Prinsted Care Home

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

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to the governance at 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.

The provider had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

There was a positive culture at the service. People and their relatives described the service as being inclusive with a homely and welcoming atmosphere. One person told us, “It’s a great place, where everyone works together, from the lovely manager to the cleaners and kitchen staff.” A relative told us, “All the staff are very kind and attentive, there is a good atmosphere.” Staff spoke positively about their experiences, one staff member said, “The best thing is that everyone is friendly and cares about the residents.” Another staff member told us, “It’s really like a family here.” A third staff member described “good camaraderie” between staff and people who lived at the service. We observed that staff were friendly, gentle and kind in their approach to people.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

People, their relatives and staff spoke highly of the management of the service. People’s comments included, “The manager is lovely, a very kind and caring lady.” A relative spoke highly of leadership at the service. They told us, “There is good staff interaction, which says a lot, and a good clarity of structure.” Staff described being well supported in their roles and spoke positively about the management structure. One staff member said, “If we have a problem we can go to a team leader or the nurses or the manager, they are all very approachable.” The registered manager was described as being, “hands on” and was knowledgeable about people and their individual needs. A health care professional told us, “The manager is friendly and readily available, with genuine concern for all the residents and staff.”

The provider fostered a positive culture where staff felt they could speak up and their voice would be heard.

The provider had systems to support staff to speak up. Staff said they felt able to raise any concerns or ideas they had and gave examples of when they had done so. One example was about a change to staffing levels that had been resolved. A staff member said, “We took it to the manager, and they sorted it out quickly.” Another staff member gave an example of how their ideas had been considered and accepted. They said, “We needed a better way of allocating tasks on a shift, and now we have a clear check list, it’s working well.”

Staff told us they felt able to speak up if they had made a mistake. One staff member said, “I’m not afraid to tell them if I make a mistake because it’s a very open atmosphere.” Another staff member said, “I went straight to the nurse when I did something wrong. They explained everything to me.”

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The provider had recruited a diverse workforce and promoted a fair and equitable culture.

Staff had received training in equality and diversity and described strong teamwork, where staff supported each other and felt valued in their roles. One staff member said, “There’s a good bond (between the staff) and we help each other out.” Another staff member described how they were supported to follow their religious beliefs. They said, “We are all respected and given the time we need.”

The provider did not have clear systems of accountability or good governance.

Governance systems were not always effective. Shortfalls in the management of risks relating to choking had not been identified through systems for monitoring incidents and accidents.

Inconsistencies within care records relating to the management of risks of choking had not been identified through the provider’s monitoring, review or auditing processes. This meant the provider could not be assured that people were receiving safe care relating to risks of choking.

Some systems did not support good management oversight. For example, a clinical governance report identified the number of incidents that had occurred within a given timescale, but there was a lack of analysis to determine patterns or trends that could identify learning from the incidents.

Quality monitoring systems had not identified shortfalls and inconsistency in people’s mealtime experience, and this had a negative impact on some people’s dignity. Quality monitoring had not identified a lack of dementia friendly information and signage or that some people were socially isolated.

The registered manager told us they were in the process of reviewing the provider’s governance systems and recognised the shortfalls we found.

Other management systems worked well and ensured that records were accurate and regularly updated. For example, daily audits of medicines supported safe administration and stock control. Staff were receiving regular supervision, support and training.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

The culture of the service was open and transparent. Staff worked effectively with health and care professionals and shared information appropriately. We received positive feedback from three health care professionals who had regular contact with people at the service. One health care professional described the service as being, “a very well-run home with consistent staff,” who had a “caring and pragmatic approach to people.” Another health care professional told us staff knew people very well and said, “Staff take care to provide individually tailored care.” Records included details of information that was shared appropriately with partners to support people’s care, for example, when a person’s needs changed, staff had contacted relevant health care professionals for advice and support.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people.

The provider had systems in place to identify learning needs and drive improvements. Staff described receiving effective and plentiful training, both online and with face-to-face training. One staff member told us, “The nurses share their knowledge with us.” They gave an example of how this had helped them to understand the impact of Parkinson’s disease for a person. They described how having a better understanding of the disease had helped them to provide more effective support.

Staff had opportunities to reflect on their practice and identify areas for improvement. One staff member said, “The supervisor gives me feedback about how I work and also asks other people to give feedback.” They explained how this supported them to understand how to improve their practice.

The provider had a service improvement plan in place to drive improvements they had identified, this included environmental improvements and shortfalls identified through audits.