Grey Gables (New Milton) Limited

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 assessed 5 quality statements from this key question. We have combined the score for this area with scores based on the rating from the last inspection, which was good. We identified breaches of regulations relating to dignity and respect, good governance and failure to notify of significant events. The provider did not have effective governance systems in place to ensure people received safe, effective and good quality care. The provider was responsive to concerns raised during the assessment but did not send multiple requested records, and we were not assured shortfalls were always fully understood or would have been identified independently. People and staff shared positive feedback about the nominated individual, who was also acting as manager. Staff told us they felt able to speak up if they had concerns.

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 had not identified the service was not supporting people with a learning disability in line with statutory guidance, and staff did not have the skills to communicate with people effectively. For example, in the minutes of a residents meeting staff had recorded ‘nonverbal when asked’ as the response when they asked 3 people with a learning disability how they felt about their care. Another response was recorded as ‘a few residents are nonverbal so unable to answer’. Staff told us they did not use any communication aids, and communication care plans contained little information on how to support people. For example, 1 care plan stated ‘I do struggle to make myself understood’ but did not contain any information about how staff could support them with this. The nominated individual told us when they took over, they identified a poor and restrictive culture had developed under the previous registered manager. Staff told us they felt the home had improved since the nominated individual took over, and they were much happier than they had been previously.

Although the nominated individual had identified concerns under the previous manager, they had not completed a robust review or action plan. This meant not all issues had been identified or fully addressed, particularly in relation to the culture. For example, we found blanket approaches to monitoring people when there was no assessed risk or need identified, and without discussion with people. This included things such as bowel movements, food and fluid intake, night checks and recording every time people moved between rooms. This did not respect people’s dignity or privacy.

Feedback from staff about the nominated individual, who was acting as manager, was positive. Comments included, “[nominated individual] is very approachable, you can tell her things, and you know she’ll act on them” and, “[nominated individual] has good intentions, she’s always been open and honest and always wants to improve”. However, staff also told us they felt the nominated individual needed more management support. We had similar concerns about the amount of pressure on 1 individual with the amount of work required with no other management support. Following the assessment, the nominated individual told us they had implemented a new management structure.

Staffing meeting minutes showed, and staff confirmed, shortfalls identified on our first visit had been discussed at a staff meeting held shortly after. Although this was positive, we were not assured from conversations with staff or the meeting minutes that concerns raised had been fully understood or reflected to staff.

Staff told us they felt able to raise concerns and were confident they would be listened to, and their concerns acted on. The nominated individual was initially engaged and responsive to feedback throughout the assessment. They showed a clear passion for their work and wanted to make improvements. However, following the assessment it became challenging to receive a response, and we did not receive multiple requested records. In addition, some of the records received contained less, and some conflicting, information than what we already held. This meant we could not be assured of the accuracy of information shared.

Although staff told us they felt confident to raise concerns, there were not effective systems and processes in place to support this.

Before our assessment, we received concerns that included allegations of racism and bullying among the staff team. We spoke with a total of 9 staff members, including in private areas away from CCTV, and by phone. We also provided posters with CQC’s number, email address and the link to our ‘Give Feedback on Care’ form to ensure staff were able to provide feedback anonymously if they would prefer this. During our assessment we received positive feedback from all staff about morale and how they worked together. Comments included, “All our teamwork is very good here”, “I feel everyone is supported” and, “It’s all about care and compassion. We’re a jolly group”

The provider had an equality and diversity policy. However, meeting minutes showed 3 people had raised some concerns about some staff members understanding of English. The provider had not considered the potential impact of this on the staff members or people or taken action to support staff to improve their English. We found similar concerns during our assessment. When we fed this back to the provider, they told us they would look into learning resources with staff to see how they could best support them with their English.

Although we received mostly positive feedback from staff about how the service was managed, we were concerned this demonstrated a lack of understanding of the shortfalls we found in relation to clear and effective governance arrangements.

There was a lack of robust oversight, management structure and no overarching quality assurance system. When audits were completed, they were not effective and did not identify the shortfalls and breaches of regulation identified during our assessment. For example, for April there were a minimum of 14 incidents or accidents in people’s records that were not identified in April’s audit. They had also not identified when notifiable incidents had not been reported to CQC as required. Although there was a manager registered with CQC, they had not worked at the service for over a year. We had not received any application to de-register, or to register a new manager. The provider told us these were submitted but has not provided evidence of this despite multiple requests. Following our assessment, the nominated individual sent us an action plan which addressed some of the concerns identified.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.