Chase House Limited

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 requires improvement. At this assessment the rating has changed to inadequate. This meant there were widespread and significant shortfalls in service leadership. Leaders and the culture they created did not assure the delivery of high-quality care. The service was in breach of the legal regulation in relation to governance. The provider had not always ensured their systems were effective or ensured oversight of quality, safety and management of risks.

This service scored 32 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service did not always have a clear shared vision, strategy and culture based on transparency, equity and equality. Leaders had failed to disclose information in a safeguarding referral they had made and left out a physical struggle between a person and the staff member indicating potential assault to the person. Mental capacity assessments not being undertaken meant we could not be assured the service always considered the least restrictive decision for people that was in their best interests. We observed and received feedback from people about them being ignored. These increased risks related to the service not always having a positive listening culture that promotes people's rights.

The service did not demonstrate they had capable leadership with the right skills and knowledge. We identified breaches of the legal regulations and concerns in areas such as safeguarding, safe care, person-centred care, consent and governance. Leaders had not independently identified and acted on these concerns prior to our assessment. Although staff felt they could approach leaders with concerns and they would be addressed, leaders were not always proactive in identifying poor practices that could impact the quality of people’s care and well-being. However, relatives felt the registered manager was approachable. A relative said, “I know the manager, she’s very approachable, she is often out and about, and I can ask questions as needed. She seems to know everyone.”

We could not be assured of the freedom to speak up. Due to our findings that safeguarding concerns and incidents were not always reported by staff or identified by the provider, we could not be assured people, and their relatives would be informed of these promptly and would be given an apology where required. Following CQC sharing safeguarding concerns with the local authority safeguarding team, we learnt people and their relatives had not been aware of these concerns.

Although the staff we spoke with did not raise any concerns about workforce equality, diversity and inclusion, we cannot be assured that all leaders valued diversity in the workforce. A leader told us it was their preference to have “white Western staff” as they felt overseas staff were task-orientated due to working to send money back home; this demonstrated a lack of cultural awareness and racial stereotyping and did not promote equality, diversity and inclusion in their workforce or the services culture.

The service did not have good governance systems in place. They did not act on the best information available to them about risk, performance and outcomes. The provider had not identified concerns related to safeguarding, managing risks, medicines, the safety of the environment, care planning and ensuring people always received person-centred care. We found people were at risk of being exposed to harm during this inspection.

The service did not always demonstrate they understood their duty to collaborate and work in partnership, to promote services working seamlessly for people due to the safeguarding concerns we identified during this assessment. However, the service continued to maintain professional links with the local authority and other health and social care teams to ensure people's health needs were met.

The service did focus on learning, but its systems were not always effective in identifying or making improvements. For example, although audits were in place around tissue viability, monitoring incidents related to people's emotional distress, medicines administration and environmental safety, these had failed to identify shortfalls in staff practice or inform improvement needed and ensure these were acted upon. This increased the risk of people receiving care that did not meet the minimum standards we expect.