Strathmore 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 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.

The provider was previously in breach of the legal regulation in relation to good governance. Improvements were found at this assessment and the provider was no longer in breach of this regulation.

This service scored 71 (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 and vision and strategy for the service which the leaders were aware of. People and relatives knew who the registered manager was and felt comfortable speaking with them or any other member of staff with any concerns. We saw the registered manager visited the lounge several times during the inspection, speaking to people by name; everyone told us they were very happy, and we did not receive any negative comments from anyone we spoke with.

Although the home needed some modernisation, we observed it was very well organised and had a relaxed, welcoming, supportive atmosphere, and a calm well-managed feel to it. A person told us, “I have nothing to complain about, they [staff] do everything I ask them to do. If I had any concerns I would be happy to say so, but I don't have any.”

The atmosphere in the home was positive and reflected a supportive staff culture. Various staff team meetings were held regularly to provide updates, to identify from staff’s perspective any potential gaps in quality, and to ensure the provider was meeting people’s needs. Leaders engaged regularly with the staff team. Meetings had been set up which provided an opportunity for people and their relatives to have a say in care provision. A staff member said, “I feel very much part of the staff team, and I have no issues with the culture of the service.” A person told us, “It’s nice in here; it’s a nice nursing home and it gives me a purpose to get out of bed and if you didn’t, they [staff] would encourage you to do so.”

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.

Leaders of the service were suitably experienced and qualified and had clearly defined roles and accountabilities. Leaders had worked previously in the social care sector and so had the skills and competence to get involved in the direct delivery of care if required. A relative told us, “We went to visit several care homes but the people and atmosphere here was so friendly that it just felt right to choose to bring [person] here and I am very glad that I did. We should have done it 2 years ago. [Person] has settled in so well which we find remarkable because of his personality. The staff are fantastic; they are so patient with [person].

The provider ensured there was always suitable managerial cover; this included leaders being available to provide advice to staff throughout the night and at weekends. Staff told us they felt supported and received the necessary support and supervision. A staff member told us, “I feel the registered manager has the skills, knowledge and experience to do the job; they are empathic and respectful.”

Leaders were knowledgeable about issues and priorities for the service; they had access to appropriate support, including staff support groups and individual line management. Leaders took full responsibility within their roles and challenged poor performance when necessary.

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

Staff told us the felt able to raise concerns and that they would be listened to. There were mechanisms in place for staff to speak up and a culture in place to encourage them to do so. A staff member told us, “Our leaders are empathic and respectful.” A second staff member said, “When I came here, speaking up was raised during the induction and [registered manager name] has an open-door policy.” The service user guide included a range of information on how to raise any concerns, and included contact details for the provider, the local authority and CQC.

Good communication was in place through team meetings, daily huddle meetings and formal individual supervision sessions, to ensure staff had regular opportunities to engage with leaders. This was also supported by policies and information supporting staff to raise concerns externally if required. The registered manager told us, “I have an open door, and my office is near the entrance front door. We have policies in place, and staff can talk to me anytime, and can shut my door if they need. Staff have supervision meetings where they can discuss any issues. I would never want anyone to feel bullied, and I encourage staff to talk to families who can speak to me at any time. We have feedback forms, staff meetings and meetings with people and relatives.”

We looked at the most recent staff feedback forms completed in February 2025. Comments provided were mostly positive but also included some comments about staff communication not always being good; 17 staff questionnaires had been completed and all returns identified staff had received a suitable induction programme; the manager was approachable, the home was clean and tidy, and staff felt supported to raise suggestions.

The most recent visitor and relative survey was done in November 2024 and 10 responses had been received. These contained very positive comments including: ‘lovely and welcoming staff’; ‘we have been fully updated’; ‘health professionals regularly attend [person]’; ‘staff are very kind’; ‘no complaints’; ‘this is the best care home [person] has been in. It was clear from our conversations, people and relatives felt their voice was heard.

