Arlington House

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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 one breach of the legal regulations. Systems of audit, quality monitoring and governance were not in place at the service. This lack of oversight from the provider had resulted in several areas of practice, such as the reviewing of risk assessments and person centred care planning not routinely happening. This resulted in a breach of good governance. You can find more details of our concerns in the evidence category findings below. We assessed a limited number of quality statements in the well-led key question and found both areas of concern and good practice. The scores for these areas have been combined with scores based on the rating from the last inspection, which was good. Our rating for the key question has changed to requires improvement. The manager was aware of the issues and an action plan with timescales and dedicated members of staff to drive improvement at the service had been developed. People and staff were positive about the overall culture and leadership within the service. Staff were aware of the improvements required and were positive these improvements would take place. However, it will take time and more work for the new systems and improvements to be fully implemented and embedded throughout the service.

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.

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

Staff and leaders demonstrated a positive, compassionate, listening culture that promoted trust and understanding between them and people using the service. Staff commented they had a good understanding of their roles and responsibilities. Staff told us the care of people living at the service was the most important aspect of their work and they strived to ensure that people received high quality care. Staff explained they felt supported and motivated by the leadership at the service. One member of staff told us, “We always do the best we can, the manager always makes us do that and helps us to be the best we can be.” Another member of staff said, “We are a good team, full of support and love. The manager has changed a lot of things for the better.” The manager added, “Staff can come to me at any time, they know that and they know I am there for them. I am working very hard with the support of the staff and the provider to implement and embed new systems.” Staff told us they felt the service was well-run and they had built good relationships with leaders.

The current management of the service were aware of the previous issues in relation to supporting staff and the culture at the service. They were in the process of planning to put systems in place to support staff and improve the morale and culture. These new systems included scheduling one to one meetings with all staff, holding group meetings with staff to gather feedback from them to improve the service. The manager had a comprehensive action plan which included development and improvements of the homes culture, vision and direction. Although improvements had been seen more time was needed to ensure that robust leadership, direction and culture was fully embedded throughout the service.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The provider was open and transparent about the current issues at the service. They stated the issues encountered were due to the previous manager not being honest about their failings and effectively hiding the work they had and had not done. This had gone on for several months and the provider had not had robust oversight of the work the previous manager was doing. The provider stated he felt it was a mistake also being the registered manager, but not having a hands-on role. Once he was aware of the issues, the previous manager was removed from the service, a new manager put in place and alerts raised with both the local authority and CQC. A new manager was in post and had started the process of registering with the CQC. The new management arrangements were creating a progressive environment, with staff feeling more supported and morale improving. The manager told us, “We’ve been let down very badly, the previous manager has done nothing for almost a year. We’re having to start from scratch with the things that have been hidden. I have had to change virtually everything to stabilise the home. I keep finding more, but one thing I can guarantee is that the care is good and safe, and people are happy.” Staff echoed this. One member of staff told us, “I started with the old manager, things are very different now. They just sat in their office with the door closed. The new manager is very supportive and out on the floor supporting us all the time. She listens and helps us.”

The provider had failed to ensure effective systems were in place to monitor and mitigate risks to people. The provider failed to have appropriate oversight of the systems and process in place to ensure the service was run safely and in line with the Regulations. Regular audits had not been carried out which resulted in care records and risk assessments not being consistently reviewed. Policy and procedure documentation did not reflect the systems and processes being used, such as around the administration of medicines and reviewing people’s care. The manager was aware of the issues and an action plan with timescales and dedicated members of staff to drive improvement at the service had been developed. However, it will take time and more work for the new systems and improvements to be fully implemented and embedded throughout the service.

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.