Farthings 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 Good. At this assessment the rating has changed to Outstanding. This meant service leadership was exceptional and distinctive. Leaders and the culture they created drove and improved high-quality, person-centred care.

This service scored 89 (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 very clear shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the challenges and the needs of people and their communities.

The culture of the service was exceptionally person-centred, open and empowering. Leaders had embedded a strong values-based approach, ensuring equality, diversity and human rights were consistently promoted in everyday practice. Staff across all roles demonstrated a shared commitment to delivering compassionate, high-quality care that placed people’s needs, wishes and preferences at the centre of decision-making.

The registered manager fostered a positive and supportive culture built on trust, openness and mutual respect. Staff described feeling valued, listened to and empowered in their roles. Relationships between leaders, staff, people using the service and external partners were collaborative and transparent, supporting continuous learning and improvement.

The change of ownership had no negative impact on people’s care, as the established staff team remained well supported and continuity of care was maintained.

The ethos and values of the home were fully embedded and consistently reflected in staff practice. Leaders reinforced these through supervision, one-to-one meetings, daily discussions and team engagement, ensuring a continued focus on positive outcomes. Values were also promoted through resident and family meetings, encouraging involvement and maintaining an inclusive, open culture.

Daily multidisciplinary meetings supported effective communication, shared accountability and responsive decision-making. Staff spoke positively about this approach, with one stating, “Everyone gets together to discuss what is happening,” reflecting the strong collaborative culture and collective commitment to people’s wellbeing.

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.

There was a strong and visible commitment to recognising, developing and valuing staff at all levels within the service. The registered manager told us, “Staff are the home’s biggest asset and nurturing them and their development gets the best out of them.” This values-based approach was reflected in the positive culture across the home and in the robust systems in place to support staff development, accountability and continuous improvement.

Staff spoke positively about the leadership and changes implemented within the service. One staff member told us, “We’ve recently been taken over, and there’s been lots of changes, all good.” Staff consistently described leaders as approachable, supportive and responsive, and said they felt listened to and valued within their roles.

The registered manager had received a comprehensive and well-structured induction into the role, including shadowing opportunities and ongoing support from the previous registered manager. This supported the development of their confidence, leadership skills and understanding of the service, helping to ensure continuity and stability within the management team and across all levels of the service.

Leaders at all levels were highly visible within the home and demonstrated a hands-on approach to leadership. They led by example and promoted inclusive behaviours, open communication and positive working relationships. This created a culture where staff felt empowered to contribute ideas, raise concerns and continuously improve practice.

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

Leaders actively encouraged feedback from staff through a range of methods, including staff surveys, supervision sessions, appraisals and informal discussions. Feedback gathered through these processes was used to inform service improvements, including adjustments to staffing levels in response to survey outcomes and workforce feedback.

Staff reported feeling listened to and supported to speak openly. One staff member told us, “Managers are approachable, I can report concerns confidently.” This reflected a positive and inclusive culture where staff felt empowered to raise concerns, share ideas and provide feedback without fear of reprisal.

The registered manager described promoting a ‘no blame’ approach, and there was a well-established culture of openness and transparency throughout the service to encourage learning and continuous improvement. Staff consistently described managers as approachable and responsive and said they felt confident any concerns raised would be taken seriously and acted upon appropriately. This demonstrated clear escalation processes and a strong commitment to fostering a culture of speaking up and learning.

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 registered manager described how they were fostering a warm and supportive culture where people’s individuality and contributions were valued, including those of external professionals working alongside the service. They were committed to creating a positive workplace culture where staff felt respected, supported and proud to work.

The service demonstrated a commitment to supporting staff wellbeing and retention through the implementation of reasonable adjustments to shift patterns and duties where required. One staff member told us, “They have made reasonable adjustments for me which have helped me stay in work.”

The staff handbook clearly outlined the rights and expectations of staff in relation to equality, diversity and inclusion across all aspects of employment, including recruitment, training, development and promotion opportunities. It also provided guidance and links to the provider’s Harassment Policy and Procedure, ensuring staff were aware of the processes in place to support a respectful and inclusive working environment.

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.

Morale within the service was positive, with one staff member commenting that the team worked well together and attributing this to the leadership and management approach of the manager.

The registered manager carried out a range of detailed audits, including health and safety, infection prevention and control (IPC), and medicines management. These audit processes were robust, with clear action plans in place and evidence of timely completion and follow-up. Over time potential risks were anticipated and reduced before escalating leading to fewer incidents overall.

The provider had an effective business continuity plan in place to respond to emergencies and unforeseen events, ensuring the ongoing safety and continuity of the service. The plan reflected local risks and challenges, with clear action plans to support delivery of key outcomes. There were established systems to regularly monitor and review the effectiveness of the plan, enabling timely updates in line with local issues and national guidance. This demonstrated a proactive and responsive approach to maintaining service resilience.

The manager submitted statutory and regulatory notifications in a timely manner as per regulatory requirements.

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.

The service had developed a strong and positive reputation within the local community and demonstrated a commitment to partnership working and continuous improvement. The provider worked collaboratively on projects aimed at improving outcomes for people.

The service had worked on a university project exploring adaptations and responses to Care Home’s when experiencing extreme weather, looking at improving support and reducing disruptions and ill health at times of extreme weather such as heatwaves. Feedback from partners was highly positive with one stating “We couldn’t have done this without your support”

The provider understood the importance of collaborative working to ensure people experienced seamless care and support. Information and learning were shared openly with partner organisations to support improvement and positive outcomes. Staff and management had developed strong working relationships with various external partners who described how it was “a privilege to work with the staff in the home”. these partnerships reduced barriers to accessing services and encouraged positive outcomes for people.

People, relatives and staff were encouraged to take part in fundraising activities for the residents’ fund and local charities nominated by the residents’ group. The owner matched the money raised with personal donations improving the activities that could be offered and funds for improvements to the garden areas. Improving outcomes for people inside the home and beneficiaries from the nominated charity.

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 highly embedded culture of openness, learning and innovation across the service, and the service was constantly evolving and improving. Leaders demonstrated how learning from incidents, feedback and concerns was proactively used to drive sustained improvements and prevent recurrence. Robust governance systems enabled effective monitoring of quality and outcomes, with data used intelligently to inform decision-making and continuous improvement. This led to improved health monitoring, more timely health referrals, reduced call bell response times and a reduction in medication errors.

Leaders clearly evidenced how improvements were identified, implemented and sustained, resulting in consistently positive outcomes for people. Innovation was encouraged, with staff empowered to contribute ideas that enhanced care delivery. Investment in digital systems, including eMAR (electronic medication administration record) and care planning technology, strengthened oversight, improved communication and supported safer, more responsive and person-centred care.

The home’s nursing team worked in partnership with the local Integrated Care Board (ICB) as the first home taking part in a pilot project, where nurses undertook reassessments of people’s Local Authority care plans. This demonstrated an innovative and proactive approach to joined up working and continuous improvement. The initiative resulted in significant positive outcomes for people. Delayed assessments were completed in a timely way by nurses who knew people well and understood their individual needs, preferences and circumstances. This ensured care plans were accurate, up to date and reflective of current needs, enabling people to receive the correct level of care and support.

By taking part in this pilot, the service contributed to system-wide learning and improvement, while enhancing people’s experiences and outcomes through more responsive, coordinated and personalised care.