Penniston Barn

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 questiongood. At thisassessmentthe rating has changed torequires 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 legal regulation in relation to governance at the service.

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 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. Systems had not fully embedded a culture that consistently recognised communal living spaces as people's home. Although staff were caring in their approach, some practices observed during the inspection did not always promote choice, dignity and ownership of the environment.For example, staff handovers took place in communal lounge areas while people were present, and staff were observed changing television channels or programmes without first consulting people.

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. Leaders had not always ensured effective oversight of the service, as governance systems had failed to identify a number of concerns found during the inspection. Leaders had also not fully embedded a culture that consistently promoted the service as people's home. However, staff described leaders as approachable, supportive and receptive to feedback.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Staff told us they felt able to raise concerns and were confident these would be listened to and acted upon by management.

The provider had created a diverse workforce and staff from different backgrounds worked within the service. Staff told us they felt supported, valued and able to approach managers with any concerns. They said they were listened to and encouraged to share ideas and suggestions to improve the service.

The provider did not always 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. Governance systems were in place; however, they had not been fully effective in identifying and addressing the concerns found during the inspection. Provider oversight had not identified issues relating to environmental safety, medicines management, maintenance standards and aspects of service culture.

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. We found evidence of multidisciplinary team involvement in supporting people's care and wellbeing, demonstrating partnership working with relevant professionals.

Opportunities to learn from incidents and drive improvement had not been fully maximised. Systems primarily focused on recording events rather than identifying root causes, themes and trends to prevent recurrence and improve outcomes. This meant the provider was not always able to demonstrate that learning had been embedded into practice or that proactive measures had been implemented to reduce the likelihood of similar incidents occurring in the future.