Scalford Court Care Home

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• 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

During our assessment of this key question, we found concerns around the governance, management and oversight of the service which resulted in a breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can find more details of our concerns in the evidence category findings below. Systems and processes did not fully support an inclusive environment for staff. Managerial oversight and monitoring of the service was not effective.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Capable, compassionate and inclusive leaders during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Systems and processes were in place to encourage staff to speak up. However, staff meetings were not regularly held and the approach to meetings was inconsistent. For example, there was no set agenda or information as to what action had been taken to follow up on issues raised at a previous meeting. The infrequency of staff supervisions was also a contributory factor in limiting opportunities for staff to share their views. The whistleblowing policy and procedure lacked detail as to staff could raise concerns to senior management or external organisations. A representative of the provider advised staff did raise concerns with them; however, there was no evidence provided on the day, or subsequently to support what if any actions had been taken in response. This restricted potential learning and developmental opportunities. Resident and family member meetings were scheduled. Minutes of a meeting where people and family members did attend showed their views were sort and the topics discussed including activities and outings, meals and how to raise concerns.

Staff views were mixed, not all staff felt able or confident to raise concerns with the registered manager as they did not feel they were listened to. Staff spoke of the limited opportunities to share their concerns as staff meetings were not regularly held. Handover meetings were viewed by some staff as being a negative experience, as the registered managers approach did not encourage a collaborative approach to problem solving or the sharing of ideas. Morale amongst the staff team was mixed with some staff feeling they were not valued or supported. Staff said they felt supported by senior care staff, and some staff said they found the registered manager to be supportive, and were confident to raise issues with them.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The provider's policy of quality management was not implemented effectively. Management oversight, leadership, systems and processes which monitored the quality of the service provided were not robust. For example, the provider had failed to identify there were shortfalls in staff training, supervision and appraisal. The lack of good governance meant the provider could not be confident of the quality and safety of the service they provided and restricted their ability to learn and drive improvement. Systems and processes, including auditing were not robust. The registered manager advised they audited a sample of care records each month, however there were no records to support what records had been reviewed, the criteria or checklist they used to audit against. There were no records as to the outcome or findings of their audit, which limited the providers ability to learn lessons and improve. The registered manager had failed to identify care plans for key aspects of people's care and treatment were missing or had not been reviewed. Audits in some areas were undertaken for example a monthly accident and incident analysis. However, there was a lack of information to evidence the learning and actions taken to mitigate further risks. An infection prevention audit stated staff had completed training in infection prevention, however the staff training matrix showed gaps in staff training in this area. Quality monitoring visits undertaken by external stakeholders had identified areas for improvement which included accident and incident recording and reporting, monitoring of care and recording of care needs, governance and audits. The feedback from stakeholders had been shared with staff as recorded in minutes of a staff meeting. The provider sought the views of people and family members annually via a survey, the results were analysed which included the action taken in response to additional comments raised.

Vising professionals raised concerns about communication with the staff and management team in relation to people's care and treatment. The registered manager acknowledged communication with visiting professionals was not always good. However, they did not advise of any actions they had taken to improve and support effective communication. A representative of the provider told us they visited the service and undertook audits and checks; however these were informal and not recorded. The registered manager told us they were working with an external stakeholder to make improvements, which included the development of systems, processes and tools to assist with management and governance. The registered manager was able to share records to support this. Staff were not positive about the management and leadership of the registered manager. Staff spoke of poor communication, which included infrequent staff meetings and how they were conducted, which did not encourage or support staff contribution. A staff member told us when speaking of the registered manager, "I don't think she is interested in what you say". A second staff member described staff meetings by saying, "Sometimes senior meetings are held now and again. There used to be a carer meeting, but no one likes these as there are too many strong characters, nothing gets resolved." This limits the ability of the provider to develop the service and drive improvement, through a shared understanding of the needs of the service by all staff.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.