Foxland Grange

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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

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.

This is the first assessment for this service under this provider. The key question has been rated outstanding.

This meant service leadership was exceptional and distinctive. Leaders and the culture they created drove and improved high-quality, person-centred care.

This service scored 89 (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 very clear shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the challenges and the needs of people and their communities.

The registered manager demonstrated an exceptional shared direction and culture. Leaders and staff had established a clear, inclusive vision based on transparency, equality, human rights and an in depth understanding of people and their communities. Staff collectively developed the home’s ‘KIND’ values, 'Kind, Inclusive, Nurturing and Diverse’, which were embedded in practice and strengthened staff confidence, belonging and accountability. The staff team recognised the importance of this and felt this involvement had made them feel more confident and valued in their roles and had led to a happy and inclusive team. The registered manager added, “We celebrate culture and have embedded our own home values.” The values were displayed in staff areas which provided a daily reminder of their shared commitment. Importantly, the values had created a culture where staff felt safe to speak up about their individual needs, enabling reasonable adjustments that supported staff wellbeing, retention and, ultimately, positive outcomes for people.

The registered manager, with support from other leaders in the home, translated this vision into sustained improvement by eliminating agency use, improving staff retention by 56 percent and creating a stable workforce that increased familiarity, confidence and continuity for people while reducing complaints and concerns. The registered manager told us, “A stable workforce has improved the quality of care for our residents by providing familiarity of staff. This has led to reduced complaints and concerns raised in the home.” Records we reviewed supported this.

Enhanced induction, protected supernumerary time, [this is where staff are extra to the number of staff that are needed on each shift] training before shifts and robust oversight had raised and sustained training performance. Career progression, apprenticeships, champion roles, sponsorship, wellbeing support and recognition initiatives further demonstrated that staff were valued and enabled to develop. This cohesive culture delivered measurable improvements for both people and staff with 1 relative telling us, “When my mother in law first moved in, there was a considerable turnover of staff. This has significantly reduced, which has enabled residents to get to know and feel confident in staff.” In creating a positive culture at the home, a variety of incentives had been introduced including, promoting staff within their roles and providing career progression, apprenticeships, home champions roles, sponsoring overseas colleagues, staff welfare and valuing the GEM “colleague of the month” initiative.

The provider had exceptionally 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 always did so with integrity, openness and honesty.

People and relatives spoke positively about the home and the management team. A relative told us, “I find that every member of the team exceeds expectations in the care that they offer to my relation. In my view this shows the great and proactive leadership at Foxland Grange. It seems that everyone is absolutely clear of their unique role and feels able to make the best decision in the interest of the individual resident.”

The registered manager had developed a culture which enabled staff to lead on day to day tasks and the development of the home. They had ensured some staff had completed the trainer course in the accredited training they implemented for people living with dementia, meaning they could develop a personal approach for people living in the home.

The registered manager was focused on ensuring they and their staff team delivered care in line with the values the team had created. The registered manager ensured Foxland Grange’s KIND values were embedded into everyday practice. They told us, “These values were developed collaboratively, with staff given the opportunity to contribute ideas and shape the home’s ethos.” They effectively monitored the implementation of these through regular observations of staff practice, care record audits, feedback from residents and relatives, staff welfare, turnover, complaints, concerns and compliments, ensuring any issues were acted upon promptly.

With direction from the registered manager the dementia care leads undertook practice observations and reflective discussions to reinforce the importance of kindness and person centred care. Resident and relative meetings helped the staff team continually review activities to ensure everyone felt included, valued and represented.

The registered manager was in the process of transferring to work at another home within the company, however were they committed to ensuring they were available for the people and staff at Foxland Grange whilst a new manger was suitably recruited and inducted into the home. They ensured they were available on the day of the site visit and after the inspection to provide support.

There were systems in place to ensure all staff understood their roles and responsibilities and there were clear lines of delegation. We had been notified of events that had happened within the service in line with the provider’s legal responsibility to so do.

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

People and relatives confirmed they knew how to complain. One person told us, “Complain, no. If I did, would speak to the manager.” Relatives said, “If I needed to complain [I] would speak to [staff members name].” and, “If I had a complaint, [I] would talk to the manager but she has just left, so would talk to [staff members names] They are both very proactive in telling us what is going on”. The registered manager was currently in the process of overseeing the opening of a new care home, however was available to offer support and guidance to the home while a new manager was recruited and inducted.

Staff felt able to report any concerns. They confirmed they would be supported during any such time and felt they would be listened to.

