East Dean Grange 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 requires improvement. 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. At the last assessment, the provider was in breach of legal regulation in relation to a negative culture within the service and quality assurance processes were not always effective in identifying or addressing issues. Improvements were found at this assessment and the provider was no longer in breach of this regulation.

This service scored 68 (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. Staff told us the culture at the service had improved with the new management team who were supportive and approachable. A staff member said, “All staff are treated equally. We work well as a team, and if there’s ever a problem, we talk about it to fix it without affecting residents’ care.” Staff told us they now had dedicated roles which enabled them to support people effectively and spend time with them. A relative told us how the improved culture at the home had a positive impact on people. They said, “It was hard to move [person] into a care home. I don't feel the previous management were skilled or experienced to run the home. There wasn't an open door policy, and I could feel there wasn’t a happy atmosphere. I felt it was horrible for the staff and there was not enough time for them to spend with residents. I've seen how this management team have stepped up to bring it back to standard and the respect they have for the workers is evident. It’s now a totally different atmosphere, it’s very relaxed.” The registered manager told us about the vision of the service. They said, “To make sure there is a safe environment for people so we can look after them well. We make sure staff are well trained. We encourage working as a team and any flexibility staff need is considered.”

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. The registered manager knew the service, people and staff well. They led with compassion, openness and honesty. Feedback from staff about the registered manager was positive. Comments included, “[Registered person] is a good manager. They listen, support us, and puts the people we care for first. They keep things organised and give clear guidance” and “If there are any problems, [registered manager] does share lessons learnt with all of us without using any names or blame individually. If there is a problem with an individual, they will privately have a word and give advice.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Staff spoke positively about leaders and were confident to raise their concerns. Comments included, “We are listened to and can always voice our concerns openly”, “We can speak up freely, and our concerns or suggestions are listened to” and “[Registered manager] is fair and is always here for us all. They are professional but fair.” The provider had a whistleblowing policy and procedure. Staff were confident to use it.

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. Staff told us leaders treated them with dignity and respect. Comments included, “Staff are treated equally, and I don’t see any discrimination”, “I feel very valued, supported and respected. All the staff are respectful towards me which I appreciate” and “There’s no blame culture here.” The provider had an Equality, Diversity and Inclusion policy and an Equal Opportunities policy which leaders followed.

The provider did not always have clear systems of accountability or good governance. There had not always been effective processes in place when things went wrong.For example, the registered manager had designated some audit processes to other staff. Some care plans did not contain up to date information or contained conflicting information. This had been identified in an audit, but it was not always clear on what actions had been completed. The registered manager had not reviewed and signed off some audits. This meant they did not always have clear oversight of governance. People had not been at risk of avoidable harm because leaders and staff knew them well. However, there should be processes in place to ensure effective oversight and governance. The provider and leaders had been open to feedback and taken immediate actions to make service improvements. However, this will take time to be addressed and embedded in the service. The provider had made improvements to other quality assurance processes such as environmental and fire risks and analysing trends for accidents and incidents. The provider had business contingency plans in place in case of emergency situations such as adverse weather conditions or staffing shortages.

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 registered manager and staff told us they worked in partnership with health and social care professionals to ensure good outcomes for people. Some staff comments included, “I deal with external professionals on a day to day basis and share the information with them if needed, making sure to protect GDPR” and “If management are not here, we all work well together with the external professionals. We record all information our electronic care planning system. We also discuss all information in staff handovers. We always update any new information from doctors, paramedics and any other professionals on our system.”The registered manager told us they had joined a registered managers forum to share learning and best practice. An external professional said, “The service is a visible presence in the community and forging strong relationships.”

Lessons were not always learnt to continually identify and embed good practice. For example, there were some shortfalls around care planning which had been identified in audits. However, the registered manager had not reviewed this, and it was not always clear on what actions had been completed. This was still an area for improvement. The provider and leaders had been open to feedback and taken immediate actions to make service improvements. However, this will take time to be addressed and embedded in the service. The provider had records on lessons learnt when things had gone wrong. It demonstrated involvement of the person and their family. Staff told us how lessons were shared with them. Some comments included, “Management always share the information with us and if there is any concern we share and discuss”, “Staff meetings are always productive. We learn a lot and discuss anything that can be improved” and “Staff meetings are helpful. They keep us updated, let us raise issues, and show that our voices matter. We also talk about lessons learned so we don’t repeat mistakes.” Leaders told us how they focus on learning and innovation to drive improvements across the service. The registered manager said, “I was involved in hydration research processes. I worked with a nurse, and then we did meetings with staff members about the importance of hydration. I appointed a hydration champion. We also look at future death prevention work and review information provided online by coroners. We talk to staff about their training. If we have a concern, I ask the staff what we can do better and take their suggestions so we can improve.”