Larchfield 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 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 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 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.

Not all the people we spoke with knew who the registered manager was. Their comments included, “Well I’ve only seen the manager once”, “I don’t know them”, “Never met [them], don’t know who [they are], “I do know the manager, [Former registered manager] but I have only met [them] twice” and “Yes, I do know the manager here. I think [they are] doing a great job.”

There had been some changes in the provider and management team prior to our inspection. We were also informed that the registered manager had left, and a new interim manager had been put in place shortly after our visit. They planned to apply for their registration as soon as possible. The new manager introduced themselves to us following the inspection and was responsive to our requests.

The management team told us they ensured the staff were valued and promoted people’s individuality, protected their rights and enabled them to thrive. Staff told us there was a good and positive culture within the home. Their comments included, “We have a good team that works together” and “I feel very positive about our team. We work well together and are able to talk about our concerns to each other.”

The provider set a culture that valued reflection, learning and improvement. The management team effectively used staff supervision and regular team meetings as a platform for staff to raise any concerns and an opportunity to share their views and opinions. A staff member described supervision as, “Very helpful. It identifies strengths and weaknesses so I can develop. We also have feedback from the daily meeting that the heads attend, so we are always kept up to date.”

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.

Overall, people and relatives were positive about the management team. One relative told us, “Everything I’ve seen, I have no negative comments at all.”

Staff found the management team to be visible and supportive. Their comments included, “Management are making the workforce more balanced”, “I have full support of my community manager, matron, deputies, always asking me how I am at the start of my shift, they are very approachable”, “Management is supportive when we raise any problem or concern” and “[Managers] encouraged me to do NVQ level 3, they are motivating people. They ask for feedback if anything can be done or improved and they act on it really quickly.”

The provider had implemented a management structure with clear roles and delegated responsibilities. During our observations, we found the unit leaders to be pro-active when running the units. They also displayed a sound knowledge of individual people’s needs. The staff reported they felt well supported by them and they led by example.

In addition to monthly staff meetings, there were daily handover meetings to discuss important information, and any risks to service delivery. There were processes to support managers and senior staff in meeting their responsibilities.

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

People were given information when they moved to the home about how to raise a concern and said they knew how to make a complaint. Their comments included, “I get quite loud and say my piece to any of them sometimes, they are all ok to talk to. I wouldn’t be frightened to say it” and “I think I could speak to anybody. Never had to.” A relative added, “If I saw something concerning, I wouldn’t know how to do it but I’m sure I could find out.” Complaints were recorded and acted upon.

Some staff told us they knew about the provider’s whistleblowing policy and would not hesitate to use this to benefit staff and people living at the home. Others were not fully clear about this. One staff member told us, “If it is really serious we would inform our senior first, if it involves the senior then we would inform [management team] and another said, “No concerns, I am happy here, my residents are happy.”

The provider had some processes in place to support staff to speak up. This included supervision meetings, handover meetings, staff meetings and a whistleblowing policy. Staff had also received training in safeguarding to reinforce their understanding and their responsibility to speak up.

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.

Staff told us they enjoyed working in a diverse team although they acknowledged this could also bring some challenges, for example a language barrier. One staff member told us, “Sometimes it’s the way they speak as there are people from different countries, but I am teaching them how they can approach the resident better. So we have to consider where they come from and their culture” and another said, “The workforce is equal and diverse.”

The provider had policies to promote equality, diversity and inclusion and to protect staff from discrimination and harassment. The staff handbook given to all new staff at the start of their employment provided guidance on their implementation within the home.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support.

Staff told us they felt supported and valued by the registered manager who was available whenever they needed them. Staff said they were supported to keep up to date with the care people required through the information recorded on handheld mobile devices linked to the electronic care planning system. Unit managers had responsibility for monitoring staff and to ensure people’s needs were met. This included checking people’s care plans and risk assessments were up to date.

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.

People and relatives told us they had access to health professionals including GPs who visited regularly. They felt their health needs were taken seriously and met.

Staff told us they regularly worked with healthcare professionals so people’s needs would be met, such as the tissue viability nurses and speech and language therapists. The registered manager confirmed they had a good working relationship with a range of external professionals.

The provider had systems and processes to ensure people’s needs were reviewed with external professionals. The provider listened to feedback from them and where a need was identified, amended their policies and procedures to promote effective communication and partnership working.

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. They actively contributed to safe, effective practice and research.

People told us they were consulted individually during a review or regular conversation, or as part of a ‘residents’ meeting’, to find out if they had any concerns or requests. We saw people’s opinions and requests were taken seriously.

The provider had launched a ‘Memory Café’ in October 2023 to help reduce the stigma surrounding dementia and care homes. The initiative had been successful, bringing together people, families, and the wider community, including healthcare professionals who joined each month. In December 2024, the service was visited by a former Prime Minister and the local MP.

The provider stated the Memory Café had provided people with regular opportunities for social interactions, stimulating conversation, meaningful activities and contributing to improved emotional wellbeing.

Staff told us the managers were always aiming to make improvements to the service in order to benefit people who used it and they enjoyed being part of this.