Marner House

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 inspection we rated this key question good. At this inspection the rating has remained 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 79 (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.

Without exception, staff were complimentary about the support they received from the management team, and the positive culture within the home. They described feeling valued, listened to and empowered to provide high-quality care. Staff gave numerous examples of how leaders had supported them to achieve positive outcomes for people.

One staff member told us, “We are kind, caring, considerate. We are approachable and accommodating. I know that people are in safe hands.” Another member of staff said, “I would describe the culture as open and honest. It’s a very good place to work.” These staff’s comments reflected feedback received from other staff, who spoke positively about teamwork, communication and the support available to them.

The registered manager provided opportunities for staff to contribute to the direction and development of the home. Staff described team meetings as ‘ inclusive and informative’ where open discussion was encouraged. One staff member explained, “All staff go to the team meetings. They are relaxed and informative. Discussions are open and you are asked your view. One of the many great things about working here is how we gel as a team and how we share the same goals.”

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.

A strong culture of kindness, dignity, respect and advocacy was evident throughout the home and was driven by the registered manager's leadership. Staff described how the registered manager led by example, coaching and supporting them to deliver high-quality, person-centred care. During the inspection, we observed the registered manager consistently interacting with people in a warm, respectful and dignified manner. The language used when talking about people reflected a genuine commitment to seeing each person as an individual and promoting their rights, choices and independence.

People spoke highly of the registered manager and the positive impact they had on their lives. One person told us, “[Registered manager] is nice. They always take time to chat to me and are interested in me.” Another person said, “[Registered manager] makes the place. They have high standards and make sure everyone follows them. But they are fun too. She asks me questions about what is important to me and how I want things done.”

Relatives had confidence in the leadership of the home. One relative told us, “I have every faith that [Registered manager] ensures people get the kind of care they would wish for their family. They not only know how to run the home, but they also know what is really important to the people there. All the small things. But they are big things to most of us.”

The registered manager and deputy manager, knew people exceptionally well, including their histories, preferences, aspirations and support needs. They used this knowledge to ensure people's experiences remained at the centre of decision-making. People, relatives and professionals consistently described a management team who listened, responded and acted on feedback. The registered manager actively encouraged people and staff to share ideas, ask questions and try new approaches, creating a positive culture of learning, innovation and continuous improvement.

One health professional told us, “I’ve worked with this service a long time. [Registered manager] is the best leader they have had. It is obvious she listens and values both the staff and people who live at Marner House. I’d say she is steady, firm and fair.”

Staff were consistently positive about the management team and described feeling respected, valued and included. One staff member told us, “Our management team can be summed up in a word, ‘brilliant’. They have an open-door policy and are always available to answer any questions.” Other staff told us all members of the management team were approachable, supportive and focused on helping people and staff to succeed rather than assigning blame when things went wrong. This fostered an environment where learning was encouraged and people felt confident to raise concerns, reflect on practice and contribute ideas for improvement.

The registered manager described having a strong management team who shared ideas, supported one another and worked together to ensure consistency across the home. Staff felt empowered to take responsibility and contribute to service development. The registered manager ensured staff had the support, guidance and opportunities they needed to develop and perform well.

The registered manager demonstrated a thorough understanding of regulatory requirements and their responsibilities in relation to this. The registered manager maintained an evidence file which contained information to show how positive outcomes had been achieved for people who had moved on from the service, in addition to demonstrating the different approaches they used to support and develop the staff team.

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

The registered manager had established a positive and open culture where people, relatives and staff felt able to raise concerns, provide feedback and share their views. People told us they felt confident speaking up if they were unhappy about any aspect of their care and knew who they could approach for support. People said they would feel comfortable speaking with any member of staff but were also aware of the registered manager. People described them as approachable, visible and accessible.

Relatives spoke positively about how the registered manager and staff in the home, responded to feedback and concerns. They told us issues raised were taken seriously and addressed promptly. This helped to build trust and confidence in the management team and demonstrated a commitment to listening and learning from feedback.

