Charnwood 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

We identified a breach of the legal regulations. The current management structure had poor oversight and governance of the care home. The care home had a new manager in place. Concerns raised at the assessment by the CQC, were not acted on effectively. Staff told us that they did not feel listened too or well supported by the management. There was a poor culture in the staff team, where staff felt they did not work well together. The service used an electronic computer system. This system prompted staff to complete tasks (like helping people drink enough). However, staff did not keep good records on what they did. There was ineffective oversight of this system.

This service scored 25 (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 poor culture in the staff team. Staff reported a tendency for staff to ‘gossip’ and not communicate effectively. Staff told the inspector that the staff team did not always work effectively together. Some staff referred to others as ‘Lazy’. Some staff explained that poor teamwork was due to poor quality training across the team. They felt that staff culture issues raised to the senior management team had not been effectively addressed.

There were poor processes in place, to ensure that there was always a well deployed and skilled team working. Training documents showed us that staff were not always well trained and rotas showed us that some shifts had multiple unskilled staff working at the same time. During the assessment, we also saw staff were not effectively deployed across the care home. So some areas had multiple staff, and others did not have sufficient staffing. Staff told us that it was particularly difficult to support communal lounges in the morning, and there was a lack of leadership to deploy staff effectively to the areas that needed increased staffing.

Staff fed back negatively about the leadership team. Multiple staff reported that the management team spent long periods of time in the office and were not visible around the care home. The manager in place was new to the service and explained that a newly employed clinical lead in the care home would allow more support to the staff team. This new staff member started employment during our second assessment visit. We have therefore been unable to assess their effectiveness on improving the leadership in the home.

Processes were in place for staff to have supervisions. These were one to one meetings with senior leadership to reflect on their work. While these processes were in place, staff reported low wellbeing and not feeling listened too.

Staff reported that they did not feel the management team listened to them when they reported concerns about other staff. One staff member said, “I reported incidents on another staff member, but nothing was done. I feel like I don't have a voice and that I don't matter.”

The service had given staff training on how to speak up about their concerns. There was also policies in place to guide staff. However, these processes had not positively impacted staff’s ability to speak up.

Staff felt that there was not always opportunities to progress to more senior roles, or try alternative roles in the organisation. The new manager explained that they intended to review staff skills and consider changes to the organisational structure. Following the assessment, the management team have advised that some staff have already been supported to move within the organisation.

Staff had engaged in equality and diversity training. There was also a policy in place for staff to follow. Despite this training, staff reported that the staff team did not always treat people well. This is because care was structured around routines in the care home, rather than people’s unique needs.

Staff told us that the management team did not clearly delegate tasks and oversee the care home. Staff explained that they did not receive effective feedback. One staff member said, “We only get negative feedback from them. They aren’t interested in staff wellbeing.” Another staff member said, “If I have made a mistake I was often told through gossip. Never did the management or senior to me come and inform me what I had done.”

The service did not effectively use their electronic care planning system. The system allowed staff to document what people’s care needs were. However, there was inconsistent or poor-quality information on what support a person needed. Monthly reviews had occurred, but not identified and resolved these care planning issues. The electronic system would prompt staff to provide support. However, we saw that these prompts were not effectively responded to. For example, a person needed support to change their medical device once a week. Records showed that the day of the week repeatedly changed, and sometimes the person went more than a week without the device being changed. We raised this risk to the management team and saw electronic prompts were still not effectively responded to at our second assessment visit. We were not assured that records were accurate. A staff member had written that they had checked someone’s bed rails, however this person did not use bed rails. Staff had also not clearly recorded that a person had been distressed during the day of our assessment visit.

People told us that there were some activities in the care home. However, they had not been involved in deciding what they would like to do. We observed a baking activity that 3 people enjoyed. However, the rest of the lounge were left without social activity. Some of these people were seen to be withdrawn or distressed.

The staff team explained that people did not always receive meaningful activities. One staff member said, “The activities are very rare and the activity co-ordinators are asked to do everything else but activities”

We did not receive feedback for partners in this area.

We reviewed records of what activities people were offered. The activities documented were not good quality. For example, in two months one person was recorded as watching TV three times, playing hangman once and participating in cooking once. This person was not engaged in any meaningful activities during our assessment visit and varied between being distressed and withdrawn. There were no processes in place to assess what activities this person would prefer to be engaged in. There had been no assessment of the person’s ability to access the local community.

The staff team felt that they were not involved in improving the service. A staff member said, “They need to start involving people on the ground when coming up with some decisions.”

There was a new manager, who had been in place for 3 months. We saw that they audits completed by the manager had not resulted in improvements to the service . The service had a nominated individual, this person is legally responsible for the safe running of the service. We requested but were not provided with any evidence of audits by the nominated individual. We were therefore not assured there was good oversight of the management team and effectiveness of the service.