The Spinney Care Home

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• 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 leadership, management and governance assured high-quality, person-centred care, supported learning and innovation and promoted an open and 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 good, person-centred care.

This service scored 64 (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 and culture based on openness, inclusion and understanding people’s individual needs.

Leaders described consistent values centred on kindness, respect, openness and treating people as individuals. Staff accounts reflected these values. They described a friendly team, supportive working relationships and a shared commitment to providing good care. Some staff referred to the team as a “family,” which demonstrated a sense of belonging and shared purpose.

Leaders communicated expectations through regular contact with staff, meetings and electronic communication. Staff generally understood what leaders expected of them and felt able to seek advice when they needed it. The consistency between leaders’ and staff members’ descriptions gave assurance that the provider’s values were understood across the service rather than known only by senior leaders.

Although there was evidence of a positive day-to-day culture, the provider had limited evidence that people, relatives and staff had formally contributed to shaping the service’s longer-term direction and priorities.

The provider did not always have effective leadership oversight at every level. Leaders did not consistently identify shortfalls independently or lead proactively.

Leadership arrangements did not always make clear who was responsible for completing particular improvement actions or who would check that the actions had been effective. This weakened accountability and reduced leaders’ assurance that required work would be completed promptly and improvements sustained. Leaders responded promptly when concerns were brought to their attention, but their approach was sometimes corrective rather than proactive.

All staff we spoke with described leaders as compassionate, accessible and available for advice. Relatives generally described leaders as responsive. Leaders engaged openly during the assessment, acknowledged concerns and arranged resources when action was required. Leaders sought clarification when they did not know an answer, rather than making assumptions.

These qualities supported positive relationships and demonstrated compassion, openness and integrity.

The provider fostered a positive culture in which staff felt able to speak up and believed leaders would listen.

Staff described an open-door approach and said they could approach leaders when they needed advice or wanted to raise an issue. Staff who had raised matters felt leaders had listened and responded constructively.

Leaders encouraged staff to report concerns about people’s wellbeing, colleagues’ practice and the operation of the service. Staff understood that they should share concerns promptly rather than wait for formal meetings. This supported early discussion and reduced the risk of problems remaining hidden or becoming more serious.

Staff accounts were consistent across different roles and levels of responsibility. Staff described respectful working relationships and confidence that leaders would take their concerns seriously. This gave assurance that openness was generally part of the service’s culture rather than dependent upon a single incident or individual staff member.

People and relatives knew who to approach with concerns and described the manager as responsive. Staff felt comfortable and confident to raise concerns with leaders.

Staff felt psychologically safe to raise concerns and seek support. This helped leaders receive information about emerging issues and supported an open culture.

The provider valued diversity within its workforce and promoted an inclusive and fair culture for staff.

Leaders and staff described a diverse workforce and expressed a clear commitment to treating staff fairly and responding to their individual circumstances. Staff across different roles said leaders treated them with respect and valued their contributions.

One staff member described the service as, “a very inclusive workplace.” Staff did not report discrimination, bullying, harassment or unfair treatment. They did not identify barriers to obtaining support or participating as members of the team.

The consistency of staff feedback demonstrated that inclusion was reflected in their day-to-day experience. Staff felt accepted, respected and able to contribute to the operation of the service. This supported positive working relationships and helped create a sense of belonging within the workforce.

The provider did not always have effective governance and accountability systems. Leaders did not consistently act on the best available information about risk, performance and people’s outcomes.

We identified a range of shortfalls that these systems had not found or fully resolved prior to our inspection. The findings extended across environmental safety, recruitment, workforce oversight, medicines and the accuracy of some care information. This showed that governance systems did not consistently provide leaders with a reliable picture of the service. While leaders completed walkarounds, audits and other quality checks they were not fully effective in identifying issues and areas for improvement.

Action and assurance records did not always clearly identify accountable people, completion dates or how leaders had checked that improvements remained effective. Consequently, leaders could not always demonstrate that identified actions had been completed promptly or that risks would not recur. This increased the possibility that inconsistent or unsafe practice could continue until identified through external scrutiny.

Following the assessment, the provider submitted an updated governance action plan which identified responsible people, dates and progress or completion information. This demonstrated a prompt and more structured response.

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.

Leaders maintained working relationships with relevant health, social care, safeguarding and commissioning organisations. They understood when information needed to be shared, when specialist advice was required and when concerns needed to be escalated beyond the service.

External professionals who contributed to the assessment described the service as cooperative and responsive. They felt able to obtain the information they required and did not identify barriers to working with staff or leaders. The service communicated with partners when people’s circumstances changed and responded to requests for information.

These arrangements enabled external organisations to contribute their expertise and provided additional oversight of people’s care. They also reduced the risk of the service attempting to manage complex matters without appropriate professional involvement.

Leaders were open when engaging with professionals and were willing to clarify information when required. This supported accurate communication and constructive working relationships. The evidence showed that collaboration with statutory and professional services formed part of the service’s usual practice.

The provider’s professional partnerships operated effectively and supported coordinated decision-making.

The provider did not always take a structured approach to continuous learning, improvement and innovation.

Leaders responded promptly when immediate action was required and updated staff when practice needed to change. This showed a willingness to learn. However, these actions did not demonstrate a systematic culture of continuous improvement.

Improvement activity was often reactive. Leaders had not established an effective and consistent coordinated improvement programme that sets priorities, accountable owners, timescales and measures of success. This limited assurance that learning resulted in sustained improvement across the service.

Leaders did not consistently evaluate whether changes improved people’s experiences, equality of outcomes or quality of life. They also did not consistently demonstrate how people, relatives, staff and partners contributed to setting improvement priorities or reviewing whether changes had achieved the intended results.

There was limited evidence that learning from external reviews, national developments or research routinely informed the service’s improvement work. Leaders had not demonstrated participation in wider quality-improvement initiatives or how effective ideas were identified, tested and shared across the organisation. This meant innovation remained limited and improvement was mainly focused on responding to individual issues.

Leaders responded promptly to feedback and updated staff when practice needed to change, and could describe changes made following individual events, professional advice and concerns. This demonstrated a willingness to learn.