Halland House

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

We found improvements were needed to some aspects of governance and record keeping at Halland House. Improvements were also needed to some care plans and risk assessments to ensure they contained all the relevant information to guide staff. The management team had identified improvements were needed at the home. Changes had been introduced and this included a range of checks and audits. Action plans had been developed to address the identified shortfalls and these were regularly reviewed at weekly management meetings. However, these had not always been recorded and did not identify all the areas for improvement we found. Although some staff told us they did not feel supported all staff were committed to improving and developing the service for the benefit of people.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Over the past 2 years there had been significant changes in the management of the service. This included new directors, manager and a consultant. When they started in post they identified a number of areas that needed to be improved and developed. They drew up an action plan to move forward. The management team were committed to this new direction. They told us that whilst a lot had been achieved they were aware there was still work to do. They told us there had been a culture change for staff. This included staff being held accountable for their actions and for example being responsible for the updates of care plans. In general staff spoke positively about the changes at the home. All staff were committed to improving and developing the home for people, to improve their quality of life and outcomes. One staff member said, “It’s a different place, we’re now doing what I thought we should be doing anyway.” However, some staff told us they were now supporting people with more complex needs and this was a direction with which they were not comfortable.

There had been changes to the structure of the service with Halland House being divided into 3 separate houses with its own staff team. Each House was overseen by a team leader. There had been changes to how people were supported each day. The support was based on people’s choices and preferences and how they liked to live their lives. Work was ongoing to ensure staff received the training and support needed to develop the service for the benefits of people and staff.

Not all staff felt supported by the management team. The management team was aware of the importance of developing a supportive and consistent team and to share findings and areas for development with the wider staff team. They had the knowledge and skills to lead the service compassionately and inclusively.

There was a clear management structure which included an on-call system. Staff were regularly given opportunities to feedback any issues through supervision, staff meetings and an open door approach within the management team. However, staff did not always feel able to discuss issues with the management team. Following the inspection, we discussed the feedback received from staff with the provider and management team as an area that needs to be improved.

Staff told us they understood the Whistle-blowing policy and how they would report any concerns related to people’s care and support to the management team. They also told us how they would raise concerns outside the organisation if they were concerned appropriate action was not being taken. However, some staff said they were reluctant to raise some concerns to the management team as they were concerned this may have a negative impact on them or their employment at Halland House. Whilst other staff were confident to raise issues and know they would be addressed. We received the following differing feedback from staff. One staff member said they were told the managers door is always open but thinks they are just going through the motions as the managers are always busy. Another staff member told us they can speak up and managers will act on issues.

There was a Raising concerns, Freedom to speak up and Whistleblowing Policy and Procedure. Staff were regularly asked for feedback in meetings and supervision. The management team undertook regular walks around the home and engaged with staff in an informal way which gave the staff an opportunity to discuss any concerns. However, as discussed in Workforce wellbeing and enablement in the Caring key question staff did not always feel able to discuss issues with the management team. Following the inspection, we discussed the feedback received from staff with the provider and management team as an area that needs to be improved.

Some staff told us they felt there was some divides within the team which made them feel on occasions the staff team was not inclusive. Other staff told us they felt the team was supportive of all staff. Some staff from overseas told us about support from the provider when they moved to the UK and commenced work at the home. This had helped to ensure they settled into both a new home and a new workplace. The management team told us as far as possible they supported staff with reasonable adjustments to enable them to work. This included taking into account individual staff abilities and adjusting hours to support staff when personal issues arose. There was a zero approach to bullying, discrimination and racism.

Staff received Equality, Diversity and Inclusion training. There was an Equality and Human Rights policy. They received regular supervision and themed and observational supervisions were currently being introduced. Following the inspection, we discussed the feedback received from staff with the provider and management team. They told us they would work with staff to identify and address issues found.

The management team told us about the changes and improvements that had been made and were being implemented since they were in post. They were committed to learning, improving and developing the service. They told us about a new governance system which was being implemented to ensure appropriate oversight of the services. This included daily weekly and monthly audits. They told us they were aware more work was needed and this improvement process would be on-going. Some senior care staff were now involved in completing audits and they told us they enjoyed being involved in this aspect of the service.

A governance system was being developed. This included daily weekly and monthly checks and audits. Individual audits identified actions and these were reviewed by the management team each week. Dates were set for action to be taken. Although the management team had good oversight of people’s support needs and some improvements and developments that were required this was not always demonstrated through clear records. Whilst the management team could tell us what actions they had taken or were planning, this was not always recorded to demonstrate if actions had been completed in a timely way or the outcome of the actions. There was a reliance on verbal information being shared amongst the management team. We found some areas where audits had not identified the shortfalls we found. This related to the medicine records, care planning and risk assessments. Some care plans and risk assessments lacked information or had not been updated in a timely way. Information about people’s care and support was not always stored in a consistent way to make it easily accessible for staff. Staff knew people well and this knowledge limited the impact the lack of information could have on people’s care. We also identified that governance arrangements had not always been effective in ensuring the home consistently adhered to the conditions of their CQC registration when 2 statutory notifications had not been submitted. The registered manager undertook a daily walk around and used this time to identify areas that needed to be addressed. This time was also used to follow up, for example, on cleaning audits to ensure that actions had been completed.

People and their relatives told us appropriate health and social care professionals were contacted appropriately when required.

Staff told us how they would contact relevant external professionals to meet people’s needs.

Feedback from external health and social care professionals were generally positive. They told us people were referred to them appropriately.

Staff worked with various external agencies including, GPs, community nursing teams, social workers and Local Authorities. Relevant information was shared appropriately.

Staff spoke about the training and explained that whilst some of it felt less relevant to supporting people with a learning disability they acknowledged people were getting older and their needs were changing. One staff member said, “I think they (management team) recognise the changing needs and are making sure we have the knowledge to support people in the future.” Some staff told us they were now supporting people with more complex needs and this was not a direction with which they were comfortable. This is an area of learning that needs to be developed with staff. The management team told us how they recognised the importance of learning lessons and continuous improvement to ensure they people received care and support that was safe and effective.

There was a governance and audit system and this was being developed to support the management team. There were regular reviews to analyse safeguarding concerns, complaints, accidents, incidents and near misses. This enabled them to identify emerging themes were identified and take action to reduce the risk of reoccurrence. Whilst this was in place further time was needed to ensure it was fully implemented and embedded into practice and actions taken clearly recorded.