Haighfield 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 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.

The provider was in breach of regulation 17 regarding good governance.

This service scored 61 (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 a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The home manager told us about the core values of the home which included Dignity, respect, choice, independence, fulfilment, compassion, kindness, a warm and supportive environment and open communication. These values formed part of the staff interview process and monitored during staff supervisions to ensure they were being upheld.

Staff turnover and sickness was at a minimum and the home manager said this was one of the methods they used to monitor staff wellbeing, maintain a positive culture and ensure staff were happy were in their roles. One member of staff said, “Everything is going very well and it is a nice place to work. Everyone is very supportive and there is good management.” Another member of staff said, “The whole staff team make it a very good place to work.”

The provider did not have consistent leaders who understood the context in which the service 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 home manager (and now CQC registered) had an RGN background which ensured leaders had a comprehensive understanding of people’s complex needs, having previously worked as a deputy (manager) which presented the opportunity gain valuable managerial experience. There were several provider representatives who worked in quality roles who provided additional oversight within the service. However, we had identified two continuing breaches of regulation since our last inspection meaning governance arrangements needed to be improved.

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

The home manager told us they looked to embed a ‘Blame free culture’ within the home and always tried to establish ‘Why’ something happened rather than blaming people.

There were several channels available to staff, relatives and people living at the home to voice any concerns they had. This included staff supervisions, team meetings, resident/relative meetings and surveys. ‘Well-being’ Wednesdays had also been initiated and provided staff with the opportunity to speak with management either about work, or any personal matters they may have encountered. An anonymous feedback box was available in case people wanted to raise any concerns confidentially.

Staff said the manager was supportive and approachable and felt confident they could speak about any problems impacting their work. There was a whistleblowing procedure in place which explained how staff could report any bad practice if needed.

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 staff team was diverse with many staff from overseas. The provider’s recruitment procedure helped ensure equality of opportunity for applicants. Staff benefited from a working culture in which equality, diversity and inclusion was promoted. Staff told us they worked as a team which felt like a family. Overseas staff described the support and guidance for them when they first began working at the home.

Staff said they were treated fairly and felt included and valued by the management team. Staff reported good morale and team working. They told us the management team were supportive and understanding of their needs and situations.One staff member said, “It is a good place to work. All the management team make it a good place to work and are very supportive.”

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.

At our last inspection in August 2022, we rated the home Requires Improvement overall and in both the Safe and Well-led key questions. This was because we had identified breaches of regulations 12 and 17 regarding safe care and treatment, aswell as good governance. After this inspection, the provider sent us an action plan telling us how they intended to meet these regulations, although we found continued breaches of regulations 12 and 17 at this inspection.

We found gaps in record keeping. This included the PCS systems used by staff to document when people’s care had been delivered, missing information in people’s care plans and capacity assessments to capture people’s decision making abilities. Prompt action to address concerns from the latest fire inspection had not been taken, although this work was ongoing at the time of our inspection. Fire doors were seen held open by inappropriate means and there wasn’t effective oversight of people’s pressure relieving mattresses to ensure they were at the correct setting. This meant there had been a continued failure to monitor and improve the quality of service provided to people.

At the time of our inspection, a registered manager was not in post and there had been inconsistent management arrangements since our last inspection. However, the acting home manager had their CQC inspection shortly after our visit and was successful in becoming registered for the role.

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 home worked in partnership with a number of organisations in the Wigan area. This included GP’s, tissue viability nurses, diabetic nurses and Wigan/Leigh hospice. Referrals were also made to other services such as speech and language therapy or the falls service where there were any concerns about peoples care.

Other connections within the community included schools and colleges, where a music student had attended the home to perform to people, providing mental stimulation. Any visiting professionals were asked to provide feedback about their experience of being at the home which could then be used to drive improvements. The home also had a designate quality performance officer (QPO) who monitored the home regularly to ensure commissioning outcomes were being met.

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. They did not always actively contribute to safe, effective practice and research.

The service has remained Requires Improvement with repeated breaches of regulations 12 and 17 from our last inspection in August 2022. This meant the sufficient improvements were not being made, aswell as learning to ensure compliance with the regulations.

The home manager told us about the systems in place to allow the service to continually improve. All ‘Near misses’ were investigated to determine the cause and any actions required. An ongoing action plan was in place detailed who was overseeing it and timescales for completion. Compliance of this document was monitored and discussed in key performance indicator meetings.

Staff said they could contribute towards making improvements to the service. Staff said they were encouraged to put forward improvement ideas and trusted the management team to listen and act. Staff told us that if things went wrong, the issues were discussed during team meetings and supervisions and handovers.