Wainford House Residential Care Home

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 changed to Inadequate. This meant there were widespread and significant shortfalls in leadership. Leaders and the culture they created did not assure the delivery of high-quality care.

The service was in breach of legal regulation in relation to Good governance.

This service scored 29 (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 shared vision, strategy and culture based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not understand the challenges and the needs of people and their communities.

The provider did not demonstrate a shared vision or strategy which promoted transparency, equity, equality, human rights, diversity, inclusion, or meaningful engagement. There was no clear leadership culture embedded within the service, and no evidence that the provider had a strategic understanding of the challenges faced by the service or the needs of the people it supports.

Opportunities were not always provided to give feedback, and not all concerns were recorded and acted upon by the management team.

There was a lack of shared direction and cohesive culture within the service. There was little evidence of effective leadership guiding day-to-day practice. The registered manager and several care staff left during our inspection. This absence of a clear, shared vision contributed to inconsistent standards of care, and a lack of accountability.

The provider did not have inclusive leaders at all levels who understood the context in which they delivered care, treatment and support, or who embodied the culture and values of their workforce and organisation.

Leaders did not have the skills, knowledge, experience and credibility to lead effectively, and they did not do so with integrity, openness and honesty. For example, the provider and registered manager failed to implement the objectives as set out in the provider’s Statement of Purpose (SoP). The SoP stated ‘We prioritize high-quality care by ensuring transparent information about our home, individualized healthcare plans, a fulfilling lifestyle, and effective responses to concerns, complaints, and protection issues.’ This was not our findings during this assessment. The provider and manager did not demonstrate they understood their role and responsibilities for ensuring people received safe, high-quality care. The provision of poor quality of care over an extended period did not demonstrate a commitment to deliver high quality care.

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

The management team did not foster a positive culture where staff felt they could speak up, and action would be taken. Describing an incident which caused them concern a member of staff told us, “I went to a care assistant and spoke to her about the situation and told her that it made me feel uncomfortable and she told me to report it to the manager. I did this and nothing was done about it.” Another member of care staff said, “I have been scared to write and put any complaints forward.”

People did however tell us they knew how to speak up, and their voice would be heard. For example, one person told us, “Someone is always available to talk to or on hand to listen and discuss anything that needs to be.”However, other relatives told us that no member of the management team was available at weekends which made it difficult to raise concerns.

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

Some staff told us they were comfortable with the culture in the service. However, others described a bullying culture where they were made to work extra shifts. A member of staff said, “I am put down for shifts without being asked, they always have training and team meetings when I am not on shift and expect me to either stay on or come in on my days off, sometimes it is my only day off that week.”

The provider did not have clear responsibilities, roles, systems of accountability and good governance. They did not act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

There was an overall lack of oversight and scrutiny of the service by the provider and the management team to ensure risks were identified and mitigated. Audits and checks completed to monitor, assess and improve the quality and safety of the service were not accurate.

The registered manager resigned from their role at the beginning of our inspection, and we did not meet them. The provider put a management team in place. Following concerns raised on our first visit a daily walkaround was put in place by the management team to check on the safety of the environment, equipment and staff performance. On our second visit we found this had not been effective in improving the issues it was designed to address, and some aspects of care and the environment had deteriorated further.

Statutory and regulatory notifications to the Care Quality Commission and local authority which are required following incidents, accidents or safeguarding concerns had not been made.

The provider had a set of policies and procedures setting out expected standards and safe working practices. Despite this there was a failure from staff at all levels to ensure these were followed.

The provider did not always understand their duty to collaborate and work in partnership, so services worked seamlessly for people. They did not always share information and learning with partners or collaborate for improvement. For example, the provider told us they engaged with external professionals to make improvements. However, we were not assured priorities had been effectively assessed as concerns remained regarding fire safety and the safety of some aspects of the home environment and the quality of care provided. People were not always supported to access services from other health care professionals as needed such as SALT, occupational health and a dentist.

Feedback from external professionals was generally positive in terms of how the provider engaged with them to review and meet people’s needs.

The provider did not focus on continuous learning, innovation and improvement across the organisation and local system. They did not encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not actively contribute to safe, effective practice and research.

A lack of analysis of events such as accidents and incidents led to missed opportunities to make improvements to avoid further occurrences and keep people safe from harm. On our first site visit day we provided feedback of our findings to the management team and shared our concerns with the provider. Despite this there were limited improvements made by our second site visit day and some aspects of the physical environment had deteriorated.