Quinnell House

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 service was in breach of legal regulation in relation to the quality monitoring and governance at the service.

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 told us of their shared vision and culture, but improvement was required to ensure it was embedded throughout the service. The provider was committed about ensuring that people received support based on equality and human rights, and diversity and inclusion. However, the unstable management had impacted on the smooth running of the home and on care staff being able to perform their role in promoting person centred care and meeting people’s health and social needs consistently. The provider shared the disappointments of the manager appointments that had not worked and was keen to move forward, staff also shared that they needed positive leadership.

The provider understood and supported people’s cultural and spiritual needs. People were treated equally, and their individual needs were met in line with their preferences.

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.

Staff commented that they had found support lacking from the senior management team and at times felt bullied. One staff member said, “We are never told we are doing good, just told we weren’t, which is so soul destroying.” The provider was not aware of these concerns and told us they would be talking to all staff to ensure that they feel supported and rebuild their confidence.

The provider had brought in an external consultant and a senior manager from the sister home which had already impacted positively on staff who said, “They are a breath of fresh air.” Staff described them as being supportive and approachable and always available to answer questions. One staff member said, “I am feeling more valued now than I have done for a while, it’s good to have that support, we are a good team, but we do need a clear leader.”

People did not always feel they could speak up and that their voice would be heard. Team meetings had been inconsistent and not well attended. The lack of regular formal staff meetings meant that actions discussed could not be followed up to reassure staff they were listened to. We saw signage that evidenced a team meeting had been arranged. With the help of a consultant the provider was working to build a culture where people felt able to speak up but this was not embedded at this time.

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.

Different cultures and religions were represented within the workforce and staff told us that any requests for changes in shift or days off due to wanting to celebrate feast days had been supported by managers. Equal opportunities and equality and diversity policies were in place and although not reviewed recently, remained fit for purpose.

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.

Whilst there were audits and systems in place to govern the oversight of the service, these had not identified and/or addressed many of the issues we found on inspection. For example, No audit or review related to fire safety had been carried out and Fire training, evacuations and drills had not been undertaken. The emergency fire grab bag was not accessible and PEEPs for people were not all in place and accurate. This was immediately actioned to ensure people and staff were safe. The overview for people’s weights had shown weight loss of up to 5kgs in a month for people that had not been checked or followed up with appropriate actions.

Staff training was not up to date and showed significant gaps. Staff supervision was not up to date and staff had not received their appraisals. Which placed people at risk from untrained staff. Oversight had not identified that not all accidents and incidents and lessons learned were documented. This put people at the avoidable risk of repeated accidents and incidents within the service. DOLs audits had not been carried out and there were a number of DoLS authorisations that were out of date and had not been applied for which meant people did not have legal safeguards in place to protect them. The MCA did not reflect the DoLS authorisations in some peoples care plans. Staff were using their own mobile telephone to take pictures of wounds and activities. This had impacted on quality of photographs and not in line with the organisational policies and General Data Protection Regulation processes.

An external consultant had identified some of these shortcomings in the week before the site visits and had produced an action plan to address the issues. Improvements however would take time to fully embed. and we were not able to assess the sustainability of planned improvements

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.

People were consistently supported across a range of different services and agencies. There were established systems in place to liaise with other professionals. These were opportunities to share knowledge and learning and consider future developments.

The provider and registered manager worked cooperatively with partners and commissioners. However, was not reflected clearly into the care documentation, so that all staff were fully aware and kept up to date with any changes and to support people safely.

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.

Because of the recent lack of robust auditing and quality monitoring there was no record of learning lessons from, when things went wrong. This had resulted in no organisational improvements at the service with no trends, themes, good or poor practice being identified for a sustained period prior to the appointment of the consultants. Accidents and incidents were not all fully recorded with actions taken to address risk and whilst we were told these were discussed at handover / daily meetings’ there was no written record of these conversations.