Rayners Residential Care 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 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.

The service was in breach of a legal regulation in relation to governance at the service.
 

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, 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 was committed to providing a caring, person-centred service which promoted people’s independence. Staff were very clear about the shared vision – ‘a home for life’.

Staff spoke of the support they receive from the registered manager, how approachable they were and how they provided valuable support around the home.

All people and relatives were positive about the atmosphere and culture at the home. We saw staff were respectful, caring and committed to providing good quality care and treatment to people living at the service.

The provider’s statement of purpose set out their aims and objectives for the provision of people’s care and the values upon which people’s care delivery was based.

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. However, the provider’s management of the service lacked the consistent level of attention to detail and structure staff required.

The registered manager and their deputy manager demonstrated they understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce. The management team led with integrity, openness and honesty. However, we identified some management actions did not consistently demonstrate sufficient capability to identify and address risks in a timely way. This included medicines management, environmental safety and infection prevention and control. Auditing activities in these areas were not effective to highlight necessary actions and inform service improvement plans.

People, their relatives and professionals spoke positively of the leadership of the service and said they were visible and approachable at all times.

People and staff were supported by a registered manager who was described as approachable, responsive, and trustworthy. One staff told us, [manager] will always help on the floor if needed and tries to accommodate all leave requests”.

Discussions with staff at all levels showed they knew people, relatives and staff individually. External professionals were positive about the management team at the home.

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

People and relatives, and external professionals felt able to raise anything with the management team. They told us they would be listened to, and actions would be taken when required.

The provider’s statement of purpose and whistleblowing policy provided guidance to staff about how to raise concerns. The registered manager was accessible to staff whether they were on or off site. Staff had the opportunity to speak with them in person and felt they could do so. They told us that they felt able to raise concerns at any time and felt they would be listened to.

There was no evidence of closed cultures. One staff member told us, “Whistleblowing of any concerns can be taken outside of the establishment … for staff or residents’ welfare”.

All staff were complimentary about each other and the way colleagues treated 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.

There was an inclusive and fair culture with equity for staff. Staff told us they were happy at the service and had the right support in place to enable them to do their jobs well. Staff told us they felt valued and respected by the management team and each other.

Staff were supported within their roles, and reasonable adjustments were made if required to enable them to carry out their work. Staff said they felt treated fairly.

Flexibility in working arrangements has been achieved for part time staff to support their family caring responsibilities. Similarly, regular night staff were enabled to work day shifts if they wished to support people during the day.

Staff said they had opportunities for professional development if they wished. One staff member told us, “From my recent appraisal, I stated I wanted to progress further…I am now completing a new qualification”. Another told us, “There is always support if you need help, management are very good at looking after us staff”.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

Audits and processes were not always effective and failed to identify the issues we found in relation to environmental safety, infection prevention and control and medicine management. The checks completed in relation to fire safety were not robust.

Water temperature checks were taken, though records indicated they were not taken at the correct temperature. We addressed this with the provider, and they told us this was a typing error on the documentation and checks were made to the accurate temperature. This could have led to a potential scalding risk.

The list of appointed first aiders displayed was not always up to date. In a medical emergency this could waste valuable time locating an appropriately qualified first aider.

These failings demonstrated ineffective governance systems in place in some areas. As a result, people could be exposed to the risk of avoidable harm. These concerns were discussed with the provider during the assessment process who took immediate action to address these issues.

The service had a sponsorship licence to recruit international staff, and some staff were recently recruited under this scheme with the help of a third party. At the time of the assessment, the provider was not in possession of full recruitment documentation for staff recruited under this arrangement. The provider has since taken steps to ensure comprehensive information is now in their possession.

Induction training for newly recruited staff and refresher training for established staff was provided. However, assessments of individual staff competency within the team were inconclusive and therefore did not show if staff me the criteria to provide safe care.

However, the views of people using the service, their relatives and staff were sought using both formal and informal processes including, face to face meetings, annual surveys and general conversations. The provider analysed and acted on feedback.

The provider clearly 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.

Staff worked in close co-operation with partners from a range of agencies, to share information, identify and meet people's care needs. Staff made referrals promptly where required and acted upon guidance. Care plans reflected regular input from a range of professionals, ensuring people received joined up and person-centred care. This approach led to measurable improvements in outcomes for people.

Feedback from external professionals was exceptionally positive about how the service worked collaboratively with them. Professionals told us the management team and staff were proactive in seeking advice and responsive to feedback.

People’s relatives described how they were encouraged and supported to work in partnership with the service to ensure seamless and person-centred care was provided to people.

The service worked proactively to build relationships with community groups, which resulted in increased opportunities for people to participate in social, recreational and meaningful activities. This had a positive impact on people’s wellbeing, with individuals experiencing reduced social isolation and improved confidence.

Children from the local primary school visited monthly and took part in structured activities. The local pub and village shop knew people well and would contact the service if they had a problem while visiting.

The provider was able to hold a VE Day commemoration party in the community as they were in the flight path of the aerial display.

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.

Auditing activity did not analyse incidents and accidents or the number and type of falls that had occurred, or the outcomes of safety checks, to establish trends and patterns. Some aspects of safety in the service had not been fully considered in improvement plans to ensure they were addressed, such as the safety of the environment and safe management of medicines.

We found some significant shortfalls during the assessment which the provider had not identified with their own governance system. The provider was open to feedback and committed to making the necessary improvements with many changes made during the assessment process.

However, we did see improvements in the service that demonstrated the service’s commitment to people’s wellbeing. Following the Covid pandemic, the provider had invested in portable air filtration systems situated around the premises and had undertaken structural changes to the building to provide external access and patios for all bedrooms on the ground floor.

Following a visit from the fire officer the provider made significant investment in improved structural fire safety measures.

To reduce footfall within the kitchen, the provider created a new food and snacks preparation room for staff.

The skill sets and lived experience of staff had been analysed to identify appropriate ‘champions’ for specific support roles. A Parkinson’s Disease lead and a dementia lead provided a clear focus for ensuring the needs of people living with these conditions were met.