Fewcott House Nursing 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 Outstanding. At this assessment the rating has changed to Good.

This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 79 (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.

The provider had a clear statement of purpose which supported staff in understanding how to deliver care safely and consistently. Management were open about the service’s limitations and recognised when people’s needs could no longer be met safely within the home. This helped ensure decisions were made in people’s best interests and aligned with the provider’s vision and values around equity, inclusion and human rights. By understanding their boundaries, the provider was able to work proactively with external professionals to ensure people received the right care in the most appropriate setting.

Professionals gave positive feedback about the service. A professional told us, “I have worked with Fewcott House for a number of years and have found the team to be most helpful. Both nurses and carers have good knowledge and an understanding of what is required within the workplace.”

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.

The registered manager and deputy were respected and liked by people and the staff. All the people we spoke with knew who the manager was and knew who to speak to if they had concerns.

Staff spoke well of the management team and told us they felt supported in their roles. One staff member said, “The managers are really fine, I can go to them, they help me with anything I ask them, they will get on the floor and help out.” Another staff member said, “I have some health issues and they help me with appointments and help me every time I need.”

Overall, staff provided positive feedback about the management of the service. One staff member commented, “I love working here, we have the most supportive team and manager.” The management team were responsive to our feedback and demonstrated they were passionate about providing quality care which achieved good outcomes for people.

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

The provider had policies in place to support staff to speak up, raise concerns, and keep people safe. Staff spoke positively about the registered manager and deputy manager staff felt able to raise concerns if needed. One staff member said, “I can speak with either manager; they are both very supportive and listen.” Another said, “[Registered manager] and [Deputy manager] are very approachable and will make time if you want or need to speak with them.”

There was a whistleblowing policy in place and staff were aware of this. Staff supervisions were held regularly and team meetings discussed any concerns raised.

Staff told us, “Leaders always say any issues or concerns, please come to us.” They also said, “Yes, I am aware [of the Equality Act]. There are no restrictions and I can speak openly.”

Staff could raise concerns during staff meetings and supervision sessions. Staff could also approach leaders about personal matters and support would be provided as appropriate.

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 service had a diverse team of staff, where equal opportunities applied without fear of discrimination. Staff were supported from the outset of the recruitment process

The provider demonstrated a commitment to supporting staff wellbeing and inclusion. Managers described how they supported staff with specific health needs and childcare responsibilities to remain in work. Staff were also encouraged to share and celebrate their cultural and religious backgrounds within the service, which included recognising and marking cultural and religious festivals. This promoted an inclusive and supportive working environment where diversity was valued.

Staff told us, “I never had any problems [with the provider] and I always had respect from management.” Another staff member told us management were visible within the service and they had no concerns about the way they are treated.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

The provider had strong and effective governance systems in place. A regular programme of audits were carried out to assess all aspects of the safety and quality of the service and to identify any issues. There were ongoing quality and safety checks of the care people received and where shortfalls were identified, action was taken. Where risks had been identified the provider had put additional safeguards in place such as enhanced medicine controls and purchasing additional equipment to ensure people’s safety.

There were clear lines of responsibility and accountability within the management structure, which helped ensure staff at the right level made decisions about the day-to-day running of the service. The registered manager was aware of their responsibilities under the duty of candour, which requires providers to be open and honest about any accident or incident that had caused, or placed a person at risk of harm. The provider had notified the Care Quality Commission of all significant events in line with their legal obligations.

The provider used a dependency tool to ensure safe effective staffing, and staffing levels were reported as good by people and professionals.

Staff told us, “The home is organised and managed well. There are no problems. Staff and management arevery good.”

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

The registered manager recognised the importance of working in partnership to improve people’s outcomes. They described how they worked closely with people, their families where appropriate, and the local authority to support positive outcomes. The service had developed effective working relationships with professionals.

Fewcott House had achieved Veteran Friendly Framework(VFF) status. They were required to meet eight standards. These include noting Armed Forces status within care plans; addressing social isolation by introducing veterans and their families to other veterans and families for social support; and signposting to support services, such as the local Royal British Legion branch and other charities that provide support for veterans or partners of veterans. The VFF is designed to enable care and nursing homes to deliver personalised care and support to the residents who are part of the Armed Forces community. Fewcott House had also achieved Gold Standards Framework which assesses the standard of end of lifecare in place within the home.

The provider worked hard with staff and other professionals to achieve these two accreditations.

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. They actively contributed to safe, effective practice and research.

The registered manager described how they used all available information to identify learning, embed good practice, and drive improvement. They maintained regular communication with the nominated individual people, relatives, and staff to share feedback and best‑practice guidance, helping to ensure the service remained safe and effective.

The provider ensured technology was used to improve people’s lives, this included purchasing equipment to identify potential arrhythmias and other cardiac concerns.

Throughout the assessment, managers were open and honest, acknowledged areas requiring improvement, and were responsive to our feedback. Staff surveys were conducted and actions in response to the feedback were shared with the team. This demonstrated a commitment to listening to staff views and continuously improving the service.

The management team showed a strong commitment to learning and continuous improvement. This included partaking in a research project to assess the impact of changes in temperature on people as well as sharing ways of working with local health professionals to support good practice. Students and trainee paramedics were supported through their training placements in the home.

They were open and transparent, and some actions were taken during the inspection to address issues identified, such as cleanliness of the environment, wording in the PEEPs documents and DoLS applications. Reassurances were received about immediate improvements made by the management team. The service responded promptly to feedback and demonstrated a clear willingness to improve. Leaders promoted an open culture where learning from incidents, safeguarding concerns, complaints, and examples of good practice was shared with staff to reduce the risk of issues happening again.

One professional said, “Best recommendation I can give is that I would put my own relatives in Fewcott House."