Ashfield 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 we rated this key question requires improvement. At this assessment the rating has changed to good.

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 71 (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.

We observed practice and reviewed documentation that demonstrated a positive, person-centred culture within the service. People were consistently placed at the heart of decision-making about their lives, and staff worked collaboratively to ensure their views, preferences and needs were respected.

For example, through discussions with a person's family and life history, staff learned they had always enjoyed listening to music from the 1950s and 1960s. We observed staff using the music at times when the person appeared unsettled, and the person became visibly calmer, singing along to familiar songs and engaging positively with those around them. This demonstrated how the provider understood the person's individual needs and experiences and used this knowledge to promote their wellbeing, dignity and quality of life.

The registered manager understood the importance of maintaining an open and positive culture and recognised the impact this has on people’s experiences. They took an active role to oversee practice, which included regular walks around the home, observed interactions and engaged with both people and staff. This helped to ensure standards were maintained and that a caring, inclusive environment was promoted.

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 openness and honesty.

We spoke with staff and the management team, who talked positively about their roles and their commitment to making a difference in people’s lives. This was reflected in the care and support we observed. Staff consistently told us they felt the registered manager had the skills, knowledge and capability to lead the service effectively.

Staff described supervision as supportive and development-focused, providing opportunities to reflect on practice, discuss challenges and identify learning needs. Staff gave examples of how supervision had improved their practice, such as increasing their confidence in supporting people living with dementia and responding more effectively to behaviours of distress. Several staff told us they had been supported to develop their skills and progress within the service. For example, one staff member had joined as a care assistant and, through training, mentoring and increased responsibilities, progressed to the role of deputy manager. This demonstrated the provider's commitment to developing staff, improving practice and nurturing future leaders. The registered manager also spoke about the support they received from within the wider organisation, which included access to senior leadership and peer networks. Throughout the assessment, the registered manager and staff team were open, honest and responsive to feedback, demonstrating a positive and transparent culture.

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

People and relatives were able to communicate openly with staff and management, and there was positive, trusting relationships between people and the staff team. Relatives told us they knew how to raise any concerns, and staff said they felt confident speaking with management if needed.

There was a clear policy and procedure in place to support staff and residents to speak up. Staff told us they felt able to raise concerns and were given opportunities to discuss these openly. One staff member said, “Yes, I feel able to speak up about concerns I may have. If I have concerns or need guidance, (registered manager) is available to discuss them and provides constructive feedback. (Registered manager) encourages staff development and ensures we have the resources needed to provide good care.”

The registered manager promoted a culture where people and staff felt their views were valued. They told us, “It’s about partnership working and making sure people feel their concerns are valid and that they have a voice.”

This open approach meant concerns and issues could be identified and addressed promptly, supporting continuous improvement and positive outcomes for people.

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 promoted equality, diversity and inclusion within the workforce, creating a culture where staff felt respected, valued and supported. Staff were treated fairly and were encouraged to share their views, which contributed to an inclusive and positive working environment.

The service recognised and responded to the diverse needs of staff. For example, reasonable adjustments were made to support staff with individual needs, such as adapted duties or working arrangements. In one instance, a staff member with a health condition was supported with adjusted shifts and responsibilities, which enabled them to continue to work effectively and feel valued within the team.

Staff told us they felt included and supported regardless of their background or personal circumstances. This inclusive approach helped to promote staff wellbeing and retention, developing a stable workforce that could provide consistent, person-centred care to people.

The provider had clear roles and governance systems; however, these were not always fully embedded. Some environmental concerns had not been identified, reflecting gaps in oversight. Some improvements were needed to ensure risks were consistently recognised and managed appropriately.

There were governance systems in place to monitor the quality and safety of the service. The registered manager and provider carried out regular audits and reviews, which on the whole, identified areas for improvement and took timely action to address them. However, areas we identified had not been identified by the service. The concerns we raised on assessment were dealt with immediately to ensure safety was maintained.

The management team understood and embedded best practice guidance. For example, care and support were designed to promote people’s independence, choice and control, with staff delivering person-centred care in a way that respected people’s dignity and individuality. This included staff who adapted support to meet changing needs while they ensured people remained actively involved in decisions about their lives.

There was clear oversight from the provider, with systems in place to monitor performance across the service and share learning. Staff described the management team as approachable and supportive, and there was a positive, open culture where feedback was welcomed and acted upon.

Overall, governance and leadership arrangements were mostly effective in ensuring the service was well managed, sustainable and focused on achieving positive outcomes for people in line with best practice guidance.

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.

We saw positive examples that the service worked in partnership with external professionals to ensure people received holistic care that met their health and wellbeing needs. Management and staff demonstrated a good understanding of the range of professionals available and how to access their support.

For example, staff worked closely with community nurses to support a person who lived with diabetes. Guidance from the nurses was clearly reflected in the person’s care plan, which included monitoring of blood sugar levels, dietary support and early identification of any concerns. Staff followed this guidance consistently, which helped to promote the person’s health and reduce risks.

Leaders worked collaboratively with people, their representatives and staff to create a culture focused on enabling people to enjoy their lives. The provider also supported people to access community resources, such as day services and local activities, which helped them to develop new skills, build relationships and engage in meaningful experiences.

Overall, this collaborative approach ensured people received well-coordinated care and were supported to live fulfilling lives.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways to deliver equality of experience, outcome and quality of life for people.

We spoke with the registered manager about continuous learning, improvement and innovation. They gave examples of how incidents and concerns were regularly reviewed to identify learning, with improvements shared across the staff team to strengthen practice. Staff were supported to complete additional training to develop within the service, achieving goals they initially thought may not be accessible. The registered manager had plans in place to develop staff in order to strengthen the clinical team. This was supported positively by the provider and the senior team.

The registered manager demonstrated a commitment to ongoing improvement. They had reflected on feedback and quality concerns identified during the assessment and were taking action to drive further improvements at the service.

The service showed a positive approach to learning, innovation and continuous development, which supported improved outcomes for people.