Horton Cross Nursing 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 the provider was in breach of the legal regulation in relation to good governance. At this assessment we found improvements had been made, and the provider was no longer in breach of this regulation.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to 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 and registered manager promoted a culture of openness, collaboration, and continuous improvement. Staff described the home as “Like a family” and praised the positive changes since the new registered manager’s appointment.

People and relatives felt informed through newsletters and meetings, and initiatives such as resident ambassadors fostered inclusion and purpose.

Surveys and feedback systems were in place, although analysis of the surveys were difficult to understand. The registered manager said they would review how they shared the survey outcomes so they were more accessible to people using the service.

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.

The registered manager demonstrated strong clinical knowledge and a commitment to empowering staff. Staff consistently described the management team as supportive and responsive, with an open-door policy and regular supervisions.

The registered manager acted on feedback, for example improving dining experiences and changes in recruitment following concerns about workforce diversity. Daily management meetings ensured effective communication and oversight.

All staff we spoke with were positive about the new registered manager. Comments included, “[Registered manager] is a very good manager, she has made a drastic difference, and I am very happy about the changes”. Another said, “I am proud of all that I have achieved as a carer here, I am also proud of [registered manager] as a manager I can tell she cares and tries very hard”.

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

Staff felt confident to raise issues or concerns with the management team if needed and felt that they would be listened to. Staff told us the “(Registered manager) door is always open.”

Staff were aware of whistleblowing procedures and felt confident they would be listened to.

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.

The provider ensured staff were treated fairly and supported. All staff completed equality and diversity training, and recruitment processes included monitoring forms.

Staff told us they felt respected and valued, with no concerns about discrimination. One staff member told us, “We are being treated equally, there is no discrimination.” The registered manager responded to feedback about workforce composition by looking at recruiting to complement the existing team. Reasonable adjustments were made where needed, and staff spoke positively about flexible support and opportunities for development.

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 robust and sustainable. Quality audits, risk assessments, and improvement plans were in place and regularly reviewed.

The provider maintained oversight through structured reporting and daily checks. Clinical governance was strengthened by appointing a deputy manager with clinical governance expertise and implementing audit trackers across departments. HR systems were fully updated, and training compliance was high.

The registered manager demonstrated accountability and acted promptly on identified risks, such as improving mattress settings and environmental safety.

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 management team worked collaboratively with external professionals, including GPs, pharmacists, and allied health teams, to ensure continuity of care. A paramedic visited weekly to triage clinical needs, and escalation pathways were clear.

The service engaged with families through meetings and events, and people participated in community activities such as garden projects and local newspaper features. Volunteer involvement and ambassador roles enhanced social inclusion.

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 registered manager analysed incidents and implemented changes, such as introducing pressure-relieving equipment following risk assessments.

Lessons learned were shared with staff, and audits informed action plans. Innovation was evident in communication systems (e.g., WhatsApp groups), electronic care planning, and environmental upgrades.

Staff were encouraged to develop skills, for example 1 staff member was supported to pursue their interest to a high level in dementia care. Continuous improvement was embedded in the service’s culture.