Brantwood Hall 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 inadequate. At this assessment the rating has remained 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.

Concerns were identified in relation to culture at the service. There was a focus on staff losing their jobs, evidenced in documentation, yet no targets for improvements were shared with them. One staff member told us, “It's a blame company.” Staff also said they had been told to, “up their game” but had not been given any tangible targets. When asked how things could be improved at the service, 1 staff member responded, “CQC get off our backs.”

Leaders and staff failed to ensure people had positive experiences and received high quality, person-centred care. There was a lack of leadership and oversight to ensure people were supported appropriately and engaged in a way that was meaningful to them. There was a failure to improve following the previous assessment and the service had further deteriorated.

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 lead effectively, and they did not do so with integrity, openness and honesty.

Since the last assessment there continued to be a lack of consistent, effective, service and provider level leadership. Two provider level leaders in place at the time of the current assessment had been at the service for a limited time. Both told us they had not received a formal handover of the service and had little to no knowledge of the previous concerns raised by CQC following the last assessment. We continued to identify widespread failings during our current assessment. Some of the concerns reflected a lack of compassion and inclusivity in the approach of the provider. The impact of such shortfalls on people’s lives went unrecognised.

Relatives shared concerns regarding the management of the service. Feedback included, “There have been a lot of managers. I don’t have trust in the management because they lied to me,” and “We have seen 5 or 6 managers come and go. It doesn’t make you have any confidence in the home” and “I don’t know the manager now. It makes me feel that [the provider] isn’t supporting the team. There should be someone above at [the provider] making sure that everything is alright. I don’t think they do this.”

Information was not openly shared with staff. One staff member told us, “I'm afraid for my job, we all are. I think the home will close. Not because of [CQC], but because they [the provider] don’t care. If something is wrong, I like to know what that is. If we are told, we can know how to put it right. I've not had any information since the last inspection, nothing.”

The provider did not ensure there were effective systems in place to support people and staff to speak up or raise concerns. There was a lack of effective leadership to promote an open and transparent culture.

Not all staff felt able to speak up and raise concerns. Feedback included, “I do speak my mind, but nobody listens. They knee jerk and move the goalposts, so we don’t know what we're doing” and “I do not feel valued or listened to.” Whilst some staff told us they were able to speak up, CQC continued to receive anonymous whistleblowing during the assessment, despite inspectors being on site speaking to staff. Multiple concerns were identified during the assessment, yet there was no evidence of these concerns being noticed and escalated by staff or leaders. This demonstrated a lack of an open culture where concerns were recognised, shared and addressed.

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

The provider employed a diverse workforce comprising staff from a range of backgrounds. Flexible working and reasonable adjustments were supported when required. However, lack of stable, effective leadership had impacted staff, and some did not feel heard and supported. Feedback was mixed and included, “I am treated equally,” and “I am treated fairly” and “There is no support from the company, they don’t care.”

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.

Leadership and governance arrangements at the service had failed, resulting in continued risks to people's safety and wellbeing. Quality assurance systems and processes continued to be ineffectively implemented and were not robust in ensuring quality improvement and service user safety. The provider failed to address serious concerns raised by CQC at the last assessment. Furthermore, during the current assessment there was further deterioration in service delivery. We identified continued regulatory breaches in relation to staffing and good governance; and new regulatory breaches in relation to safe care and treatment, and person-centred care.

The provider did not understand their duty to collaborate and work in partnership, so services work seamlessly for people. They did not share information and learning with partners or collaborate for improvement.

A lack of oversight and monitoring at the service impacted the effectiveness of collaborative working and sharing of information, as learning and quality improvement was not taking place.The provider collaborated with partner organisations but had failed to improve the service. Where partner organisations had identified concerns, these had not been adequately monitored or addressed.

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.

The provider failed to demonstrate where learning had taken place and been used to make improvements to the service. They had continuously failed to maintain oversight, learn lessons and make changes to improve people’s care and experiences.