Old Hastings 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 good. At this assessment the rating has changed to requires improvement.

This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

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

This service scored 54 (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 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. The registered manager had only been in post for a few days on the first day we visited the service. They were open and honest with us about the service and the improvements that were needed in several areas. The registered manager had not been in post long enough to identify all of the issues and concerns. For example, we highlighted the issues around lack of oversight in monitoring people’s weights, lack of training and refresher training for several key areas and ongoing maintenance issues relating to the hot water supply to the service. Despite the registered manager having a clear vision of improvements and the direction they wanted the service to go, concentrating on best outcomes for people, there was a significant amount of work required to make the improvements and then for the changes to have time to embed. The registered manager was committed to involving all staff in realising these improvements and in developing ways to learn from past failings.

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. Despite the open and honest attitude of the registered manager several staff told us they had felt let down and not fully supported by previous leaders at the service. Although the situation was improving there needed more time for these new relationships with the registered manager to develop and embed. The service comprised of different units supporting people with specific needs. The registered manager wanted to merge the units and to train and empower staff to be able to work across all areas. A member of staff said, “Managers are supportive now. All issues and changes openly discussed at a recent team meeting. The new managers are open and honest.”

People did not always feel they could speak up and that their voice would be heard. During the six months before our visit formal and recorded opportunities for staff to speak up were minimal. Staff told us they had not received regular supervision meetings and that there had been few staff meetings other than the meetings at shift handovers. Plans were in place to improve this situation, but it was too early for this to have taken effect. Staff told us their initial impression of the new registered manager was positive and there appeared now to be greater consistency and oversight. As with other management areas, this required time to embed before benefits could be realised. The registered manager had begun putting in place diarised, regular supervision meetings and acknowledged the need to capture and share both poor and good staff practice. A staff member told us, “I’m more confident now to approach the manager.”

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. Several members of staff had worked at the service for over ten years. Staff retention reflected their satisfaction at working at the service over time, despite the recent changes. 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 a proactive and positive culture of safety based on openness and honesty. Staff did not always listen to concerns about safety and did not always investigate and report safety events. Lessons were not always learnt to continually identify and embed good practice. There was no evidence to suggest that learning from accidents and incidents whether positive or negative had been recorded and shared with staff. Some people had experienced several falls and although these had been recorded, there was no analysis of when or where or what had caused the falls. This resulted in no preventative measures being put in place and no reduction in falls during the past six months. Other professionals had raised safeguarding investigations in relation to falls at the service and staff we spoke with were not aware of this. Staff did know the process to follow to report accidents and incidents and we saw some forms had been completed but there remained no input or oversight from managers at the service. Relatives did tell us they were kept informed following a fall or any other incident involving their loved ones. There had been a recent viral episode at the service and all relatives we spoke with had been informed.

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. Best practice was not shared as it had not been captured. There had been missed opportunities at the service to analyse and identify through effective auditing and oversight both good and poor practice. The service did work well with other partners and communication was effective. One professional said, “I have a good professional relationship with the staff at Old Hastings house. Communication is good and most often in a timely manner to meet the needs of the people in their care.” The registered manager told us they were being supported by the local authority, and they were beginning to share practice examples with their sister home. This work however was in its infancy and needed time to establish. People at the home regularly went out into community in minibus for regular trips to local amenities and services. Becoming known at certain locations and welcomed.

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 auditing and quality monitoring there was no record of learning lessons from when things go wrong. Lack of management oversight meant that longer term trends were not captured. Accidents and incidents were recorded and then discussed at handover or daily ‘flash’ meetings’ but there was no written record of these conversations. When incidents were recorded on care plan notes, the system pushed the latest entries to the bottom of the page which made it difficult to quickly review the latest events. The current system was due to be replaced with a better presented care plan recording process. The absence of recent supervision meetings meant that staff did not routinely have the opportunity to raise concerns or best practice with managers. Again, this had resulted in good practice being missed. The new registered manager was aware of these concerns and had begun the process of capturing lessons from incidents and trends from auditing processes. Again, this required time to embed and become usual service practice.