Eleanor Palmer Trust 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.

The provider was previously in breach of the legal regulation in relation to good governance. Improvements were found at this assessment and the provider was no longer in breach of this regulation.

At our last inspection we rated this key question requires improvement. At this inspection 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 82 (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 ethos, values, attitudes and behaviours of leaders and care staff ensured people were treated with respect and dignity and staff treated people as equals. People told us they felt safe and comfortable and were able to lead a good quality of life.

Staff told us, they felt included and empowered to influence the way the service is run. All staff we spoke with told us they felt the service had improved in the past 12 months and they felt supported and empowered to keep people safe. A staff member said, “It is better now than before. The team is friendly, and the manager listens to our ideas."

Since our last inspection the provider had implemented an improved culture of effective leadership and teamwork to reinforce the organisation’ vision and uphold its traditions. People received person-centred care and their human rights were respected. Staff and leaders communicated with each other in daily observations, staff meetings, and the availability and approachability of staff at all levels. We observed staff were caring and committed to providing good quality care and treatment to people living in the home. Staff respected and valued each other. Staff were very positive about the management team and complimented them for how supportive they were. The registered manager said, “Myself, [deputy manager] and the entire team here strive for excellence and are passionate about delivering quality care.”

The provider had exceptionally 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 always did so with integrity, openness and honesty.

The home was managed by the registered manager, who was supported by the deputy manager and a director who oversaw the management of the service on behalf of the provider. Senior staff also supported the management team. The registered manager told us they were well supported and had daily discussions with provider representatives to maintain the service and deliver good quality care. They said, “We have worked very hard to improve the service. We all work together well. I get fantastic support.”

The management team maintained an open culture where staff felt confident reporting concerns, contributing to the overall safety of the service. Staff reported that the management team maintained an open culture where staff felt confident reporting concerns, contributing to the overall safety of the service. Some staff spoke highly of their manager, consistently praising their supportive leadership, clear communication, and genuine commitment to both staff well-being and person-centred care. However, some staff said that the management team was not always visible around the home. They told us there were occasions when they did not feel they were respected or spoken to appropriately. We mentioned this to the registered manager, and they acknowledged this feedback as part of their continuous improvement and development of the service.

Staff and managers treated colleagues from other organisations with kindness and respect. People and relatives spoke positively about the home and the management team. A relative said, “The manager is very visible and they do a good job in running the home. Family and friends have insight into running care homes and they are impressed with [registered manager] and her team.” Another relative commented, “The manager is amazing. She arranged for a dementia session for families of residents and it was very insightful.”

The registered manager also ensured people with dementia had access to select fruit and vegetable's from the home's allotment giving them a sense of the colours and texture of the food, which were then blended into soups and smoothies for people to enjoy. A relative told us," The care they show to [family member] and give them day in and day out is excellent and [family member] feeds off the love they give them. We smile when we leave, they are clearly doing well. Changes aren’t needed the home is run really well. [Family member] loves it there and it meets all their needs both mental and physical. ”This further demonstrated and care, compassion and attention to detail within the home, led by the registered manager.

It was evident the provider had fostered an involving and positive culture where all staff, people and relatives were respectful of one another. Staff were also positive about the opportunities within the home to develop their skills. A staff member said, “The training is great here, and we get lots of chances to learn new things."

The service fostered a positive culture where people felt they could speak up and their voice would be heard. There was regular engagement with people and their representatives and a strong focus on supporting people to thrive, develop skills, have new experiences and live the life they choose.

Staff said they were able to speak with the manager or unit leads (team leaders) to discuss any concerns. Staff felt they would be listened to respected. A staff member said, “The manager listens to our feedback and resolves things quickly.”

Records showed meetings took place with relatives, people and staff to listen to feedback and address concerns. There were processes for staff to follow should they wish to speak with external agencies such as the local authority, the CQC or the police, if they were unable to report concerns about people’s safety to the provider or if concerns were not acted upon by the provider.

People and relatives could contact the service at any time to speak with managers. A relative said, “I can contact the manager and they always listen and respond.”The provider was open and transparent with people and relatives. They listened to their views and opinions. They apologised to them when things had gone wrong in the home or mistakes had been made.

