Walton Manor Residential and Nursing 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 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 as requires improvement. At this assessment the rating has remained requires improvement. This meant the management and leadership was inconsistent. Leaders did not always support the delivery of high-quality care.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Leaders told us they had an open-door policy to encourage transparency and communication across all levels. They emphasised the importance of sharing and learning from concerns and challenges identified. Regular staff surveys are conducted to gather feedback and inform improvements. Staff told us they felt able to voice their ideas and were confident they would be acted upon. Comments included, “Yes I feel that any ideas for improvement are welcome,” and “Staff often voice opinions and ideas.” Some relatives described visible leadership, and staff who work in a way that supports shared values. Comments included, “Staff support relatives as well as residents,” “They won't do anything without asking me first,” and “Leader's muck in and get heavily involved." However, our observations of the limited impact of audits and repeated issues not being addressed, showed a disconnect between systems and action. Inconsistencies in communication were raised by relatives, with some reporting variable experiences of engagement and follow-through on concerns. One relative told us “The manager does not know [Name] at all.”  While the provider demonstrated visible leadership and staff felt empowered to share ideas, some ongoing audit findings and delayed improvements limited the impact of quality assurance processes. The home manager had only recently returned to post and was providing direct care alongside leadership duties. Despite this commitment, mixed feedback from relatives and missed opportunities to act on known issues highlighted a gap between leadership intentions and consistent implementation.

The provider had inclusive leaders who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. At the time of our visits the home manager was not present, but we observed the deputy manager was open and approachable, had a good understanding of people’s needs and guided staff to ensure these were met. When we spoke with the home manager, they were passionate about the home and was aware of their role and responsibilities. Staff we spoke with described managers as “approachable.” However, we found systems in place were not always effective which led to a lack of oversight of people’s care plans and maintaining a safe environment. Leadership structures and audits exist, but they are not always effective in ensuring high standards of care or addressing recurring concerns.  Feedback from relatives we spoke with was mixed. Some relatives said managers are visible, approachable, and actively involved. One relative said, “They are always around and very approachable.” However, others mentioned inconsistent leadership visibility. One relative told us, “I’ve only seen the manager once in five years.” Another relative said, “We don’t see the manager much.”

People did not always feel they could speak up and that their voice would be heard. There were processes for raising concerns and providing feedback. The provider had clear information in place for people and for staff on how to raise concerns, including clear complaints and whistle blowing policies. Leaders told us they had created an open-door policy where staff were able to speak up and share their concerns. We saw evidence where concerns or complaints had been raised, they had taken action to address these. Several relatives told us they would feel confident raising concerns with staff or the manager. One relative said, “I have not had to raise complaints but if I did it would be taken seriously.” Some relatives we spoke with described being listened to and having their concerns responded to promptly. One relative said, “If we ask for things to be done, they do it straight away.” However, other relatives felt their concerns were not fully acknowledged, and follow-up actions were not always consistent. One relative told us they didn’t feel their voice was “fully heard.” Due to this mixed feedback, we were not fully assured people would always speak up and raise concerns.  

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked with them. Staff told us they were treated fairly. There were procedures in place to consider staffs individual needs and to ensure staff were treated equitably. Staff we spoke with told us they felt they were treated fairly and with respect. Management engaged with staff to involve them in the running of the service. They had an open-door policy and regular staff meetings. Staff spoke positively about how they worked as a team and felt supported.  

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. Although audits initially appeared regular and structured, they failed to identify issues observed during the assessment, such as inaccurate or outdated care plans. There were issues in record-keeping, including missing or inaccurate care documentation and incorrect names. Issues across health and safety and infection prevention control (IPC) were not addressed through existing audit processes. Medication audits failed to detect discrepancies in medication records and unsafe storage. Breaches of confidentiality were found, including unsecured personal records left accessible in communal areas and people’s rooms. Some relatives feedback highlighted accessible leadership and systems that often respond well to concerns. However, others noted missed and repeated sustainability issues, such as delays in addressing environmental repairs, cleanliness concerns, high management turnover, delays in medical access and the need for families to prompt staff to follow through on healthcare advice.  The service was in breach of legal regulation in relation to Regulation 17 of The Health and Social Care Act 2014 Good Governance.  

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 told us family members and friends could visit them without restriction. The home actively involves external community organisations and professionals to enrich residents' lives and promote wellbeing. The home had strong partnerships with local entertainers and sports clubs, helping to reduce isolation and build community connectedness.  

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. The home’s quality assurance systems and processes require improvements to ensure quality checks are effective. Although systems for monitoring and quality assurance are in place, we found these mechanisms are not yet embedded effectively into practice. Concerns, such as inconsistent care documentation and poor infection control, demonstrate learning audits are not routinely leading to service improvements, reflecting missed opportunities to foster a culture of continuous improvement.  On the first day of the assessment, we raised our concerns about cleanliness and incorrect disposal of personal protective equipment (PPE) within the service, However, when we arrived for the second day of our assessment, we found the provider had not acted and our concerns.