Medway House

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 remained 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 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.

There was a positive culture in the home, people we spoke with enjoyed living at the services. They felt their needs were considered and they got on well with staff. A person commented, “This is a good place to live.” Staff were supported and enjoyed working there. A staff member said, “I am happy the manager is helpful and here to support everyone.”

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.

We observed the registered manager and staff supporting people in a person-centred way whilst demonstrating and understanding the needs of the people. Staff spoke positively about the registered manager.

The registered manager told us they were supported by the provider and had training opportunities to support their professional development. Relatives confirmed the home was managed well by the registered manager.

The provider had a range of policies and training in place to ensure staff were able to provide care in a safe and effective way. Audits and reviews of the service appeared to be effective in ensuring the service was well run.

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

The service promoted an open culture where staff felt able to raise concerns. A whistleblowing policy was in place, and staff understood how to use it. The registered manager said they had an open‑door approach and said staff were encouraged to speak directly to management if they had worries or concerns. A staff member told us, “If I had any concerns, I know the manager will listen and act on them.”

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 an equity, diversity and inclusion policy and procedure detailing their commitment to encouraging equity, diversity, and inclusion among their workforce and eliminating unlawful discrimination.

Staff had training on equality and diversity. Staff told us they understood they were expected to be treated respectfully, and they believed diversity was valued. Staff were supported through staff supervisions and team meetings. We observed the registered manager being actively responsive to staff and supporting them.

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 registered manger had measures in place to support staff to improve their skills with training and supervision. They ensured staff understood their roles well and had to support staff effectively.

Care plans sufficient information which informed staff clearly how to appropriately support people.

Audits and spot checks in place were effective in ensuring a good quality of care was being delivered to people. The registered manager had good oversight of what was happening in the service.

The service had a business continuity plan in place, in the event of an emergency, staff would be able to continue to deliver support to people.

The registered manager was aware of the duty to submit required statutory and regulatory notifications to CQC and the Local Authority as required.

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’s processes promoted and maintained good working relationships with other external healthcare services to provide integrated care that met people’s support needs and enabled them to keep healthy. Staff reported any health care concerns to the relevant professionals, and management.

They also supported people to access community-based health care professionals. This included dentists and to refer themselves to health care services, such as their GP, to maintain and promote continuing independence through joined up healthcare. One professional said, “The manager communicates with us on a regular basis and are very adept at managing the presenting behaviours of people we have placed here.”

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not always actively contribute to safe, effective practice and research.

The arrangements in place to ensure that the provider was appropriately managing circumstances where there were restrictions on people’s liberty were not always effective. The manager could not demonstrate the blanket restriction of locking the fridge and freezer were proportionate and the least restrictive option available.

The manager assured us that they were involving people fully in seeking reasonable adjustments around these restrictions.

Notwithstanding the above, audits about other aspects of the service, such as those related to the safety of the premises, were carried out appropriately.

There were procedures in place to ensure learning happened when there were incidents and accidents. Staff were encouraged to reflect on their work, share experiences and identify opportunities for development.