There was a whistleblowing policy in place and staff were aware of this and the procedures they needed to follow. Staff were actively encouraged by the registered manager and other team members to identify and raise concerns if needed. The registered manager told us this was important in creating a positive culture at the home.

The provider valued diversity in their workforce.

Staff felt they were treated in an inclusive way and their diverse needs were considered. The provider confirmed there were policies in place to ensure this was effectively delivered to staff. The registered manager spoke positively about valuing all team members. They said, “We believe in quality and not quantity. We have many overseas workers who require renewal of visas to remain working in the UK. We offer colleagues sponsorships to support them with this. This supports the home to recruit successfully whilst maintaining a stable workforce. Our overseas colleagues are highly valued.” We saw feedback from staff who had been sponsored who praised the process. One staff member wrote, ‘I am writing to express my heartfelt gratitude for your assistance in getting my sponsorship. I am grateful for this opportunity, and I will always give my best.”

The provider had clear responsibilities, roles, systems of accountability and good governance.

There were effective systems in place to monitor the quality of the service and when needed this information was used to make changes. There were audits and checks in place which effectively monitored all aspects of the care and support people received including, their environments, management of medicines and the care planning and records in place.

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.

There were systems in place to ensure the provider worked in partnership with other agencies and professionals to ensure care was safely delivered to people. There was an exceptional standard of partnership working that improved people’s experiences and strengthened the wider community. Professionals gave positive feedback about staff and confirmed the approach improved coordination. With 1 professional saying, “Some excellent staff, particularly team leaders.”

The registered manager shared ways of working they had introduced to enhance partnership working. Through conversations with professionals, they identified that previously on occasion information about people or previous professional visits was not always available promptly. Following this the individual professionals’ area was created in the reception area of the home. Here, professionals sign in and collect a blank professional’s update sheets and feedback form, which they complete during every visit. The receptionist leads on ensuring the relevant department staff have this form with the update following the visit. Professionals and staff confirmed this has been a positive step and ensured visits ran more smoothy and promptly.

The home also recognised the roles of other health professionals and introduced a ‘Lunch and go’ incentive which enabled professionals to order a sandwich bag which they could take away with them, if they chose. The sandwich bag was then made while the professionals carried out their visit and left in the professional’s area for them to collect after their visit. Visiting professionals also had the option of having hot and cold drinks from the bistro area of the home during their visit or to take away, which we saw them using during our inspection. The registered manager told us this so far had been, “Very successful”.

Leaders also developed innovative partnerships beyond the service. Working with a national charity and local networks, the home delivered regular dementia talks for families and the wider community, becoming a trusted source of advice and a member of a local dementia alliance. The registered manager told us, “Foxland Grange have found the local community have benefitted from these conversations and this has led to a huge impact, not only within Foxland Grange, but building the trust and knowledge about the care we deliver with the local community.” The registered manager gave examples of how many of the local community go into Foxland Grange to ask for advice and support. The registered manager told us, “We are honoured to not only be a care home, but a safe space to support with the experience and knowledge and connections we have.”

Partnership with a national veterans’ charity led to a formal accreditation status and embedded identification of veterans within admissions and care planning, ensuring people’s military histories, memories and interests shaped personalised support. This demonstrated sustained collaboration, shared learning and a strong contribution to inclusive community support. The registered manager told us, “We recognised that these experiences were an important part of the residents' identities and that providing opportunities to reminisce, share their stories and connect with others with similar experiences could contribute significantly to their wellbeing and sense of belonging.”

The provider focused on continuous learning, innovation and improvement across the organisation and local system.

We found an exceptional culture of learning, improvement and innovation. The staff team actively sought opportunities to strengthen people’s health, wellbeing and experience, including participation in a national oral health survey, where 29 people who lived at Fox Grange, chose to contribute to research on oral health in care homes. People were happy to be part of this project, felt appreciated and were glad to support this research initiative.

Innovation was also driven by people’s ideas. Following Residents’ Council discussions, the service co-produced a sustainability programme that expanded recycling, introduced safe battery disposal and enabled people to participate in recycling of newspapers independently. This was led by the home’s sustainability champion.

Staff creatively reused materials for personalised art activities. For example, a person particularly enjoyed transforming discarded newspapers into sculptures, demonstrating how sustainable practices could support creativity, independence and personal fulfilment. Another person with a passion for gardening participated in a composting initiative and they began using flowers grown in the home’s gardens for dining table displays and herbs to support the kitchen, helping people see the practical benefits of their gardening activities. These initiatives demonstrated that learning was translated into sustained improvements which promoted choice, independence, creativity, environmental responsibility, exercise and personal fulfilment.