The Old School House 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 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 provider was previously in breach of the legal regulation in relation to good governance. Improvements were not found at this assessment, and the provider remained in breach of this regulation.

This service scored 50 (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 always have a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not always understand the challenges and the needs of people and their communities.

Feedback from relatives and professionals highlighted disorganisation and inconsistent standards of care, which indicated the provider’s values were not fully embedded in practice. Comments included, “It’s been a bit disorganised but was better yesterday” and “Many quality concerns related to out of hours and managing care to a high standard.”

Staff were not always observed promoting dignity or choice, and care delivery did not consistently reflect person-centred values. These findings show the culture was not consistently focused on people’s rights, independence and wellbeing. However, some staff told us teamwork was positive and morale was improving. Many staff commented on the consultant supporting the service and explained they were really “helpful” and “have improved things, I can approach them and tell them anything.”

The provider did not always have capable and effective leadership, and leadership instability continued to impact quality and safety

There was no registered manager in post and frequent changes in management, including interim arrangements, had resulted in a lack of continuity and clear direction.

Staff and relatives described mixed experiences, with some saying leaders were supportive, but others describing management as defensive and not always approachable. Some improvements had begun, such as increased leadership presence on the floor and daily meetings.

Overall, leadership arrangements were not stable or effective enough to ensure consistent high-quality care.

A professional told us, “I am not always convinced of their sincerity in their interactions with professionals and feel that the management, are saying the right things but, I am not sure that what they are saying will result in lasting positive changes. I found the management team can be defensive and do not agree with some comments made or changes suggested.”

A relative told us, “I’d give management of the home a score of 40 out of a 100. It should be at least 80. I haven’t got a clue today who is running the place.”

The provider did not always support an open and transparent culture where people and staff felt confident to raise concerns, although some improvements had been made.

Most relatives told us they could raise concerns, however, gave us mixed feedback about whether this led to improvements. When asked if they felt confident in raising concerns, relatives commented, “Yes, I do but I have given up a bit as nothing changes/ happens having raised the same issues multiple times” and “Yes absolutely, even in relation to small things, my emails never go unanswered.”

Some staff told us they were not confident about escalating concerns. However, others described opportunities to raise concerns through daily meetings and team discussions, and reported that communication had improved more recently.

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.

Staff told us they felt welcomed and part of a supportive team, and leaders described promoting different cultures within the workforce. Staff did not raise any concerns in relation to equality and diversity.

The provider had an Equality, Diversity and Inclusion Policy in place.

The provider did not have effective governance systems in place to ensure safe, high-quality and sustainable care. This remained a significant and ongoing concern.

Governance systems were either not fully implemented or not effective in identifying and addressing risks. For example, for key issues such as care planning, fire safety risks, medication protocols and gaps in infection control monitoring. These findings demonstrated a lack of effective oversight and accountability, placing people at risk.

Governance systems were not always effective in ensuring records were accurate, complete and contemporaneous. People’s care plans had contradictory information providing inaccurate guidance to staff. A professional told us, “Our experience is that access to up- to- date and comprehensive information is inconsistent. Without reliable access to accurate records, it is difficult to fully assess needs or provide safe and effective care. This presents a potential risk to residents and limits our ability to support appropriately.”

Oversight from the provider was not effective, and improvements had not been sustained or implemented following our previous assessment.

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.

We received mixed feedback from professionals about the service working with partners. Comments included, “Communication with senior leadership has, at times, lacked openness and transparency and concerns raised have not always been acknowledged or acted upon” and “(There has been) some attendance at forums but not consistently.” They also told us there had been attendance to specific workshops, for example managing complaints.

The provider was working alongside local authority teams and other professionals as part of safeguarding and improvement activity. However, professionals told us, improvements were often driven by external involvement rather than proactive internal leadership. A professional told us, “Safety events are only recorded when questions are asked at the time of the visit.”

The provider was open with us about challenges within the service and had plans to improve the quality of care.

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.

There was repeated evidence of similar concerns from our last assessment, in relation to IPC (Infection, prevention and control), governance and lack of stimulation. This indicated that learning had not been embedded and resulted in continued breaches of regulation.

Although the provider had introduced actions such as daily meetings, spot checks and a service improvement plan, these had not yet resulted in consistent improvements. Professionals reported that while immediate action was sometimes taken, issues often reoccurred.