Dorandene - Care Home Learning Disabilities

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

The service did not have a registered manager at the time of the inspection and had not had a registered manager in post since May 2023. However, there were plans in place for the current deputy manager to submit their application to register with the Care Quality Commission. The current deputy manager was being supported by an experienced interim manager. People and staff told us they knew who the management team was and that they were approachable. There was generally an open and inclusive culture at the service whilst there were still areas of improvement from the last inspection. The management team’s values needed further time to become embedded in the service, Whilst staff did not always know the organisation’s values, they understood how to be respectful and inclusive. People’s care had improved due to the management team’s work and partnerships with external agencies, such as community healthcare professionals, but there were still areas of improvement. The provider had policies and networks in place which championed equality, diversity and inclusion. The provider told us about the systems that were already in place such as the employee assistance programme and various employee networks, and the plans they had for improvements. The systems in place to audit the service were not always robust enough. The provider had undertaken a recent quality assurance audit and identified this. This had already been addressed by the new management team who had a strategy to regularly audit all areas of the service.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The management team promoted an open culture across the service. Managers were visible and approachable throughout our site visits. Staff told us they felt supported and could approach management with issues. Whilst staff could not always recall the wider organisation’s values, they told us they knew how to ensure there was a positive culture and atmosphere in the service. The management team told us they had a strategy for embedding the organisation’s and their own values within the service.

The service improvement plan did not specifically address cultural changes which needed to be made. There was a focus to manage staff sickness which was not being managed under the previous management and there was a focus on organising the records and paperwork which would have a positive impact on the culture of the service. Staff meetings addressed changes to be made to the environment and staff skillset. We did not see a discussion about values and culture within the service.

Staff told us they generally felt heard by the management team and felt included. However, we saw from staff meetings that there was a lack of recognition in relation to staff achievements.

The service did not have a registered manager at the time of the inspection and had not had a registered manager in post since May 2023. However, there were plans in place for the current deputy manager to register with the Care Quality Commission. The current deputy manager was being supported by an experienced interim manager. Staff supervision meetings were recorded as a list of actions without evidence of a mutual discussion. There was a lack of evidence of leadership showing an understanding or acknowledgement of staff input. This was also the case with team meetings. Team meetings were led with honesty and there was evidence of compassion for people receiving a service with actions to address identified issues. However, there was a lack of recognition for the work done by staff. The manager had communicated with people and relatives via an introductory letter which included compassionate intentions and encouraged inclusion from those receiving the letter.

Staff told us they felt able to speak up and were aware of the whistleblowing policy. We saw whistleblowing and safeguarding posters displayed in the service.

The provider had a whistleblowing policy in place which stated that staff would receive support and protection from reprisal if they were to raise a concern. There were contact details providing various options for staff to make contact. Supervision notes and team meeting minutes lacked evidence of a dialogue with staff and a lack of staff voice which indicated that speaking up during these opportunities had potentially been missed.

Staff told us they generally felt valued and respected in their roles by the management team. However, some staff commented that workloads were not always shared equally. The management team told us they had already identified this and were working to upskill staff in order to take on further responsibilities.

The provider had policies in place which championed equality, diversity and inclusion. The provider told us about the facilities which were already in place such as a dedicated health and safety department and an employee assistance programme, and they provided information on future plans for the service and the wider organisation. The Provider Information Return (PIR) stated that the provider has set up Networks to represent diverse groups within the organisation such as a Women’s network to celebrate and champion work by women, transwomen and those who identify as non-binary, the Pride network which champions the rights of LGBTQ+ colleagues and their allies, and the Disability Employee Network for any colleague with a disability or chronic condition. The PIR also stated that staff have regular one to one supervisions to create an open-door policy and so staff could feel comfortable to approach management on professional or personal issues that relate to them. However, we found that supervisions were up to date for only 30% of staff which meant these opportunities had been limited. The management team provided evidence of group supervisions having taken place which they had counted towards supervisions and provided assurances that every staff member would receive a one to one supervision as a priority.

Staff told us they knew their roles and responsibilities and felt supported by the management team to fulfil their accountabilities. Staff told us they were held accountable by the management team and that the management team reiterated areas of improvement until these had improved sufficiently. However, we found that the management team’s values needed to be embedded in the service further.

Audits had not been completed since the previous manager had left the service in January 2024. Prior to that they had not been routinely completed and had not always identified the concerns we found within the assessment. For example, despite prompts within the audits, the need for Learning Disability and diagnosis specific training to be delivered in line with RSRCRC had not been actioned. Audits lacked evidence for the judgement and analysis made by the person completing them. We saw concerns had been raised within staff supervision about the environment, but this had not been identified and actions had not been clearly recorded to address the same concerns within audits. There had been a more recent Quality Assurance audit which identified multiple service wide concerns which indicated a lack of sufficient governance oversight up until that point. For example, fire safety practices were previously not always being completed. The new management team was aware of these areas already and had a plan for prioritising. This included working more closely with external partners, which we could see happening. It also included ensuring the staff team were accountable for their actions. This had resulted in a staff turnover which had resulted in a period of inconsistency. There were now key workers in place again and we saw improvements had been made but there were areas where further work was ongoing, such as ensuring all staff have completed all of their training. We contacted the provider following our site visit who provided assurances including that they were recruiting a specific team to oversee the service.

Since the last inspection, relationships with partners and communities had improved. People were benefitting from a improved relationships as they were able to join local communities and services including healthcare and social services. We saw external trips being prioritised on the days of our site visits. This sometimes meant that people who remained in the service were not always receiving the same level of attention. The management team told us they were working on this by recruiting further staff and reducing the number of agency staff so that there was more consistency and people could choose a regular member of staff to join external activities with.

Staff and the management team told us they had prioritised external activities because people said that they enjoyed these the most. Staff had tried to ascertain whether people would like to join religious groups and whether people would like to go for regular meals. The management team acknowledged that there was further work to be done but were proud of the progress and the way this had improved people’s quality of life.

Feedback from partners was mixed with some commenting that there had been improvements and others commenting that the improvements were too slow, partly due to the frequent changes in leadership.

The provider is within support measures led by the local authority which require monthly attendance. The provider is engaging with this process. The service improvement plan states that managers will be attending the local 'Redhill Network' Group to share good practices and find connections for volunteer groups to support with maintaining the grounds. There was a plan for providers to be invited to Dorandene events throughout the year, such as garden parties and fun days.

The management team was engaging with the local authority’s support measures to achieve compliance across the service. The management team and provider representative were receptive to our feedback and provided assurances that they were overseeing the service. The management team and provider took immediate action when we informed them of the impactful issues we identified in this report.

The lack of current auditing and quality assurance measures meant that there was not an account of the current outcomes for people receiving a service. There was therefore not a baseline from which to measure improvement to peoples experience. We saw no evidence of contribution to research. There was a service improvement plan in place which demonstrated actioned and planned improvements as a result of the last inspection.