Stratton Court

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.

This is the first assessment for this newly registered service. This key question has been rated Good.

Good: This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 68 (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.

There was a positive culture at the service and people’s needs were a priority for staff. Staff gave us mixed feedback, some staff liked working for the organisation and would recommend it as a place to work while others told us there were certain groups of staff which made the culture difficult to thrive in. The registered manager told us the organisation had systems to help prevent closed cultures and had worked closely with staff to ensure their voice was heard. These included encouraging staff to speak up, involving senior leaders with local staff meetings and acting swiftly to address any issues as they arose.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

The provider had taken a proactive approach to make improvements to internal systems since the last inspection. At the time of the assessment, most actions had been completed. There was an action plan in place to focus management’s attention on outstanding tasks, which was still being worked through. We discussed the issues we identified during the assessment with the management team. They acknowledged when things had gone wrong and implemented actions to address shortfalls. Staff meetings took place regularly and these covered issues relevant to the team. The organisation had visible senior managers. They visited the floors often to meet with people and staff.

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

Although the provider supported people using the service, staff and other stakeholders to speak up through supervision, team meetings, meetings with senior managers and regular surveys, we had been contacted prior to the inspection by numerous anonymous staff members who indicated they felt their jobs would be at risk if the provider knew their identities. Staff contacted CQC to inform us of concerns they had about the managers at the service, unprofessional behaviour and conflicts of interests. During the inspection we spoke to several staff. Staff told us they felt comfortable speaking up and did not have any concerns with the management team. We could not corroborate any of the anonymous concerns which had been raised but were concerned so many anonymous concerns were made to CQC rather than staff feeling confident using internal systems to report issues.

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.

Recruitment and human resources procedures ensured staff were not discriminated against. Staff were required to undertake training about equality and diversity. The company values included an expectation that staff supported and respected each other.

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 provider had systems for monitoring and improving the quality of the service. Staff and managers at all levels carried out a range of audits and checks to make sure people received good quality care and risks were appropriately managed. However, we found some instances where these checks missed crucial information for people and led to a delay in continuity of care. For example, one person’s dietary assessment was delayed as staff misplaced their food diary, which was in paper form, requiring staff to start a new one. We found not all manager’s roles were clear to people. The service employed a general manager whose main role was to manage non-care staff at all levels; however relatives told us the general manager was very visible to them, and they spoke exceptionally highly of them. This caused some confusion as relatives believed they were the deputy manager and did not understand their actual 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.

We received mixed feedback from outside partner agencies and other professionals about the service’s collaboration with them. Some partner agencies told us they were concerned the service did not effectively escalate concerns or implement appropriate mitigation, for example, when people had multiple falls. Some professionals told us they had difficulty when communicating with staff and felt their advice was not being implemented resulting in poor outcomes for people. However, during the assessment we found the service was effectively monitoring people’s needs, documenting appropriately and escalating concerns in a timely manner. We found no evidence to suggest the service was delaying making appropriate referrals and when they found concerns, they made attempts to support people while working to secure additional resources. The service had a mini-bus and people were supported to regularly access the community.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

The provider promoted a learning culture across the service. Relatives told us they thought the service was of good quality and staff were kind and caring. Staff were supported to develop their skills and take part in training as well as external qualifications. One staff member was undertaking their Nurse Associate Apprenticeship with support from the service. They told us, “I've just come back from placement, and I couldn't wait to get back.” Staff took part in team and individual meetings with managers. The provider carried out audits at this service to ensure learning was shared; staff understood the challenges of the range of needs of people living at the service and shared ideas. We found learning had taken place across the organisation and information was shared about good practice and legislation. The registered manager was aware of and had agreed to take part in several new initiatives, for example, using sensors on walking frames to reduce falls and agreeing to be part of a mentorship programme with a local organisation which aimed to improve governance.