Wayside Care 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 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 inadequate. At this assessment the rating has remained inadequate.

This meant there were widespread and significant shortfalls in leadership. Leaders and the culture they created did not assure the delivery of high-quality care.

The service was in breach of legal regulation in relation to their governance systems an in notifying the CQC of significant incidents in accordance with the law.

This service scored 36 (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 based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. The culture of the service was not person-centred, open, inclusive or empowering. Leaders, managers and staff did not have a well-developed understanding of equality, diversity or human rights. The culture of the service did not prioritise safe, high-quality, or compassionate care. For example, the provider failed to ensure the home was safe for people to live in, they failed to complete effective risk assessment for people and failed to ensure safety measures were in place to minimise the risk of harm. For example, they failed to ensure actions from fire risk assessment and legionella risk assessment had been implemented. They failed to ensure people were the centre of the care provided, and they failed to effectively ensure assessments engaged people, were current and based on best practice. The culture was not based on transparency and staff failed to identify and challenge poor practices. These issues put people at the avoidable risk of harm.

The provider did not have inclusive leaders at all levels who understood the context in which they delivered care, treatment and support, or who embodied the culture and values of their workforce and organisation. Leaders did not have the skills, knowledge, experience and credibility to lead effectively, and they did not do so with integrity, openness or honesty. Throughout the inspection we were informed information was available and actions had been completed. However, this did not stand up to scrutiny. For example, when asked about the action from the legionella assessment we were informed all action had been completed yet managers were unable to locate the documentation to support this. When asked basic questions based on the assessment like the clear identification of drinking water it was clear this action had not been taken despite assurances from the management team.

The provider and management team failed to demonstrate they understood risk in the context of a care home. For example, they failed to demonstrate they understood or applied safe evacuation procedures or the safe provision of infection prevention and control practices. They failed to demonstrate they understood and championed equality, communication and engagement with people in the development of their care and support plans which often contained generic assessments and in multiple instances missing or incorrect information. These issues put people at the risk of inconsistent and unsafe care which did not meet their personal needs or preferences. Leaders did not demonstrate the credibility, capability, or integrity required to lead the service effectively.

People did not always feel they could speak up or that their voice would be heard.There was limited assurance staff felt able to raise concerns, although some external reporting indicated some concerns had been raised. Governance and audit systems were ineffective in identifying or escalating risks. There were repeated environmental and safety concerns which were not addressed in a timely way. Unsafe practices were observed without evidence of challenge from leaders or colleagues and there was limited evidence of structured mechanisms for staff feedback or learning. While significant concerns were identified and raised during the inspection, these appeared to be escalated externally rather than proactively through internal reporting systems meaning the culture did not embrace or promote an atmosphere where staff could freely and safely speak up.

The provider did not always value diversity in their workforce. They did not always work towards an inclusive and fair culture by improving equality and equity for people who worked for them. Leaders did not demonstrate there were effective or proactive ways to engage with and involve staff. There was a lack of focus on hearing the voices of staff with protected equality characteristics or those who were excluded or marginalised, or who may be least heard within their service. There was a lack of inclusion as leaders could not evidence staff were able to effectively engage and challenge poor practices leading to perceptions of isolation and marginalisation. This was evidenced by the poor practices and derogatory language witnessed during this inspection and the lack of oversite and engagement and redirection by leaders.

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. Governance systems were inadequate. The provider failed to identify risks, act on known concerns, maintain effective oversight of safety and quality. Audits failed to identify significant risks, including care planning inaccuracies and environmental hazards. Known risks were not acted upon in a timely way, with issues such as fire safety concerns remained unresolved over time. Leaders lacked oversight of day-to-day practice and did not consistently understand or respond to risks affecting people. Records and monitoring systems were incomplete and unreliable, limiting accountability and shared understanding of performance or focusing on improvement. There was a failure to learn from issues or embed improvements, with repeated concerns identified during this inspection and from past inspections. The provider did not have clear governance systems, accountability, or leadership oversight to ensure safe and high-quality care. We identified multiple incidents where the provider had failed to notify the CQC of significant events which had occurred within Wayside Care Home as they are required to do by law.

The provider did not always understand their duty to collaborate and work in partnership, so services worked seamlessly for people. They did not always share information and learning with partners or collaborate for improvement. Partnership working was not always effective, as evidenced by escalation from external agencies and lack of improvement following concerns. There were instances where communication and engagement with GP’s and District Nurses were positive but there was inconstant engagement regarding missing information or inconsistencies in records.

The provider did not focus on continuous learning, innovation or improvement across the organisation. They did not encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not actively contribute to safe, effective practice. There was no evidence of sustained learning or improvement. Repeated issues identified in previous inspections had not been addressed. Systems such as audits and reviews were ineffective and did not identify or address significant risks, including care planning inaccuracies and environmental hazards. Issues identified were repeated over time, with little evidence of sustained improvement or implementation of corrective actions. Unsafe practices continued without being identified or addressed through internal processes, and care delivery remained task-focused with limited evidence of development or innovation. Leaders responded to concerns reactively following inspection challenge, rather than through proactive governance systems. There was no evidence of a structured approach to learning, improvement, or innovation within the service.