Milverton 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 improved 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 75 (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 shared vision, strategy and culture that aimed to deliver high-quality, person-centred care. Leaders had clearly set out improvement priorities and engaged staff in driving these changes. A staff member told us, “The management team have a very clear vision about where they want the care home to go and I agree with it.”

Leaders had focused on improving culture through visibility, engagement and listening to staff. The registered manager described how they met with all staff individually and introduced regular meetings, supervision and recognition initiatives to improve morale and communication. Staff described positive changes, with one staff member telling us, “There has been a lot of positive change… everyone knows where we should be heading to.”

The provider had inclusive leaders at all levels who understood the context in which they delivered care, 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.

Since our last assessment a new registered manager was in post, as well as other leadership roles at the service. The registered manager and deputy manager had relevant clinical qualifications and experience, and there was a clear focus on developing staff and promoting from within. Leaders were committed to being visible and supportive, with the registered manager explaining they spent significant time in the home and observing care to understand staff and what processes were working and where changes needed to be made. Staff were positive about the changes the management team have made including strengthening leadership throughout the service. Staff described the management team as “friendly”, “approachable” and “working well as a team”.

People and relatives were complimentary about the management team and improvements made, with managers being more accessible and approachable. Relatives felt listened to and that their feedback was used to make improvements at the service.

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

The provider promoted an open culture where people and staff were encouraged to raise concerns and share feedback. Systems such as staff meetings, supervision and family meetings supported this approach.

Staff told us they felt able to raise concerns and were supported to do so. Relatives also felt confident to speak up, with one stating, “I would feel comfortable about saying something… we were taken seriously”.

Leaders had recognised the importance of strengthening speaking-up arrangements and were reviewing the freedom to speak up guardian role to ensure effective oversight.

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 systems and practices in place to support equality, diversity and inclusion within the workforce. Policies relating to equality and diversity were in place and staff were supported through training, supervision and development opportunities.

Leaders promoted an inclusive culture by supporting staff development and recognising individual contributions. The registered manager described a commitment to developing staff skills and career progression, including supporting staff to gain qualifications. Staff confirmed this approach, telling us they had “opportunities for training and career progression”.

The service demonstrated consideration of diversity in practice and ensured an inclusive working environment.

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

Since the current leadership team had been in place, there had been significant development of audit systems and service improvement planning. Leaders had introduced a comprehensive programme of audits and checks, including clinical audits, health and safety monitoring and incident analysis. Oversight arrangements ensured audits were reviewed centrally by the registered manager and used to inform service improvement plans.

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 worked collaboratively with external partners to support people’s care and improve outcomes. The service engaged with local authority quality teams, healthcare professionals and other stakeholders to drive improvements. Staff described positive joint working with healthcare professionals, including GPs, pharmacists and specialists, to meet people’s needs.

The service also engaged with the local community, for example during care home open week when local groups visited the home.

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 a focus on continuous learning and improvement. A service improvement plan was in place, incorporating learning from inspections, audits and partner feedback. Leaders demonstrated a proactive approach to innovation, such as introducing a new electronic care records system to improve accessibility and quality of information.

The service used feedback from people, relatives and staff to inform improvements. Feedback confirmed “there is a focus on continuous improvement” and that stakeholders were positive about changes made. Staff also described ongoing changes and adaptation, stating, “We are trying different things to work out what works… there is always room for improvement”.