Moorhead Rest 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

We identified breaches of legal regulations. We found issues relating to the culture of this service and staff did not always feel listened to by the management team. Governance processes were not robust, and policies and procedures were not always being followed. Audits were not robust enough to identify the concerns found during the assessment process and there was a lack of provider oversight and quality checks. There were missed opportunities for lessons learnt as recent safeguarding concerns were not discussed in team meetings. Not all partners felt this service worked well with them to improve the level of care provided.

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.

Staff felt there was not always an open culture and advised of conflict in the management structure. Staff felt confidential conversations were passed on to other staff members and did not trust private conversations would be handled professionally. Staff told us they attended staff meetings regularly and that the newly appointed registered manager had attended a meeting to introduce themselves to the staff team. The director spoke of the appointment of the new registered manager who was due to commence their role and their plans to improve the service they offer.

We saw evidence of staff meetings taking place; however, the tone of these meetings evidenced a negative culture. A new experienced manager had been recruited and was waiting to commence their role. The new manager had been working closely with the directors to ensure improvements could be made to the service. Staff had completed training in equality and diversity.

Staff had mixed views on the management team and whilst some staff felt able to approach them, most staff did not feel this way. One staff member said, “They can’t keep things confidential. Everyone knows if staff have an issue.” Other staff members referred to the management team as ‘unapproachable.’ Staff told us they were supported, however, they felt if there was a problem, they wouldn’t be listened to or they wouldn’t be treated fairly. Staff did not hold confidence in the management teams experience.

Processes in this area were not robust. Staff meeting minutes evidenced a negative culture and did not record vital information such as recent safeguarding concerns which meant the opportunity for sharing and lessons learnt was missed. There were a range of audits in place, however, they were more of a tick box exercise rather than an analysis of events that had occurred. The audits were not robust enough to identify concerns found during the assessment process. We saw no evidence of provider audits or quality checks to ensure safe and effective systems were in place.

Staff told us they felt able to raise concerns should they have an issue. However, they felt this information was not always kept confidential. Staff knew how to access the whistleblowing policy.

Staff meeting minutes evidenced a poor culture where staff did not appear to be given the opportunity to speak up. We saw evidence of staff meeting minutes, handovers and supervisions, however, there was no evidence staff were invited to contribute any concerns they had about the running of the service during these meetings.

Staff told us they didn’t always feel that they were treated fairly. One staff member said when asked if staff were treated fairly, “Some are, some are listened to, and some are not, rule for one and not another.” Staff told us they felt certain staff members were favoured by the management team and their day at work depended on which members of the management team were working that day. Another staff member told us there was a disparity in how people were paid and that some staff were paid for training whilst others were not. Staff felt as a team they worked together to ensure a more positive workplace. The director told us they have clear policies in place for equality and diversity and that they actively monitor workforce diversity data and seek feedback from staff on their experiences of inclusion. However, we have not seen any evidence of this feedback.

Recruitment processes were not robust, and promotions were not evidenced. When a promotion occurred, there was no record of a formal interview taking place to ensure the person was suitable for their role. There did not appear to be an equal opportunities process. There was a lack of oversight in this area to ensure a fair and equitable workplace that was inclusive for all.

There was a clear conflict within the management structure and a lack of accountability when things went wrong. The management team often told us they were not responsible for certain tasks and there was no ownership of the systems and governance processes. Staff told us they knew the management team well and believed concerns relating to people’s care would be addressed in a timely manner.

There was a clear lack of oversight when it came to the safety and management of the environment. The fire service had recently served an enforcement notice with several works still outstanding to ensure compliance. There was a lack of robust auditing in place and no evidence of provider oversight of governance systems and processes. The audits that had been completed had not been reviewed so it was not clear what action had taken place where concerns had been identified. Notifications were not always being made to the Care Quality Commission as required, however, this was rectified during the assessment process. There were limited investigations into safeguarding concerns and there was no clear management structure or job description of managerial roles which led to important governance processes being missed. There was no registered manager in place, however, an experienced manager was going through the recruitment process.

Relatives told us their loved ones had input from social workers when needed.

The manager told us they worked alongside various stakeholders to improve systems and processes.

Feedback in this area was mixed. Whilst some partners felt they worked well with the management team; others found the management team to be challenging to work with. One partner praised the directors for their openness and willingness to take on board new ideas to improve the service they deliver.

The management team were working with various stakeholders including the medicines management team and the infection prevention and control team to improve systems and processes.

Staff and managers told us they had not had any conversations regarding recent safeguarding concerns and this information hadn’t been shared during team meetings. Staff did not always have trust in the leaders of the service and this meant opportunities for learning and improvement were not taken up.

Although we saw some evidence of lessons learnt, these records were brief and not detailed enough to learn from incidents that had occurred. There had been recent safeguarding concerns and there was no documented evidence of what action had been taken in relation to talking to staff, ensuring training was up to date or any measures to help prevent future occurrences. We saw no evidence of any outside resources used to help improve systems and processes to help mitigate future safeguarding incidents.