Carrington House Limited

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 inspection we rated this key question good. At this inspection, the rating has changed to 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 service was in breach of the legal regulation in relation to governance. The provider had not always ensured their systems were effective or ensured oversight of quality, safety, and management of risks.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The culture at the service was not always positive.The management team wanted what was best for people and had the quality of their care and support as a clear aim and value. They encouraged staff to put people at the centre of all of their decision making. However, in practice some staff practice could be described as more institutionalised rather than person centred leading to a less positive culture. For example, mealtimes were not always a positive experience for people and people were not always supported to follow their personal preferences and interests. People were not always engaged with in a regular and meaningful way. One relative said, ‘‘I think the service is okay, but I do worry that sometimes [family member] is a bit bored.’’

However, people and their relatives were positive about their support at the service. Staff were positive and happy when supporting people and some aspects of the service had a more positive feel. One person said, ‘’I would recommend living here to anyone. Its brilliant.’’ A relative told us, ‘‘I think the [management and staff team] are doing the best job they can, and I would not want [family member] living anywhere else.’’

The provider had inclusive leaders at all levels who understood the context in which they delivered care and support. They did so with integrity, openness, and honesty. The management team were an active presence at the service, spending time with people and staff. They listened and took feedback seriously. As a result, people and the staff team felt included in discussions about the running of the service. Staff felt well supported by the management team. People and relatives told us the management team were kind and caring. One person said, ‘‘[Registered manager] comes and says hello to us most days. They sort things out if we are not happy.’’ A relative told us, ‘‘I would 100% say the service is well managed. I think [management team] want what is best for people.’’

The provider fostered a culture where people felt they could speak up and their voice would be heard. Staff knew how to speak up and raise concerns and told us they would feel comfortable doing this. People and relatives knew what to do if they needed to make a complaint and were assured that these would be investigated and taken seriously. The registered manager kept a record of concerns and made sure people were responded to with a resolution and any changes that would be made as a result of the concern being raised. One relative said, ‘‘I have had one occasion where I was not happy, and I raised this straight away. It was dealt with immediately and never happened again. Excellent.’’

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 felt well supported and told us they could approach the management team to have discussions about any help they needed in their job roles. The provider’s recruitment process was fair and equitable.

Governance systems were not always effective in identifying where improvements could be made at the service.Whilst some audits were being completed at the service, these were not effective in identifying some areas where improvements could be made. The providers internal audits and governance had not identified some of the issues we found during this inspection. For example, in areas such as fire doors not being safe, medicines not always being administered or checked safely, people not being supported to engage in their preferred pastimes, some people not being supported to feedback about the service, some aspects of how staff supported people not always being dignified and respectful and some care plans needing more information to help guide staff to support people safely.

The management team were completing some audits that were effective in areas such as health and safety, staff training and supervision, people’s care and support being monitored and overall quality monitoring of the service. The provider also completed checks and audits to monitor the quality of the service. The management team took our feedback seriously and sent us evidence they would start to address these areas during our inspection.

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.

People saw health professionals if this was needed. Visiting professionals were positive about the staff team and how they worked with them. The registered manager worked well with partners such as the local authority. Staff supported people to places of interest in the local community such as cafes and gardens and invited partners from the community, such as entertainers into the service. Staff dedicated to providing past times to people, made an effort to celebrate holidays and days of interest. One person said, ‘‘I like it when we have [entertainment] in.’’ A relative told us, ‘‘There is a board, and it details what is going on. They have someone come in like a singer most weeks I think.’’

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.

The registered manager and management team were keen to improve at the service and took our feedback seriously. However, it was more difficult to see how some areas that needed improving were being actively addressed in the areas we identified at this inspection. The service improvement plan for the service did not contain detail to show how the service would improve based on audits. The registered manager reacted positively to the findings from this inspection and sent evidence to show they would improve in identified areas immediately. However, some areas, such as reducing the risk of an institutionalised culture, needed time to implement and embed, to show how changes had been made and sustained.

Despite some of our findings, the staff and management team always looked for improvements and ways to help people have the best experiences of support they could have. Staff told us how they noted and shared what worked well when supporting people so improvements to the way they were cared for could be sustained. One person said, ‘‘If there’s anything I want done differently I just tell the staff, and it is changed straight away.’’ A relative told us, ‘‘[Registered manager] is great at their job and always looking to make things better for the people living at the service.’’