Milford 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.

The provider had a set of ‘care commitments’ that outlined the standards and values people and staff could expect from the organisation. There were 7 ‘care commitments’ that were published on the provider website and also shared with staff during their inductions. The regional director told us these values were included in surveys, meetings and published on provider records.

The registered manager told us they were completing their induction and taking time to get to know people, relatives and staff. They had a ‘meet and greet’ event planned during our site visit to formally meet with relatives. They said listening to people and relatives was an important aspect of their role and they were keen to improve the service for people if they were not happy.

Staff feedback was they were happy working for the provider and understood what the provider expected from them. Comments from staff included, “Barchester is a good company to work for” “Values are put into practice on a daily basis; the Barchester way” and “Values are implemented by staff on a day-to-day basis. Everyone has the same goal which is to enrich the lives of residents and give them the best experience.”

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.

There was a daily head of department meeting which enabled leaders to communicate with each other about what was happening in the service. There was a newly registered manager in post who had previously worked at the service as a nurse. This gave them a good understanding of the service and knowledge of the provider policies and procedures.

Leaders were supported by the provider. Various central office staff were employed to help with all aspects of managing this service. For example, there was a learning and development lead, a clinical development nurse and a central quality team. These staff visited regularly and helped with care monitoring, analysis, training and compliance.

Staff had found it unsettling to be without a registered manager. However, they were positive about the new appointment, and most staff already knew the registered manager. Comments about the management from staff were positive. Comments included, “Management listen to us and I feel very supported” and “It is a nurturing environment here.”

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

The provider had a speaking up policy which was available to all staff. There was a system for staff to share any concerns at the service or anonymously if they wished. Staff we spoke with knew how to raise concerns and were confident they would be listened to. One member of staff said, “I am confident they [leaders] would listen to me and take me seriously if I raised concerns.”

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 had been provided with equality, diversity and inclusion training in their inductions and refreshers were provided annually. There was a diverse range of staff at the service and various cultures were celebrated with themed days or information sharing. The provider had ‘inclusion weeks’ which encouraged services to celebrate diversity and inclusion. At a recent ‘inclusion week’ staff had brought in different drinks from their culture to share with everyone. A taste testing had been organised for people and staff.

Staff were able to submit requests for flexible working and had their rotas in advance to help them plan for things like childcare or cultural events.

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. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

Governance systems were established with various checks on quality and safety taking place across the service. Regular audits were being completed for areas such as medicines, kitchen, housekeeping and care documentation. Audits and checks were carried out by various staff which helped to reduce risks of complacency. The provider had a central quality team who carried out announced and unannounced visits to check quality and safety. Each visit had different areas of focus depending on how the service was performing.

The provider was planning on moving governance records onto an electronic system. This would give the provider better oversight of information and actions needed. Work had been completed to move care planning records onto an electronic system. The provider had waited to give staff the opportunity to gain skills and confidence with this system before changing more ways of working.

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 service had links with a wide range of stakeholders. Various healthcare professionals were communicated with about people’s health needs. Regular visits from the local GP surgery gave people consistency with healthcare. One professional told us, “Milford House is a caring and compassionate home, I see only good things. They do a good job.”

Leaders and staff recognised the importance of links with external stakeholders that could develop and improve outcomes for people. There were links with the local hospice service for example, to access training and support. Staff had developed partnership working with a local nursery for children. This was a 2-way relationship which people enjoyed. Children were welcomed into the service and people were also able to go to the nursery for visits.

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.

The provider had taken action to continually develop the service. There had been new electronic care planning and recording systems which helped give everyone better access to care records. The provider completed regular feedback surveys with people, relatives and staff to hear what people had to say. This enabled action to be taken to make improvements in response. Surveys were completed annually, however, depending on feedback received they could be completed more often. Most recently completed surveys provided positive results. Scores for all areas such as person-centred care, nutrition and dining and life enrichment were over 90%.

The regional director told us there was a 6 monthly board meeting where there was a focus on learning from each other. This was not just about learning when things went wrong but also when things were going well. Services that were identified as being successful through CQC ratings, good recruitment and commercial success were analysed. The aim was to see how they were operating and what could be shared with other services not as successful. The regional director said the organisation liked to “celebrate success”.