Paul Murphy Centre

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 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 remained requires improvement. This meant there were shortfalls in leadership. The providers governance processes were ineffective as they were not identifying key areas for improvement. The provider was in breach of legal regulation in relation to good governance.

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.

The provider did not have a clear shared vision, strategy and culture’ They did not always understand the challenges and the needs of people and their communities. The provider was not pro-active in monitoring and discussing where a closed culture could start to develop. When asked why some people often remained in their room, we were told, that was their preference, but we found no evidence people had been involved in decisions to promote inclusion and opportunities for people to grow, reach goals and be supported to become the best version of themselves. Staff were actively supported to enhance the knowledge of their role by completing additional health and social care related qualifications. Staff told us they worked in a positive environment, but some staff members told us, a change in their rota had impacted upon their rest days and they had suffered with tiredness as a result.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support. Leaders were visible and respected by staff and family members. The registered manager had improved the staff culture since their appointment, and this was evident from staff feedback. Additional support was provided to the registered manager by the nominated individual, but we found prior to the nominated individual’s appointment, the registered manager had not always been supported with regular supervision. A staff member told us, “[Registered Manager] is very helpful and if I want to know anything, I can ask them.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Staff were confident to speak up and told us they had read and had access to safeguarding and whistle blowing policies. Where concerns were raised, investigations took place, and an apology was offered. Complainants were informed of any actions to prevent the same thing from happening again.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them. The provider valued staff and staff confirmed they worked in an inclusive environment which was fair, and they were heard. Staff member of the month had been introduced which had increased staff morale.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. Governance systems were ineffective as they did not capture gaps in peoples care and support and health and safety measures were not robust across the home. Audits were in place to assess the efficiency of medicines management, but the process did not identify where there were gaps in the recording of fluid thickeners or where medicines were being crushed without the appropriate directions. The electronic care planning system was not being used to its full potential to assist the provider in identifying gaps. Some care records were not reviewed in the agreed time scales and where a care plan was reviewed, the reviewer was not identifying information which was inaccurate. For example, a person’s swallowing needs had changed, and the care plan had not been updated. A review of safeguarding found appropriate referrals had been made but there was a section on safe staff recruitment which did not identify where a staff member did not have satisfactory employment checks in place. The provider did not have an embedded process in place to ensure the health and safety of the home was continually monitored and assessed, both internally and externally. This put people at risk of unsafe care. Although the provider was operating before the guidance of right care, right support, right culture was available, they were not working to support autistic people and people with a learning disability to live an ordinary life and have the same rights as any other person.

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. There was regular engagement with commissioners and visiting professionals spoke positively of the registered manager’s willingness to improve the service. The registered manager had engaged with family and friends with regular meetings to provide updates about the service.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not always actively contribute to safe, effective practice and research. The provider’s model of care did not always align to current best practice of right care, right support and right culture which included ensuring people led a fulfilled life. Further work was needed to ensure people had the support to develop skills, have new experiences and live their lives the same as any other person. The provider was responsive to feedback from our assessment and actioned concerns immediately relating to the health and safety of the home and medicines management.