Walton Manor

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 good governance.

This service scored 57 (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, and engagement. We received positive feedback from relatives about the staff. One relative said, “The staff are very kind, they do very well.” We also received positive feedback from a visiting professional about staff attitude and how they followed through on advice and actions.However, it was felt by a medical professional that concerns could have been reported sooner to prevent deterioration in people’s health.

At the time of the assessment, there was no registered manager in post, leading to inconsistent leadership. We found the service did not implement learning following complaints at the service. Upon review of complaints received by the service, we found concerns which had already been identified through previous complaints and where improvements should have been made. This included staff not always recording where people received, were offered or may have refused personal care, call bell alarming for long periods and concerns with people’s laundry. Even though there was some analysis of accidents and incidents, the provider could not demonstrate that that incidents were promptly investigated. We found there was a delay in when incidents were actually reported to the managers which meant investigations to prevent reoccurrence were not always timely.

The provider had not fostered a positive culture where staff felt they could speak up and they would be heard. Staff knew how to speak up and gave examples of when they have spoken up but told us they did not feel listened to, and no explanations provided to why their suggestions were not considered. People did not raise any concerns about being able to speak up. Monthly meetings were held with people to inform them of any changes and get suggestions of what they would like from the home. All relatives we spoke to knew how they would raise concerns if they needed to.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The provider did not have effective systems in place to monitor the quality of service and the running of the home. Although the service completed audits and checks these had not identified the concerns we found during our assessment. Upon review of people’s care records and incident forms, we found incidents were not being flagged in a timely manner by staff. Leaders did not have oversight of incidents which occurred at the service. Some were only identified in audits of care records and had not been specifically highlighted at the time of the incident. We also found errors in some of the recorded incidents.

There were a number of gaps in people’s daily logs to evidence what personal care had been provided, the provider’s governance system had not identified this. There was a lack of oversight on the liberties people were being deprived of as the provider had not completed any Deprivation of Liberty Safeguards (DoLS) applications for some people, even though the provider was aware of these people, applications for the authorisations had only been made after our visits. The service was conducting their own medication audits, however these had not always picked up on the issues we found during our visits. The system to assess staffing levels as the service was not clear. The service also previously failed to respond to staff concerns about staffing. During our visits, we reviewed air flow mattresses in use by people at risk of pressure sores. Their air flow mattresses were not set at the correct setting according to their weight. The air flow mattress audits had failed to identify this. The provider had recently completed a mock inspection and was working though an action plan to improve the service. The provider was very receptive to our feedback and started taking action to address some of the concerns we raised. The concerns demonstrate a breach of Regulation 17 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.