The Beeches Nursing and 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 changed to requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to good governance. Governance processes had been inconsistent. Although there had been recent improvement, these changes were new and not yet fully embedded. There were still some areas that required further improvement..

This service scored 61 (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. Staff and people spoke positively about the culture of the home and how they had seen recent improvement. One staff member told us, “I can honestly say there has been a big change in culture and delivery of care since the management changeover.” Management had policies and procedures in place to support working towards a shared vision.

The home had capable, compassionate and inclusive leadership but this had been inconsistent, and the home had recently been through a period of change. Leaders had not always had the skills, knowledge, experience and credibility to lead effectively, or they did not always do so with integrity, openness and honesty. The new leadership of the home understood the context in which the provider delivered care, treatment and support. They embodied the culture and values of their workforce and organisation. Management worked together and there was improved oversight to ensure the newly appointed manager was working effectively and had the support needed in their role.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. People and staff told us they felt concerns raised would be listened to and action taken. Policies supported staff to speak up, providing routes for anonymous concerns as well as signposting them to external agencies.

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. Recruitment processes, training and policy and procedures were in place to support equality, diversity and inclusion. Staff told us they felt they were treated equally and fairly.

The provider did not have clear responsibilities, roles, systems of accountability and good governance. They did not act on the best information about risk, performance and outcomes, or share this securely with others when appropriate. This resulted in a breach of regulation in relation to good governance. Although governance of the home had recently improved, there were still areas in development and new systems that had not been fully embedded. For example, fire safety issues were known but had not been fully addressed. Improved auditing and supervision processes were new and needed to be embedded. There was insufficient evidence of continuous provider oversight.

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 was working to an improvement action plan agreed with the local authority. Partners fed back there has been improvement in terms of partnership working. A professional told us, “Communication with the home is much better and we are not having to chase things up all the time now.” A staff member told us, “The service works very well with relatives, professionals, and external services. We maintain open and regular communication with families, keeping them informed about their loved ones' care and involving them in decision-making where appropriate.”

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. Systems did not always support improvement and sharing learning. There were avenues to collect stakeholder feedback and learn from incidents, but these needed further improvement to ensure they effectively supported improvement and innovation.

The provider was aware this was an area for development and was open to improving systems and processes. The management were part of several networks to learn and share good practice.