Squeaks House Residential 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 was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality person-centred care.

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

This service scored 39 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Provider systems and processes designed to monitor the quality of the care provided was not always effective. The provider and manager did not always understand the challenges and the needs of the people being supported.

The provider and manager did not recognise deficits in their governance and monitoring systems. We found the learning and improvement culture was not as robust and embedded within the service to make sure all risks were managed and minimised. Staff were unable to clearly demonstrate an understanding of the provider’s ethos and values or confirm where this information was located.

The provider and manager did not have the skills, knowledge and experience to lead effectively.

Whilst there was an established manager at the service to support and guide staff, the provider’s and manager’s governance arrangements had failed to identify the issues we found during our assessment or to address actions highlighted by the Local Authority in a timely manner. This lack of oversight placed people at risk of receiving unsuitable or unsafe care.

The manager told us they felt supported by the provider and although they had not received formal supervision since commencing in post, they could contact the provider by telephone at any time.Staffs’ comments about the manager were positive and included, “The manager is approachable”, “I feel supported by the manager and provider. I can always approach them” and “The management team are supportive. I have gone to them with a couple of issues, and they were dealt with.”

The provider fostered a culture where people felt they could speak up and their voice would be heard.

Arrangements were in place for gathering peoples’, relatives’ and staffs’ views relating to the quality of the service provided at Squeaks House Residential Care Home.

There were systems in place to enable staff and others to speak up when something was wrong. Staff understood this and told us they felt confident doing so. Staff we spoke with knew they could raise concerns with the provider, manager and other external agencies. Staffs’ comments included, “The management team are supportive. I have gone to them with a couple of issues, and they were dealt with” and “I feel supported by the management team and the provider. You can always approach them.”

The provider and manager had not worked towards an inclusive and fair culture for people who worked for them.

There was a diverse workforce at the service, with staff employed from a wide range of backgrounds, cultures, and experiences.The provider and manager were unable to provide examples of how they developed and supported a compassionate, collaborative, and inclusive culture at Squeaks House Residential Care Home for all staff employed at the service. However, staff spoken with confirmed there were opportunities to discuss their development through formal supervision and appraisal. Staff felt there was good teamwork at the service.

The provider did not always have clear responsibilities, roles and systems of accountability or good governance arrangements.

The quality assurance and governance arrangements in place were not effective in identifying shortfalls found at the service as part of this assessment. As stated within this assessment report, this referred to non-compliance with the Mental Capacity Act. Risks to people’s safety were not routinely identified and recorded. Care plans were not routinely accurate or recorded all of a person’s care and support needs. Not all care provided by staff for people using the service was person-centred. Staff’s training was not embedded in their day-to-day practice and improvements were required relating to the provider’s recruitment practices, supervision and induction arrangements. Whilst the manager implied, they were aware of the above, they had not taken enough action to address this and to mitigate the potential risks of people receiving inappropriate care.

A Service Improvement Plan had not been devised and implemented. The purpose of a Service Improvement Plan is to proactively identify and monitor performance, address weaknesses in service delivery and recognise areas for improvement. The manager confirmed at the time of our assessment on 12 and 13 March 2025, there was no documented Service Improvement Plan for the service.

Senior staff were not available to provide support and guidance to staff to enable them to effectively carry out their roles and responsibilities. Staff did not recognise their responsibility and accountability to identify and question poor practice with colleagues when this was evident. For example, whilst people were supported with their moving and handling needs or during people’s dining experience.

Services that provide health and social care to people are required to inform the Care Quality Commission, (CQC), of important events that happen in the service. This enables us to check that appropriate action had been taken. The provider and manager had recognised and submitted most statutory notifications to the Care Quality Commission as required.

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

Information demonstrated the service worked with others, for example, the Local Authority, healthcare professionals and services, such as the local Dementia Intensive Support Team to support care provision. However, as previously stated some of the actions highlighted by the Local Authority following their PAMMS visit to the service remained outstanding.

The provider did not always focus on continuous learning and improvement across the organisation and local system. They did not always actively contribute to safe and effective practice.

The provider’s audits had not been effective at identifying where improvements were required. Concerns we identified during our assessment had not been picked up by the provider’s internal audits or through their own visits to Squeaks House Residential Care Home. For example, medication audits viewed had not picked up what we found during this assessment.