David 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 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 good governance.

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 had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

Staff understood the values of the service and were focussed on providing individualised care that met people’s needs. The interim home manager had undertaken modelling sessions to educate the care staff about the expectations of the provider and how to provide compassionate care which was inclusive of people’s needs. They also told us, “During team meetings I reinforce the values and freedom to speak up culture.”

The provider did not always have inclusive leaders who understood the context in which they delivered care and support and embodied the culture and values of their workforce and organisation.

At the time of our assessment and in the year preceding our assessment David House did not have a permanent home manager in post. They are required to have a manager registered with the CQC as part of their registration. David House has not had a registered manager since January 2024. The provider was in the process of recruiting a registered manager and would keep us updated as to how that progressed.

However, people and care staff were complimentary about the interim home manager. They felt able to speak openly with them and felt they would be listened to. Care staff felt well supported in their roles and told us how the interim home manager helped guide them to develop their knowledge and skills within the care sector.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. A whistleblowing policy was in place, which included details of the provider’s freedom to speak up guardian. An anonymous suggestions box was also in place where staff could raise concerns or suggestions.

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. The interim home manager told us, “We want to make sure we have equitable representation. It is important to make people feel like they are represented in all aspects. We want to make sure people have staff to talk to who understand where they are coming from and what their beliefs are.”

Appropriate policies and procedures were in place to ensure staff worked in an environment that was free from discrimination.

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.

There continued to be a lack of robust governance systems in place. Audits were not undertaken to review the quality and safety of key areas of service delivery, including in relation to infection prevention and control and medicines management. Where checklists where in place we saw these had not always been kept up to date. Some checklists had been completed which identified areas requiring improvement, but there were no action plans in place or follow up to ensure these areas were addressed.

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.

Staff worked in partnership with people at the service to make them more informed and involved in the service. The interim home manager said, “We are now ensuring people are being listened to and we show them respect. We had to change our approach to conflict resolution and improve our communication with people, providing solutions and explaining why and what the alternatives are available.” People told us they felt comfortable speaking with staff and felt able to speak openly with them. There was also an anonymous suggestions box in place where people, and staff, could put forward ideas. The interim home manager reviewed these comments, and we saw many of the suggestions had been implemented.

Staff also worked in partnership with other health and social care professionals working with people who lived at the service. Staff were receptive to feedback from these professionals, and the interim home manager told us, “We have open and honest conversations (with professionals) and (they) give constructive feedback that can be worked on to improve practice.” Staff also supported people to access local community groups that were important to them.

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.

Whilst the interim home manager had implemented a number of changes at the service including the beginnings of a refurbishment plan and work on improving the culture at the service, there had not been sufficient learning and improvement at the service since our last assessment. There continued to be a lack of governance systems in place. They had plans to move to an electronic care records system, but this had experienced delays and continued to not be operational at the time of our assessment. The provider told us after the site visit that arising issues about the system had been resolved and implementation was in progress.