Barton Brook Care Home

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 good. At this assessment the rating has changed to requires improvement. This meant the management and leadership, had been inconsistent which did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to good governance at the service.

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 not established have a shared vision, strategy and culture.

Whilst we acknowledge the new leadership was beginning to make improvements around the culture across the home, further time was required to ensure these were fully embedded and improvements sustained. Critical to the home’s success, is a stable leadership team, that leads by example, and shapes a culture that is inclusive, where everyone is equally valued.

Not all leaders understood the context in which the provider delivered care, treatment and support. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively.

Leadership within a service that faced challenges such as those experienced at Barton Brook Care Home, should not simply be the responsibility of the care home manager or the providers regional management team. Unit managers, nurses and senior carers had critical roles to play, but the provider needed to ensure sufficient time and resources were dedicated to these roles. Furthermore, ‘leadership’ should be everyone’s business and staff of all grades need to better understand their roles and responsibilities and the impact of their actions, or lack of.

Staff had not always felt they could speak up and that their voice would be heard.

Most staff consistently expressed a view that they did not feel valued or positively engaged in the ongoing changes at Barton Brook. Some staff did not clearly understand the rationale for certain decisions and felt decision making was often poorly explained. Other staff recognised the need for change but felt it was too ‘top down’ and not collaborative enough in nature.

We raised these concerns with the provider, there was an acknowledgement more work was required to build meaningful trusting relations with staff where people felt able to speak up.

The provider valued diversity in their workforce. Barton Brook benefited from a workforce that was representative of the communities it sought to serve. Despite the wider workforce challenges, staff from diverse backgrounds told us they mostly felt supported.

The provider 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.

The home did not have a registered manager at the time of this assessment. Registered managers, like registered providers, are legally responsible for quality and safety. An interim home manager was post, supported by the providers regional leadership team.

The areas for improvement identified throughout this report demonstrated the providers systems and processes for audit, quality assurance and questioning of practice had not been operating effectively. Improvements made in response to previous CQC inspections and regulatory action, had not been sustained. This was a breach of legal requirements for good governance.

Without question the provider was tackling many issues and had identified multiple priority actions. There was a service improvement plan already in place and the provider was working with commissioners and other stakeholders around this. However, having a stable leadership team, with a manager who is registered with CQC, and with the right people, doing the right job at the right time, is going to be critical to success going forward.

The provider did not always understand their duty to collaborate and work in partnership, so services worked seamlessly for people.

Better integration of the ‘health and social care offer’ at Barton Brook would in future enable better collaboration with key stakeholders such as local NHS services and commissioners of adult social care. However, the provider needed to first ensure the basic fundamental standards of quality and safety were consistently being achieved and sustained.

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.

The provider needed to extend the reach of Barton Brook beyond the setting of the care home. Opportunities for sharing good practice and learning from others should be embraced to help drive continuous improvement.