at the next inspection.

Relatives told us they knew who the manager was and felt informed and reassured by the improvements made. One relative said, “From our conversations with [managers name] we know they have many more ideas and plans to make further improvements. Also, in those conversations with [manager’s name] we have come to recognise that their whole ethos is the wellbeing of people, and this is top priority in their management of the home.” Staff spoke positively about the changing culture and the provider’s ethos to deliver high-quality care and support.