The Croft Nursing Home (Barrow)

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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 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.

The management team had the appropriate skills and experience to lead effectively, understood the risks and priorities for the service and acted with openness and honesty during this inspection.

The service incorporated different visions, goals and outcomes for people living in the two different units. Both of which demonstrated the principles for right care, right support and right culture were being applied. People, their relatives and staff were listened to and their suggestions/ideas were continuously considered in contributing to the service provision.

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.

A new general manager had recently joined the management team to support the registered manager, and this was seen to be a positive. They were very proactive in wanting to improve the quality of service and in recognising where improvements were needed.

There was some evidence of a lack of consistency in management of oversight of the service over the last year. Any areas of concern found during the inspection had not been identified through the current oversight systems and processes used for monitoring the quality and safety of the service. The need for a more improved system had been recognised by the management team and was to be introduced at the end of the month.

Relatives told us they felt the service was well managed. One relative said, “It’s well managed.” Another said of the managers, “They’re brilliant.”

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

Regular meetings between the managers and staff took place. Staff were given opportunities to discuss performance via a supervision and appraisal process. However, the frequency of staff supervisions had not always been completed in line with the providers policies. Staff told us they could speak up about anything and were listened to and things acted on. For example, where new ideas to engage people in making healthier food choices was presented by staff this fully embraced by the management team.

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 staff we spoke with spoke very positively about their experiences of working at the home. Staff told us they felt supported by their individual managers and felt positive about the work the general manager had done so far with them. Staff told us they felt very included especially when they put forward new ideas for improving outcomes for people.

The provider did not always have clear systems of good governance. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

There were a range of quality monitoring and auditing processes in place. However, improvements were needed as some processes were not always effective in identifying the concerns we found during the inspection. Recruitment files we looked at had not been consistently completed, and no regular audits check on those files completed. There had been a lack of oversight on induction training and on the frequency of staff supervision. Elements of some safety checks for fire including ensuring regular evacuation drills had also not been identified. A new oversight and monitoring system that had been identified to commence at the end of this month would now include all these areas.

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.

Relationships with the local GP and practice members were seen to be working well together. Effective working was seen with the learning disability team and other health professionals. The service had good local community engagement with several organisations supporting people to access services and have good outcomes.

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.

There was a strive for improvement and development evident by the new general manager and management team. We saw several ways in which service actively involved staff, people and their relatives in developing the service and evaluating it. One relative told us, “They send questionnaires occasionally. If I get in touch they go the extra mile. They involve me with everything.”