Patron 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 assessed all the quality statements in this key question. We found a breach of regulations. The provider had systems such as audits to monitor the quality and safety of the service, however these were not always effective. They did not always identify or address the issues we found during this assessment. For example, in relation to safe staffing, medicines management, infection prevention and control and the submission of CQC notifications. At the time of our assessment, the service did not have a registered manager in post, but a process was underway to recruit to the management team. Managers were visible, and staff found them approachable. The acting manager knew the staff team well, which meant prompt action could be taken when support was needed. Staff and leaders were committed to providing a good service to the people who lived at Patron House. Results of a recent staff survey indicated staff felt they could speak up and there was a positive culture where equality, diversity and inclusion was promoted. The provider had a range of initiatives in place to support staff’s diverse needs. We received positive feedback from health and social care professionals. They told us they felt staff had the best interests of people at heart and aimed to provide a good service. The provider was keen to promote ongoing service development and innovation.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff and leaders promoted a positive culture and were committed to providing a good service to the people who lived at Patron House. This reflected the provider’s vision which focused on supporting people to live healthy and independent lives, helping them make informed choices and responding to individual needs. Staff were aware of the importance of equality and diversity and respected individual needs and preferences.

Regular team meetings, handovers and supervision helped staff to feel involved in the service. The results of a recent survey suggested staff felt valued, respected and included in the workplace.

At the time of our assessment, the service did not have a registered manager in post. The previous registered manager had retired, and a process was underway to appoint a new manager. The provider was keen to make sure recruitment to this post was robust to ensure the leadership of the service was effective. Staff felt the management team were approachable and led by example. One staff member said, “I like [acting manager], she’s getting a lot more done. There’s been a few managers in a short space of time. I do feel listened to.” The acting manager told us their overall experience of working for the provider and with other staff and managers was positive. However they also felt they may benefit from more support at times. The managers present during this assessment were open to challenge and feedback. Although they had not been aware of some of the issues and concerns we identified, the team addressed these promptly.

The provider held monthly manager’s meetings to develop the team and share best practice. The provider sent us information about their management development programme which aimed to develop managers from existing employees within the company by creating learning and networking opportunities.

There was a positive culture where staff were encouraged to share their views. Most staff and people felt confident that the management team would listen and address any concerns they had. Comments from staff included, “I am able to speak to my line manager, straight away. [If not listened to] I would go to the next manager, and then keep going step by step” and “Sometimes you get help sometimes not. Some staff keep quiet. Managers are able to help.”

Staff had access to policies to support them when identifying concerns or raising issues. A complaints process outlined how people could raise concerns if they were unhappy with the service. Feedback from people and staff was gathered via resident meetings, staff supervision and surveys. Feedback was generally good, although the actions taken to make improvements were not clearly documented in meeting minutes. We highlighted this to the management team during the assessment.

There was a diverse workforce, and an awareness of equality, diversity and inclusion. The acting manager knew the staff team well, which meant prompt action could be taken where necessary to support staff. They told us what they had done when a staff member reported concerns. Results of a recent staff survey indicated staff felt there was a positive culture within the service and the provider promoted equality, diversity and inclusion in the workplace. For example, 100% of the staff who completed the questionnaire felt they were part of an inclusive culture at work which welcomed and reflected diversity.

Staff had access to policies relating to equality, diversity and rights. This helped ensure staff were treated fairly and their needs could be met. The provider had a range of initiatives in place to support staff’s diverse needs. For example, confidential counselling services, financial advice and wellbeing support.

Staff understood the expectations of their role and had regular contact with the management team to discuss issues, challenges or changes. The acting manager told us they were aware of some shortfalls, such as the weekly medicines audit not being regularly completed and issues with staffing which were impacting on cleaning and staffing on night shifts. Sufficient changes had not been made in a timely way to improve these areas. There had been several recent management changes. We were told one of the senior managers had submitted an application to register as a manager with CQC, although we found no record of this. The recruitment of a permanent manager for the service was due to progress in September 2024.

During this assessment, we found a range of service level and provider audits were in place to monitor the quality and safety of the service, but these were not always effective. The provider’s systems did not always identify or address issues we found during the assessment. For example, in relation to medicines management, infection prevention and control and staffing levels as already described. In addition, we found some incidents which happened at the service had not been notified to CQC as required. This was an oversight, and statutory notifications were submitted to CQC following our visit. Whilst we did not find evidence that people had been directly harmed by these issues, risks were increased because the systems were not robust enough and there was not sufficient oversight of the service at the time of our assessment. The provider took prompt action to respond to the concerns raised and make improvements.

People and their relatives told us staff referred to health and social care professionals to ensure individual needs were met. People were encouraged to maintain relationships with those who were important to them, and visitors were welcome in the home.

The management team told us they worked in partnership with other professionals. Staff told us the support of health and social care professionals was important in providing a good service and they shared positive experiences of when people’s health or wellbeing had improved. For example, one staff member told us how they had worked with managers to arrange an occupational therapy referral so that a person could get equipment to support their independence and safety.

We received positive feedback from health and social care professionals. They told us they felt staff had the best interests of people at heart and were open to engaging with them to provide a good service. One professional said, “All of the carers I know do their utmost to help residents live their best lives.”

The provider worked in partnership with other organisations to support care provision, service development and joined-up care. This included a wide range of health and social care providers as well as education providers and organisations such as the National Association of Care Catering and Care and Support West.

Most staff told us they were encouraged to speak up and had opportunities to feedback to management during informal conversations, supervision, team meetings and staff questionnaires. Not all staff said they had received a questionnaire. The recent staff survey indicated staff felt their feedback would be listened to and responded to. Managers and the staff team were committed to providing a good service. During this assessment managers acted promptly to address shortfalls.

Staff confirmed that learning from incidents was discussed in handover and staff meetings. However, learning from incidents was not well documented to support reflection and collective problem-solving. The management team confirmed the procedure in place for documenting medicines errors and sharing learning was not being followed. Changes were made in response to feedback and the management team told us about the improvements they made during the assessment. The provider was keen to promote ongoing service development and improvement. There were strong external relationships which focused on improvement and innovation.