Rothsay Grange

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.

Although not all the people we spoke with knew who the manager was, everybody said they felt comfortable speaking to any member of staff. One person’s relative said, “They are very accessible. If the office door is shut, then I speak to the receptionist and arrange to speak to somebody in the management team. If the door is ajar, then I can knock, and they will always speak to me.”

Staff told us the management team were visible and accessible. Comments included, “I see them all the time; they ask how I am. I have contact details for them.”

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.

Staff told us there had been many changes in management. Most staff told us they were keen to have a permanent manager in post who would stay and provide consistent leadership. One staff member said, “I want a permanent manager. This is my sixth manager since I’ve been here, the team need stability. This year alone we’ve had 2 new managers.”

People living at the service and their relatives also told us they had seen different managers but told us the current management team were approachable and pleasant. A few relatives told us they felt there was an improved atmosphere at the service. One person’s relative said, “If I had one concern it would be all the changes on the management side which I find a bit concerning, although it's never seemed to affect the care.” Despite this, we received many positive comments about the deputy manager. Most of the people we spoke with, including people, relatives, staff and health professionals told us the deputy manager was “approachable” “knowledgeable” and “proactive.”

The provider was aware of the recent management changes and told us they were in the process of recruiting a suitable long term general manager for the service. In the interim period, the service was led by an operations manager with support from the deputy manager. The provider’s senior management were also a regular presence at the service.

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

Staff told us they felt able to raise concerns about poor care. They told us they were encouraged during meetings to raise any concerns and knew who to speak to. One staff member said, “I would go straight to the nurse. If I wasn’t listened to, I would go straight to the manager. I could also go to the regional manager or to human resources to get advice on who to speak to. We have ‘speak up posters’ in the office.”

There was a speak up champion at the service who staff could speak to about any concerns they had. The manager said, “We have speak up champs and [staff name] is ours. We regularly converse and we will chat about anything. Our speak up champions also have regular meetings with the provider to discuss how things are.”

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 a diverse staff team in post. Staff told us they felt valued and included. One staff member said, “It’s so good, I get on well with everybody. We are all friendly here. I can speak to the nurses if I am concerned.”

The manager gave examples of how they supported staff to feel included and valued. They said, “For our sponsored staff, we buddy them up with someone else and we have things like inclusive week where staff educate each other on their cultures. It’s not just overseas staff we support. We have an army base close by and some staff might have partners who are deployed so we support them too and try to be adaptable and flexible.” The manager told us the provider encourage staff to celebrate any religious festivals, by moving staff between services to make sure shifts were covered.

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.

There was a schedule of audits and checks carried out across all areas of the service. Audits showed action was taken where areas of improvement were identified. Analysis of clinical aspects of the service such as nutrition, skin integrity and infections were carried out monthly to identify any trends, alongside daily stand-up meetings. The provider carried out regular assurance visits and action plans were produced which meant there was additional oversight at provider level. This included input from the provider’s dementia specialist with recommendations. Records showed identified actions had been completed or were ongoing.

The leadership team told us they assured themselves of the standard of care delivery through observations of staff. The deputy manager said, “The care is good here. I know that because we check constantly, we do spot checks, we talk to people and to the relatives. Barchester has a find and fix policy, so we aim to fix things straight away. Staff do make suggestions, and we discuss and work out what works and what doesn’t.”

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 a good relationship with the local GP service and teams of other health professionals. On the second day of our inspection there was a planned networking event for different local organisations. The manager said, “We have good links with the community. We have the local school choir coming in soon, the rotary club have their monthly meetings here and the ladies from the local women’s institute come in and do arts and crafts with people.” We were told the service had put on falls prevention sessions for people and families using the service and for members of the public.

One visitor told us the service had supported a local charity recently. They told us “Last year, they chose us as their charity to support for the year, which was really lovely.”

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.

Incidents and accidents were reported, investigated, and analysed for trends. Lessons learned were shared with staff during staff meetings and daily handovers. Staff had regular training and updates and all the staff we spoke with said they felt trained to carry out their roles.

The manager told us how learning was shared amongst the provider’s services. They said, “We share good practice amongst homes. Recently, deputy managers presented a challenge they had identified and what they'd done to improve.”

The provider was proactive and responsive about the feedback we gave during the inspection and acted on any issues we found promptly.