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 felt they were treated fairly by managers, and worked well with them as a team. Staff completed training in equality and diversity and had an understanding of what it meant. Recruitment and disciplinary processes were in place and ensured there was no disadvantage based on staff's specific protected equality characteristics. The provider had processes to ensure an inclusive workplace where staff were treated and supported as individuals. A staff member said, “The managers treat us very well. They are very good, very professional.” The provider had registered as a Disability Confident employer meaning they promoted the recruitment and development of staff with disabilities.

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 act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.

At our last inspection, we made recommendations for the provider to ensure effective quality assurances systems were in place to identify oversights and areas for improvement.At this inspection we found there were effective systems to monitor the quality of the service people received. Regular safety audits and monitoring systems helped identify potential risks before they became an issue.

The registered manager and deputy manager carried out observations of staff competency, audits and team meetings. We saw that work was ongoing to continually improve the performance of the service. A range of audits were completed across all parts of the service, to monitor its safety and quality.

The registered manager completed daily walk arounds to ensure people were supported appropriately, staff were carrying out their roles as expected, and the building was safe and maintained. Action was taken to address issues that were identified. A service improvement plan was in progress and updated when actions were completed. These included recommendations made by the local authority following their visits to the home. Representatives of the provider carried out governance visits to the home to review the service and check the management team’s ability to lead the service effectively.

The manager was visible and supportive, helping staff to perform and develop their roles. They engaged with people and staff throughout the day. There were clear arrangements for accountability in the home. Clinical audits ensured an oversight of these areas and ensured best practice guidance was being followed. For example, pressure sores, wounds and other injuries were recorded, treatment was planned, monitored and reviewed.

The provider clearly understood and carried out their duty to collaborate and worked in partnership, and services worked seamlessly for people. They always shared information and learning with partners and collaborated for improvement.

Staff and leaders worked exceptionally well with partner agencies to ensure people using the service were part of their community. Staff and leaders had worked extremely well to make links with the community and had been involved in a number of key initiatives. These included family and community workshops such as “Understanding Dementia” which were well attended. The provider had pledged a commitment to ongoing development and continuous improvements in dementia care standards.

Leaders in the home worked very well with people, families and professionals. They were able to network and contact external organisations, such as the local authority, for advice, guidance and developments within the health and social care sector.The registered manager was involved in pilots and research projects. One initiative involved dentists and hygienists coming into the home supporting people with their oral health. The aim was for people to enjoy their food and mitigate the risk of decay and infection. The provider has involved people to become oral health champions and audits included checking people were changing their toothbrushes at least every 3 months.

The registered manager was very proactive and was also a chair or co-chair of the Barnet Registered Managers' Network and Skills for Care network meetings. Feedback from external partners was very positive about the work that was carried out by the provider and registered manager. A professional told us, “[Registered maanger] is closely engaged with the network to facilitate the network meetings to ensure the content is useful and relevant. Eleanor Palmer Trust very kindly funded a guest speaker at the network who presented on gaining confidence and wellbeing at work. This was greatly appreciated by all of the network members.” The registered manager also said, “I took part in a research study on the wellbeing of registered managers. This has historically been an area that has been overlooked.”

The provider had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

There was a culture of continuous improvement and utilising resources to try new ideas and innovations. The management team were involved in a number of initiatives to enable continuous learning, development and improvement in the home. For example, researching the impact of caffeine on people and the increased risk of urinary infections and falls. The registered manager told us they wanted to improve people’s health outcomes by reducing these risks. They made sure they sought people’s consent to remove caffeine from their diet.

The provider also used technology to improve the lives and wellbeing of people. For example by using Artificial Intelligence devices to play people’s favourite music or installing acoustic monitors with people’s consent. These can detect or analyse people’s movements and sounds and alert staff if they seem unwell or are likely to have a fall.

The management team analysed incidents and supported staff to look at what went wrong, what could be prevented and what needed to change in the future. This was carried out in a positive way to enable wider learning as part of improving the service. Staff attended team meetings with the management team to discuss various matters. An internal action plan had been developed by the provider to help drive continuous improvements.