Seaview Haven

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 regulations in relation to good governance and staffing.

This service scored 43 (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. While some policies were in place, these were not consistently translated into practice. Staff told us they did not feel involved in shaping the direction of the service or their feedback was meaningfully considered. For example, staff said they raised concerns or ideas but were not always told what had been done in response. One staff said, “Staff are quite demoralised”, and some other staff described a lack of day-to-day support and oversight. This had an impact on morale and contributed to a disconnect and closed culture between the leadership team and the workforce team. Although the provider had devised an action plan to address areas of concern, they did not have a clear strategy in place to make the necessary changes and ensure all staff were engaged in this.

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.

At the time of our inspection, the manager was on annual leave. The director told us the manager completed daily walkarounds of the service.

We received mixed feedback from staff regarding the leadership and accessibly to management. For example, one staff member told us “The manager doesn’t know much about the people, only what’s on paper”, and “It’s not easy to speak to the manager”. We observed staff were frequently going into the main office to find the care co-ordinators for support, this demonstrated leaders were not always visible and present across the service floors for staff and people.

We observed examples where some people became frustrated with repeated questions being asked from another person, we gave this example to the management team and shared how this observation could have been noted by management had they been more present and visible for staff on the floor.

We were not assured leaders always maintained effective oversight of people’s care and staffing.

People did not feel they could speak up and their voice would be heard.

Arrangements were in place for gathering peoples’, relatives’ and staffs’ views relating to the quality of the service provided at Seaview Haven. However, there was no analysis of the data or an action plan where areas for improvement were highlighted and recorded. For example, in relation to staffing levels and improvements to staff interactions with people using the service, resulting with some staff feeling they were not listened to. Although there were systems in place to enable staff and others to speak up when something was wrong these were ineffective. Some staff told us they feared being treated unfairly if they spoke out. This suggested staff did not always feel psychologically safe to raise issues or challenge poor practice.One staff said, “We definitely do not feel valued”, another staff said, “They (managers) either don’t listen to us or don’t take action”.

We were not assured people or staff could speak up to the provider or manager and their voice would be heard. Staff told us they had limited opportunities to meet as a team to give feedback, raise concerns or share best practice. For example, staff told us staff meetings were arranged and then cancelled, this meant there was a risk staff may not raise concerns. Following the inspection the provider told us they had introduced smaller staff meetings along with the daily handover.

However, staff we spoke with knew they could raise concerns with the Local Authority and safeguarding team.

The manager did not always value diversity in their workforce and not all staff employed at the service felt there was a fair culture at the service.

There was a diverse workforce at the service, with staff employed from a wide range of backgrounds, cultures, and experiences. The manager was unable to provide examples of how they developed and supported a compassionate, collaborative, and inclusive culture at Seaview Haven for all staff. The manager did not work towards an inclusive and fair culture by improving equality and equity for people who worked for them. Staff confirmed there were few opportunities to discuss their development through formal supervision and appraisal. There was a lack of effective systems to promote equality, diversity, and inclusion within the workforce. However, the provider told us they authorised time off for staff to celebrate religious festivals where practicable. There was minimal evidence of regular leadership oversight to ensure equality, diversity and inclusion principles were embedded in staff development, or day-to-day practice. Not all staff felt there was good teamwork at the service and mainly attributed this to cultural and diversity differences within the existing staff team. Staff told us: “We don’t feel they [management team] treat us fairly and we feel discriminated against. We don’t speak up because we are fearful of reprisals”. When we raised this with the manager, they stated they had not been aware of this issue. However, they said they would look into ways to solve the issue.

The provider’s systems of accountability, audits and governance had not ensured all areas of the service were safe. They did not always act on the best information about risk, performance and outcomes

The provider’s senior management team oversaw the auditing and governance procedures of the home’s management team and attended the service daily; there were also a range of quality monitoring procedures in place including audits of various aspects of the service. However, audits and governance procedures had not identified the issues we found during the inspection as detailed in the various sections of this report.

The systems and processes failed to ensure people’s records were always detailed, complete or contemporaneous. Some people’s care records were incomplete, and did not contain sufficient information for staff to manage people’s specific needs or conditions. The manager did not ensure multiple risks were being adequately monitored or managed. For example, risks around people choking, pressure area care and weight management. This placed both staff and people at risk of avoidable harm or abuse.

Services which provide health and social care to people are required to inform the Care Quality Commission [CQC], of important events which happen in the service. This enables us to check appropriate action had been taken. The provider had submitted statutory notifications to the CQC as required.

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. Information demonstrated the service worked with others, for example, the Local Authority, healthcare professionals and services, such as the local Speech and language Team to support care provision. Feedback from some professionals indicated communication and responsiveness was good.

The provider and the manager 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 manager did not always use their policies to focus on continuous learning and improvement from incidents, audits and information gathered at the service. Staff confirmed they did not have regular staff team meetings to discuss items, issues or feedback arising from running of the service. Staff felt this was missing in the service as this would give them the opportunity to discuss important aspects of the service and identify areas needing attention. Staff said they did not discuss events or lessons learned from those events which could also encourage reflection and collective problem-solving. This did not demonstrate the provider consistently involved the staff team or used their policies and procedures for effective and meaningful learning, measuring outcomes and impact on the services provided.

The staff team were motivated to provide care and support to people as their needs and health were changing. However, we received a mixture of feedback from staff. Some staff felt supported by the management team. Some staff felt the management team needed improvements regarding their insight and awareness of what was going on in the service and the quality of it. They said, “I have raised things with the manager and nothing changes. The manager is very quick to tell staff off but not quick to listen to us”. From staff feedback and our findings of issues, the provider and the manager did not always encourage staff to speak up with ideas for improvement and innovation and actively listen and engage with them. Where we identified shortfalls during this assessment, the provider was responsive to our findings and started working on areas of improvement.