Staff were encouraged to raise concerns, challenge practice where necessary and contribute ideas about improving the service. One staff member said, “We are encouraged to speak up. Our management team want to hear our thoughts and ideas and they listen. It could be something about our working arrangements, like working hours or about something different we could try for one of the residents. All ideas are welcomed.”

The registered manager recognised some people, or staff might not feel comfortable speaking openly in larger meetings and had taken steps to ensure alternative opportunities were available. This included maintaining an open-door policy, enabling staff to have informal discussions and raise concerns at any time. The registered manager told us, “People we support are at the heart of the service. A lot of work was undertaken about making it an open service and it works.”

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 described an inclusive workplace where they felt valued, respected and supported. Feedback demonstrated the registered manager actively promoted equality and inclusion by considering individual staff circumstances and supporting flexible working arrangements to help staff achieve a healthy work-life balance.

One staff member told us, “I have always felt supported by the manager. They made changes to accommodate my childcare whilst still putting the residents’ needs first. The manager helping me with this made me feel good, valued and it means I can come to work and give my all.” Another staff member said, “The option to work longer hours so you have a day off in the week has been beneficial. It gives you that precious family time.”

Staff spoke positively about the diversity of the workforce and the team culture. One staff member told us, “Where 1 person's strengths are weaker, there is someone else that supports that and helps strengthen them. We are a team. We’re a very mixed bag of a team in terms of age, gender and experience. It’s beneficial. We pick each other up, guide and support each other.”
Staff had completed equality and diversity training.
 

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.

The provider had governance and management systems in place to monitor the quality and safety of the service and identify areas where improvements were required. A range of audits and quality assurance processes, including observations of practice, medicines competency assessments and regular environmental audits, were completed to help ensure people received safe and effective care.

However, some audits had not been fully effective in identifying issues across all areas of the home, including the step-down flats. This meant some environmental concerns we identified during the inspection had not been recognised. The registered manager acknowledged this and demonstrated a willingness to review and strengthen auditing processes to ensure oversight arrangements were consistently applied across all areas of the home.

The provider also undertook additional quality assurance checks to support the management team and maintain oversight of the service. These checks demonstrated a high level of compliance with organisational expectations.

The registered manager used audit findings, feedback from people and their representatives and oversight from external agencies to drive positive change within the service. Most audit findings had been recorded appropriately onto a service improvement plan with actions and timescales identified to address any areas requiring development.

The registered manager ensured key responsibilities were delegated during their absence. Staff were trained and supported to undertake additional responsibilities, helping to promote continuity and consistency. The registered manager told us, “They (staff) make sure the home runs the same whether I'm here or not.”

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.

Staff worked in partnership with a range of professionals, organisations and services. Staff understood collaborative working was essential in helping people progress towards their goals and receive joined-up care. One staff member told us, “We are a very outcome-focused service and to help achieve that we have to work with lots of different organisations. Everyone has something to contribute. It could be getting used to being out and about in the town or seeing a consultant. It’s very varied but very important.”

Relatives told us staff worked in partnership with them and they felt involved in their loved one’s care. Records evidenced effective communication with relatives and showed actions had been taken in response to reviews and feedback.

Staff also encouraged people to maintain and develop community connections. This helped people remain socially connected, develop confidence and build skills that supported their wellbeing and independence.

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 and the provider demonstrated a commitment to continuous learning and improvement by actively seeking feedback and learning from others. Following positive feedback from existing staff about the value and impact of specialist acquired brain injury training, the provider had developed a revised induction programme for new starters. The revised programme incorporated brain injury training from the outset, helping to ensure staff were better equipped to understand and meet the needs of people living at Marner House.

The registered manager also promoted learning through the regular sharing of news articles, sector updates and findings from other CQC inspections during team meetings. This enabled staff to reflect on best practice and consider improvements within their own work. In addition, learning and innovative ideas were shared across the wider provider group, supporting continuous improvement across services.