Calton House 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 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 regulations in relation to 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 did not have a clear shared vision, strategy and culture which was 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.

The provider had failed to model and monitor a positive and empowering culture where people were encouraged to develop skills and live their lives like any other citizen. Although Calton House Limited was a supported living setting the culture was more reflective of a care home. The provider also owned and worked with one of 3 housing providers. Staff told us it was difficult to raise concerns about the accommodation due to the blurred division between the two agencies. The provider used parts of the accommodation to store their personal belongings; this did not support people to develop a strong sense of ownership of their homes. The way accommodation was organised did not reflect the principles of Reach Standards or The Real Tenancy Test.

Not all leaders understood the context in which the provider 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.

Morale among some staff was low and they told us they lacked confidence in leaders. The registered manager acknowledged recent changes to management had been destabilising for some staff. They were planning a weekly open day when staff would have an opportunity to meet with them and raise any issues. However, staff told us they were not confident they would be listened to or their views respected.

There was a senior care manager who had been in the role for approximately 3 months. Care managers told us they were well supported by the senior care manager.

Following the inspection visit the registered manager told us they recognised there was a cultural problem within the service and had commissioned an organisation to undertake a review to identify areas for improvement.

People did not always feel they could speak up and that their voice would be heard.

The separation between care provider and housing provider was not always clear. The provider was more involved in the housing side of the business, but staff told us they sometimes attended meetings about people’s care. At these times it was not always clear which organisation the provider represented. Staff told us this could make it difficult to raise issues about accommodation.

One person told us; “Sometimes I feel I can’t complain. I feel a bit of a burden.” Another said, “Not sure who is in charge, if I had a complaint I would go to staff.”

The provider did not always value diversity in their workforce. They did not always work towards an inclusive and fair culture by improving equality and equity for people who worked for them.

Staff had not been asked to complete a health questionnaire when they were offered a contract so the provider may not have been aware of any hidden disabilities which needed to be taken into consideration.

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.

Audits were completed but these had failed to identify the issues reported here. The culture of the service was not monitored or prioritised. The service was not consistently operated in line with Right Support Right Care Right Culture or the principles of the supported living model.

Calton House Limited did not consistently advocate for people in relation to housing matters. Tenancy agreements stated people had a licence agreement only and were not entitled to 4 weeks’ notice if the registered landlord wished to terminate the contract. Although this was not legally enforceable the provider had not highlighted this for people.

We found improvements were needed to ensure individual risks for people were identified and action taken to mitigate risks. There were concerns relating to people being treated with dignity and respect and how people were supported in line with the Mental Capacity Act 2005.

We identified an incident which should have been notified to CQC but had not. We raised this with the registered manager who told us they would ensure all incidents were notified as required going forward.

Some staff were employed who were in a close personal relationship. There was no policy to cover this scenario. The registered manager told us they would ensure one was developed. Other policies were out of date including those covering Equality and Diversity, Recruitment, Safeguarding and Induction. The registered manager told us they were in the process of updating all policies.

Following the inspection visit the registered manager told us they were making changes to the management structure to improve oversight of the service.

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.

Although we approached some professionals for feedback, we did not receive any. Records showed staff escalated medical concerns when needed.

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.

People’s quality of life and outcomes were not monitored. The provider did not demonstrate high expectations for people.

Incidents and accidents were recorded and information about actions taken and any lessons learned was included on the record.