Buxton 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 inspection we rated this key question requires improvement. At this inspection 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.

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 service 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 and registered manager had a clear vision for the service which aligned to the service values which were, honesty, excellence, approach, respect and teamwork. Everyone understood the shared values and direction of the service. The registered manager had an ‘open-door’ policy in place and people; their relatives and staff told us they were accessible. The registered manager told us they held ‘drop in’ sessions but was always available. There was a strong emphasis on teamwork within the service, and everyone was working towards the same goals. There were clear processes in place to ensure continual improvement. The service actively sought the views of people and their families through meetings, surveys and informal conversations.

The service 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.

People, their relatives and staff were complimentary about the leadership of the service. The registered manager had the right knowledge, skills, and experience to lead the team. Supported by the provider and the senior team, everyone was positive about the registered manager. Some of the comments included: “I have felt supported by all senior staff and management since starting in this role”, “The operations manager [name] is a fantastic support to everyone at Buxton House. They are approachable, understanding, and always willing to help”, “The registered manager is really supportive and feel confident with them and feel they take action on concerns, and the home is well led”, “The registered manager is approachable and a good manager”, “The leadership team are fair and address any issues.” The registered manager kept their knowledge and skills up to date through training, peer support, publications and updates to legislation.

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

Staff knew how to raise concerns and speak up. There were various channels available to staff both within the service, for example through the provider, and to external agencies such as the local authority. Staff were confident in the registered manager and senior team to address any problems they had. They told us the registered manager was approachable, and they were confident any issues would be addressed. The providers comprehensive policies underpinned working practices within the service.

The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

Staff told us they were happy, felt accepted and appreciated by their colleagues, the provider and the registered manager. Policies and procedures were in place and incorporated all aspects of recruitment and staffing such as retention plans, equality, diversity, fairness and protected characteristics. The policies underpinned acceptable practices within the service which was reinforced by staff training.

The service 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 act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.

Leadership and oversight were multi-layered, this included checks carried out on behalf of the provider. Governance and oversight were robust, and improvements made at our last inspection had been sustained and strengthened further. Comprehensive audits and checks were in place to identify areas for development. The registered manager had made all notifications to CQC as required by law. A notification is the action that a provider is legally bound to take to tell us about any changes to their regulated services or incidents that have taken place in them. All audits and checks produced an overall service improvement plan; this has clear timescales and responsibilities. Reviews of action plans were ongoing and had the scrutiny of the provider. The service had several meetings which included daily, weekly and monthly reviews of the whole service. The registered manager kept a detailed review of the clinical governance which meant people’s individual needs were know, shared and planned for. The providers comprehensive policies underpinned working practices within the service. A health and social care professional told us, “I feel they have safe strategies in place and a supportive management team.”

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

Partnerships with external organisations were well established with the service. A health and social care professional said, “We work so well as a team with Buxton House.” The location of the service was within short distances of the town centre, parklands, beaches and recreational areas. The service sought to fundraise for local and national charities. This had included working with organisations to support and enhance people’s experience of living at Buxton House. For example, a regular appointment with ‘Dementia Friendly Barbers’ who had visited the service to provide service for people. ‘Brews and Blooms’ with a local florist. People and staff continually made good use of outside spaces and their local community. The service continued to establish relationships and be a member of the local area. People were supported to celebrate and observe national holidays and commemorations such as, ‘Armed Forces Day.’

The service 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 contribute to safe, effective practice and research.

The registered manager told us about the ways in which they were continually looking to enhance the service. There were several initiatives planned for introduction throughout the remainder of the year, for example, improvements the dining experience with a focus for people through their dementia journey and a holistic relaxation programme which was in its early stages but had showed positive results. The provider had oversight of the service and undertook their own internal audits and checks to ensure safe operation of the service. Feedback about improvements and the management of the service was positive. The registered manager was confident they had safe systems and were complimentary about their team. The registered manager understood the importance of continual improvement within the service. The registered manager was confident their systems, processes and their own responsibilities to provide effective oversight of the service.