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.

Leaders provided flexible working agreements to staff to account for personal circumstances such as caring responsibilities and health issues and had put reasonable adjustments in place for some staff to help them carry out their role. Leaders took steps to ensure staff were representative of the population of people being supported. Staff told us they were treated equally by leaders. A staff member told us, “All staff are treated fairly and equally and are supported with childcare responsibilities.”

Managers engaged with staff via appropriate forums such as individual supervisions, various staff meeting types and staff surveys, to ensure their voices were heard. Staff were confident they could raise concerns directly with their leaders, and had received training in equality, diversity and human rights. A staff member said, “I would feel confident to say anything in the staff meeting.” We saw comments made in most recent staff survey were overwhelmingly positive, and more recent comments received during this inspection included: “The service is good, and I feel comfortable”; “The culture is very good, nobody is superior”; “We can freely talk to managers and the owners.”

Staff had access to equality training to help them understand about protected characteristics, bullying and harassment and relevant policies were in place, in-line with current best practice guidance.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

The provider was previously in breach of the legal regulation in relation to good governance. Improvements were found at this assessment, and the provider was no longer in breach of this regulation. However, further improvements were necessary to ensure audits were more robust in identifying any gaps. For example, we found risk assessments were not always in place for areas such as choking, the use of creams, and oxygen use. The registered manager took immediate action to resolve these issues during this inspection and provided us with updated information following our site visits; this gave reassurance the issues we found had been understood and promptly dealt with. A new audit schedule was also put in place, identifying a new series of daily, weekly and monthly audit tasks.

Staff were clear about their roles and accountabilities and had regular opportunities to meet, discuss and learn from the performance of the service. A clear organisational staff infrastructure was in place. The provider had a business continuity plan, which covered the relevant areas. Policies which were reviewed as part of this inspection were up to date. Daily staff shift handover meetings supported staff at all levels to work safely with people. Performance and risks were routinely discussed in staff and leaders’ meetings.

Staff were complimentary about the registered manager. A staff member told us, “Since [registered manager name] has been here, the place has got so much better, and the culture has improved. [Registered manager name] supports us all; she tells staff about things that need doing but she is supportive and it’s not a blame culture. I feel so much better now than I did before, and it is a pleasure to come into work. It is better organised, and we are getting things done. I feel valued, supported and included.”

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 provider, registered manager and staff worked in partnership with local organisations and people were supported to engage with the local community, which had a positive impact on them. People’s daily lifestyle was identified in their care plans; this provided information on what each person was interested in and liked to take part in.

A ‘thank you’ cards book was available in the reception area and a ‘memories’ booklet with pictures of activities done, including singing, a summer fayre which raised £215 for the resident fund, trips to garden centres, dominoes, table tennis, owl and dog therapy, violin playing event, knitting, tabletop games, and Halloween celebration.

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 provider had suitable systems and policies to ensure continuous learning and improvement. We noted where concerns had been found with people’s medicines, these concerns were identified and shared with the staff team. A monitoring document was used to track issues, identifying the action taken, and the individual lesson learned. The registered manager was responsive to feedback from all sources during this inspection.

The provider was committed in ensuring quality assurance was in place to maintain high standards of care. There were established standards for various aspects of care such as medication management and people’s safety. The provider and registered manager regularly reviewed incidents and medication errors, and any necessary improvement actions were recorded.

The provider regularly assessed the care provided through audits, and by analysing feedback from people and their relatives. A person told us, “I can talk to the staff and the nurses; there is always someone to talk to. Staff take care of all my medicines for me, so all my worries have gone. The staff take me out to the shops in a wheelchair if I need anything.”

All staff we spoke with confirmed leaders encouraged them to speak up with ideas for improvement and innovation and actively invested time to listen and engage; we also verified this by looking at a range of meetings which had taken place throughout the year. The provider adequately trained staff and they understood the quality standards and procedures.