Whiteheart Health Care Wiltshire

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 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 service. This key question has been rated requires improvement. This meant the management and leadership was inconsistent.

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 provider had shared their values statement with people, setting out what they should expect from the service. Staff told us the registered manager demonstrated these values in the way they worked.

Leaders did not always have the skills, knowledge, experience and credibility to lead effectively. Leaders were not aware of relevant legislation for the service and nationally recognised good practice. During discussions with leaders about governance it was clear they were not aware of all regulatory requirements. For example, the registered manager was not aware of all regulatory requirements in relation to staff recruitment checks, requirements for staff training and national guidance about the safe management of medicines.

However, people told us they knew the registered manager and found them to be friendly, approachable and responsive to their needs. Staff told us they found the registered manager approachable and were confident any concerns would be listened to and resolved.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. The registered manager told us the service had speaking up procedures, which staff could use if they needed to. Details were shared with staff during induction, team meetings and supervision sessions. Staff told us they knew how to raise any concerns and were confident the management would listen to them and respond.

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 provider had processes in place for staff to request flexibility in their work patterns, for example to enable staff with caring responsibilities or those with health conditions to remain working. Staff were aware of these processes and told us they felt supported by the management team.

The provider failed to have clear responsibilities, roles, systems of accountability and good governance. They failedto act on the best information about risk, performance and outcomes.

Governance systems were not established or effective in assessing and monitoring the quality and safety at the service. Audits being completed were not effective in identifying shortfalls in areas such as medicines management, risk management plans, staff recruitment and training. The registered manager was also the Nominated Individual for the provider, and no systems had been established for any independent review of the service provided or outside scrutiny. Audits of care records had been completed and signed off by the registered manager. However, they were not identifying inaccurate information or when risk management plans needed updating.

Feedback from the local authority commissioner reported they had identified shortfalls in risk management plans and medication records at their last quality assurance assessment. The local authority was assured that the provider took action to address the shortfalls raised. However, similar shortfalls have been identified at this inspection, demonstrating the improvements had not been sustained.

The provider understood their duty to collaborate and work in partnership with other services. They shared information and learning with partners and collaborated for improvement. The registered manager told us they worked in close collaboration with a range of professionals to help make sure people received continuity in their care. People and relatives gave examples of the service working in partnership with other agencies, including health and social care services.

Professional partners gave positive feedback about working in partnership with the service to meet people’s needs. Comments from partners included, “I have always found [the registered manager] to be very responsive whenever I have wished to speak with them. They have always been ready to provide me with any information I required” and “They work effectively [with us] to ensure continuity of care, respecting people’s choices and wishes.”

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. The registered manager had developed improvement plans following individual incidents. However, these were focused on resolving individual issues, rather than applying learning to improve the service as a whole. The registered manager did not have an overall plan setting out improvements that were needed in the service or how they were going to be made.