Hope Green Residential Home Also known as 1-1244000026

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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 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 remained 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 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 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 always understand the challenges and the needs of people and their communities. There had been no manager in post for over 3 months which impacted on the consistency of agreed aims and ambitions for the service. The new manager told us they were working with staff to re-build relationships of trust, to develop a shared vision for the service. A staff member said, “It’s great having the new manager, people work harder. A lot of things are being actioned much quicker.”

The provider had leaders who understood the context in which the provider delivered care, treatment and support and leaders had the skills, knowledge, experience and credibility to lead effectively. However, although the provider had completed an internal audit, they had not always identified issues we found during this assessment. There had been changes and inconsistent management at the service for approximately 4 months prior to this assessment. A new manager and new deputy manager had been recently appointed and were supported by a regional management team. Where we identified areas for improvement the management team were receptive to our findings and had created an action plan to address these issues.

Although the provider promoted a positive culture and encouraged openness, some staff felt hesitant to speak up due to recent changes under the new manager. They expressed concerns about increased pressure to achieve a good CQC rating and uncertainty around new ways of working. One staff member said, “You’re pulled left, right, and centre, and [staff] are afraid of making mistakes or losing our job.” This meant not everyone felt confident their voice would be heard. However, the new manager and deputy were aware of these challenges and understood the need to rebuild morale within the team. The manager acknowledged that some staff may feel unsettled by the changes but was committed to giving them time to adapt to the new systems. Other staff told us they were confident about speaking up. The provider’s whistle-blowing policy was clear for staff to follow if they had concerns.

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. The provider valued diversity in their workforce. Staff told us they felt valued. There was an open and inclusive recruitment procedure, and the staff team consisted of people from various backgrounds and cultures. There was an open and inclusive recruitment procedure.

The provider had systems and processes in place to assess, monitor and mitigate the risks relating to the health, safety and welfare of service users but did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate. At our last assessment, we found the service’s quality assurance processes had failed to identify concerns. At this assessment we found continued concerns with the provider’s governance processes. We identified failings with the quality of monitoring of people’s care and support needs, particularly recording when they had received support with eating and drinking varied. This information was not always recorded in real time, and not all staff completed actual checks of people. However, the provider had completed an internal audit, drafted an action plan and was working closely with the new manager to address issues raised.

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. The manager told us they have acquired a new GP who worked well with them and visited each week to discuss any health concerns people may have and to offer support where needed. Consequently, people benefited from the partnerships the provider was building with the GP and local health services such as mental health teams and district nurses.

The provider did not consistently prioritise continuous learning, innovation, or improvement across the service. Although some progress had been made since the last assessment, not all previously identified issues had been addressed. The service had been rated 'requires improvement' for the 'Well-Led' key question in the last 3 assessments. At this assessment, we found the provider had not made or maintained the necessary improvements. Several concerns raised in previous assessments remained unresolved. Although breaches of regulation were rectified in the last assessment, we have found new breaches in this assessment. This demonstrated a poor culture of learning and insufficient action to achieve and maintain long-term improvements.