St George's Nursing Home (Oldham)

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-centered 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-centered 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 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 management team said the aim was to provide person centred care and individualised care. They wanted people living in the home to live to the best of their abilities and have their independence promoted. They shared this vision with staff in meetings and all the staff that we obtained feedback from shared a version of this goal. One staff member said the service offered “care planning based on need, dignity and choice”.
The provider was supportive of this shared direction and facilitated new equipment and technology as necessary to assist with people’s changing needs.
 

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 organisation and workforce. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.
The manager of St George’s Nursing Home had been with the service since it opened, beginning her career there as a nurse. Similarly, the deputy manager also started as a nurse within the service. Their long-standing commitment and experience had equipped them with a deep understanding of the service, enabling them to lead with confidence and effectiveness. One staff member said, “I have worked at St George's since it opened and in my opinion this is the best management team we have had since opening, they are fair, open, transparent and supportive.”
Regular contact with staff through meetings and an “open door policy” ensured management were knowledgeable about any issues within the service and any changes to processes or legislation were communicated to staff effectively.
 

The provider was exceptional at fostering a positive culture where people knew they could speak up and their voice would be heard. The service had a Freedom to Speak Up and Whistleblowing Policy which was shared with all staff. A suggestion box offered a confidential way for staff to report concerns if that was the preferred method and staff could also report concerns to the lead nurse on each unit. Staff across all roles were actively encouraged to speak up, and when a staff survey revealed a desire for greater involvement in broader service matters, a quarterly carers forum was introduced in response. Safeguarding and freedom to speak up were consistently included in staff supervision agendas, reflecting the provider’s and management team’s understanding of the importance of providing opportunities to raise concerns. The provider and management team understood their responsibilities to investigate concerns and protect those who raised them, taking appropriate action when necessary. There was clear evidence that staff voices led to meaningful change; for example, when the need for mental health counselling was raised, the service responded by introducing this valuable support resource.

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.
There was a diverse staffing team at St George’s Nursing Home who were all treated equally. Staff said they felt valued and were treated fairly. One staff member said, “I also feel that our management take into consideration staff’s family needs. They are very flexible regarding childcare.”
The provider explained that they had begun delivering autism training to staff following the recruitment of a team member who is autistic.
Staff completed equality and diversity training and one staff member said, “We have a diverse, multicultural team, and the workplace fosters fairness and inclusivity. When concerns arise, I feel confident that they are addressed fairly and professionally.”
 

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver high-quality, sustainable care, treatment and support. They always acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate. The home's organisational structure fostered a strong emphasis on continuity and the delivery of high-quality care. The introduction of deputy managers provided valuable support to the registered manager, while also strengthening accountability and transparency within the leadership team. Staff worked collaboratively, maintaining a consistent focus on improving care standards and cultivating an open culture where concerns could be raised freely, supporting early identification of potential risks. The lead nurses played a vital role in the service offering support to staff, relatives and people living in the home. One of the lead nurses was also a Dementia Champion providing information to families and advice to all units, helping to ensure a high quality of care for everyone. Each unit in the home had activity champions, providing a link between the activity team and the unit. The champions then fed back to the management team ensuring people’s preferences, concerns and suggestions were consistently considered. One dementia champion explained how they were able to support a new person who was anxious and prone to wandering in the home. Through discussions with the person and liaising with the activity team they were able to provide reassurance and suitable activities improving their mental health and communication. The systems implemented by the provider and management team together with consistent and open communication enabled complete oversight of the service and helped to ensure that good quality care was consistently provided. Audits on several areas including medication errors, physical interventions and infections took place regularly and were discussed at meetings with a focus on driving improvement. Lead nurse meetings included regular discussions of appraisals and supervisions and a lead nurse from the challenging behaviour unit shared that management-led meetings enabled them to “analyse and improve the care provided to service users.” They also explained how the implementation of new systems, ongoing staff training, regular documentation checks, and robust auditing processes all contributed to the provision of high-quality care. For example, the registered manager explained how Infection Prevent Control (IPC) audits were previously completed annually and environmental audits were completed monthly by the IPC champion. These results were shared with the unit, maintenance and management team. The monthly environmental audits identified that a monthly IPC audit would be beneficial which was subsequently introduced ensuring issues were dealt with in a timely and effective manner. The provider celebrated staff success with employee of the month and when compliments about staff were received from family members, management asked the staff how they would like to celebrate, for example, they arranged for a singer to come in and the family who had given the compliment were also invited to attend. The home has received external awards including Annual Certificate of IPC Excellence and Six Steps End of Life Care. Staff also receive long service awards from the company in recognition of their loyalty and hard work. The deputy manager conducted daily morning walk arounds, which allowed for the prompt resolution of any staffing issues and provided a valuable opportunity for night staff to share important updates and information. Staggered management shift times ensured that a member of the leadership team was available throughout the day to provide support and oversight. The registered manager explained how the quieter evening periods offered a meaningful opportunity for nursing staff to approach her for guidance or support as needed.

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.
The service worked effectively with other healthcare professionals and feedback from stakeholders was positive. The local authority said, “They communicate well with us and attend all MDTs related to the individual”

A community mental health nurse who worked closely with the service told us, “When visiting I have found the nursing staff to be helpful and professional in terms of sharing information regarding the health and well being of the service users. They provide up to date and relevant information and are able to update me on any changes in the services user’s health. I have had access to nursing records and they are up to date and relevant in terms of care delivered and any changes to treatment.”
The service had a good relationship with their local GP service which enabled effective communication between the services and consequently consistent care.
 

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.
The provider demonstrated a strong commitment to learning and development, both for staff and the service as a whole. Actions identified through audits were clearly focused on continuous improvement. During our inspection, the management team was open to feedback and eager to explore ways to enhance the quality of the service.
One staff member told us, “This has improved significantly over the last few years. Residents and their families are consulted each year and their opinions on the service acted upon.”