SeeAbility - Heather House 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 requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to governance. The providers governance system failed to identify all the concerns we found during this inspection.

This service scored 61 (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 registered manager told us, “Our values are respect, imagination, learning together to be our best and we believe in each other. Learning together is really important, we learn every day. We are open and honest and work as a team. Everyone needs to have a voice, if staff feel something is not working, it’s important they come forward. Respect is important, it’s 2-way, I lead by example and treat people and staff with respect and am hands on. Our values are part of our recruitment advert and our induction training.”

Not all leaders understood the context in which the provider delivered care, treatment and support. They did not always embody the culture and values of their workforce and organisation. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively, or they did not always do so with integrity, openness and honesty.

We identified breaches of regulations and concerns in areas such as safe care and treatment and governance. Leaders had not independently identified and acted on all these concerns prior to our inspection. This meant some development was needed in their skills and knowledge to lead effectively.

One relative told us, “I’m definitely comfortable to complain, I’m a very vocal parent. The registered manager is very approachable. I think they do annual questionnaires. It’s the most incredible place. For our family, it’s been life changing.”

Staff members told us, the registered manager was visible, accessible and approachable.

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

People living in the services were asked for their views and were given the opportunity to speak up daily both informally, and in meetings. We reviewed people’s daily support notes and noted people spoke up, and their decisions and choices were respected. This meant people’s voices were heard.

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 supported to give feedback and were treated equally, free from bullying or harassment. They told us they had access to relevant policies.

The registered manager told us about the organisations flexible working policy which meant staff could apply for adjustments in their work to be made if needed. They gave examples of when this had happened in practice.

The provider did not have clear responsibilities, roles, systems of accountability and good governance. They did not act on the best information about risk, performance and outcomes, or always share this securely with others when appropriate.

The provider’s own governance systems had failed to identify people were not always receiving safe care and therefore prompt action had not been taken to make improvements.

Quality assurance audits had been completed by the provider, however, these had not always been effective in identifying the shortfalls we found at this inspection, such as the inconsistencies or missing information we found in care plans, the safeguarding concern which had not been reported, the concerns relating to food storage and medicines stock management.

Where the provider’s audits did identify concerns for action, they did not always bring about improvement. For example, some of the concerns relating to fire safety, therefore monitoring systems were not always effective.

Although the registered manager was responsive to the concerns raised and started to make improvements during the inspection, they required time to embed them into practice.

People mostly received care and support in accordance with the principles of ‘Right care, right support, right culture’ guidance. People were supported to eat healthily and were supported to engage in meaningful activities both inside and outside of their home.

The registered manager was able to confidently tell us how they ensured safe record keeping by following the principles of General Data Protection Regulation (GDPR).

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.

Professionals, staff, and the registered manager shared with us positive examples of collaborative working in partnership. One professional told us, “My main observations are that the knowledge the staff team have of each resident’s needs and the care in which they take to ensure their quality of life is truly admirable. I have never felt as reassured about the people’s living environment as I have from Heather House. I see the staff team undertaking regular training, staff observe my sessions with people to increase positive ways of working with the individuals outside of the support. It is truly a joy to turn up to work alongside the staff here and feel valued and heard, as we try to collaboratively ensure the needs of the people are met.”

The provider strived to focus on continuous learning, innovation and improvement across the organisation and local system.

However, we found some concerns during the inspection which we have highlighted throughout our report. Although the provider was motivated to learn and improve the service for people, the lack of effective risk and quality monitoring systems meant they might not always be aware of shortfalls to enable prompt improvement and learning.

The provider was responsive during our inspection and told us what action they would be taking and how they were taking learning from this inspection and would be sharing this across their organisation.

The registered manager shared with us several examples of how they were improving people’s experience, they told us, “Having our own team of physiotherapists on site is hugely beneficial. Having the ‘innowalk’ equipment which helps wheelchair users improve their muscle function, bowel and urine output, it also helps people be more awake and alert, it brings joy and for people who used to be able to walk, it helps them to be able to stand up and be proud again.”