Hatton Grove

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 inspection we rated this key question good. At this inspection the rating has changed to requires improvement. This meant the service management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care. We identified a breach relating to good governance. The provider’s systems for monitoring and improving quality as well as monitoring and mitigating risk had not always been operated effectively. Whist people received personalised care, this was not always safe and the provider’s checks on the environment, cleanliness and medicines management had not always identified risks to safety. Records were not always accurate or up to date. This meant there was a risk people would not receive appropriate care and support. The manager had recently started work at the service and was not registered with CQC. They had previous experience of working at other services and demonstrated a good knowledge about best practice. Staff, people using the service, and their relatives liked the manager and thought they had introduced some positive changes. The manager worked with other care services to understand and develop best practice. There was a positive culture at the service, where all stakeholders felt supported and empowered. We did not assess all the quality statements within this key question. We did not identify concerns relating to these areas which we judged as being met at our last inspection.

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.

There was a positive culture at the service. People using the service, staff and relatives felt empowered, involved and respected. Comments from people’s relatives included, ‘’It is a home from home’’, ‘’I cannot fault it’’, ‘’The staff are wonderful, helpful, friendly and caring’’ and ‘’This is a vital service.’’ The staff spoke positively about their experience working at the service. They told us they would recommend it as a place to work and a place for a loved one to be cared for. We witnessed staff being respectful to people using the service and each other. This included the manager who took time to praise staff for good pieces of work, to ask questions about their practice and to share their experience and ideas.

There was no registered manager at the service. The manager had started work a few months before our assessment. They told us they were in the process of applying to register with CQC. They were experienced and had a management in care qualification. Relatives and staff praised the managers open and transparent approach and told us they were supportive and knowledgeable. An external professional told us, ‘’[Manager] is working well to clarify processes and put clear policies in place. I have great communication with [them].’’ The manager worked closely with other managers of local care homes to develop systems and learn from each other. The manager praised the staff team telling us, ‘’The staff are very knowledgeable and committed.’’

There were suitable procedures to enable staff and others to speak up if they had any concerns. They staff were familiar with these and told us they felt confident raising concerns.

The provider’s systems for monitoring and improving the quality of the service had not always been effectively operated. During our assessment we identified risks within the environment and with medicines management. Despite regular audits and checks, these risks had not always been identified and had not been mitigated. Some records were reviewed were out of date, not detailed enough or inaccurate. For example, we reviewed some care plans and risk assessments which included templates with the wrong person’s name. Where updates had been added, these were not always clear and it was sometimes hard to identify the relevant current information. The provider had recently started to undertake audits of medicines. We were not assured that improvements had been made following these or that they were sufficient to improve quality. For example, where administration records had gaps, these had not been identified or followed up. Failure to effectively implement systems and processes to monitor and improve quality or monitor and mitigate risks placed people at risk of receiving inappropriate care and treatment.

The provider’s systems for learning and improvement had not been fully embedded. Whilst the manager had introduced new checks and audits, these were not always effective and staff custom and practice had not always been challenged. For example, staff routinely left records about people’s care unsecured in communal rooms, did not lock away cleaning products and did not keep laundry and sluice rooms in a poor condition. This meant the staff were not always following best practice regarding safety or confidentiality. The provider supported staff to attend a range of training and work with others to understand about best care practices, including working with people with a learning disability, supporting people with complex needs and end of life care. The manager had information about latest guidance as well as changes in legislation displayed and they shared these with staff. These were discussed at team meetings to help staff learn from these and ensure practice was in line with required standards.