Christopher Grange Rhona 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 service 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 newly registered service. This key question has been rated 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 in breach of legal regulation in relation to good governance at the service.

This service scored 57 (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. There had been several recent changes in the leadership team. Some staff told us they did not feel well informed by the provider regarding the management changes. Staff did tell us they enjoyed working at Christopher Grange Rhona House and several staff had worked at the service for many years. One staff member told us, “I love working here. The nurses know what they are doing.”

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. some people told us they did not know who the managers were. A new deputy manager had been appointed prior to our assessment starting who had recently reviewed some systems and processes to improve the running of the service, however, the improvements could not be fully measured as they were very new. Staff told us they hoped these systems would improve the management oversight. A staff member told us, “The deputy manager is working hard and trying to get structure for oversight of what’s happening in the home.” Another staff member told us the new deputy manager had come in to introduce themselves which was an appreciated gesture. The current management team did demonstrate an understanding of their responsibilities under duty of candour and records demonstrated where the provider had apologised to people when things had gone wrong.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Staff told us they would not hesitate to raise any concerns about people care and told us the clinical lead was approachable and supportive. One staff member commented, “You can go to any of the nurses with any problems. The clinical lead is fantastic.” They added, “I would raise any concerns with the clinical lead and would feel supported.”

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, faiths and backgrounds were represented within the staff team. One overseas worker told us they felt fully welcomed by the staff and received good support when settling into their role.

The provider did not 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. Audits were completed, however, were either inconsistently completed or did not identify all shortfalls found during the inspection. For example, care plan and care record audits did not identify inconsistent record keeping or conflicting information. Medication audits and environment audits did not identify the safe storage of prescribed creams or appropriate storage of PPE. There was an overall home improvement plan in place however, this focused on environment improvements and did not capture areas of focus required in relation to people’s care.

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. A visiting professional told us, “There is consistency and continuation of care, they escalate appropriately, don’t sit on issues and follow processes.” Family members felt informed about people’s care needs. One family member told us, “Staff keep us up to date if [Name] is unwell. There is good communication and messages are passed on.”

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. Systems to monitor the quality and safety of the service and people’s experiences through reviewing and learning from events which occurred had been newly implemented but not embedded into practice. This meant we were unable to assess their effectiveness in improving people’s care. Staff did not have the chance to discuss or share their views with their manager through individual supervision sessions or regular team meetings. We discussed the importance of these opportunities with the provider and the management team who told us they were aware this needed to be an area of focus to improve culture and relationships with staff.