Greystoke Manor

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 requires improvement. At this assessment 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 71 (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, “We’ve always had comments to say how friendly we are here. It feels like a home. It may not be quite as modern as other homes, but sometimes that’s what draws residents here.”

The provider’s Statement of Purpose states, ‘We recognise that every individual is unique. Our approach to care is based on respecting each service user’s dignity, privacy, independence, and personal preferences. We work closely with service users, their families, and relevant professionals to ensure that care and support are tailored to individual needs and delivered in a compassionate and respectful manner.’ One person told us, “I used to live downstairs, but it got a little bit noisy. I asked if there was a room upstairs available and they said ‘yes’. So, they supported me to move upstairs. It’s nice and quiet here, I prefer it.”

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 workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

People and their relatives felt the home was managed well, and that any suggestions or comments would be listened to. One person said, “They listened to our feedback about where to have the quizzes. People didn’t want to have them indoors on a hot day, so now we have them outside in the garden.” The registered manager completed daily walk rounds so they could chat with people and address any concerns they might have.

Staff were positive about the management of the home. One staff member said, “[Registered manager] is really supportive, and I can speak about anything. I can raise any concerns at team meetings. These are arranged when you’re on shift to catch everyone. We also have supervisions.”

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

Staff told us they found the management team approachable and accessible. Staff supervisions and staff meetings enabled staff to have a voice. Separate staff meetings were held for day staff and night staff so everyone could attend.

The provider had a whistleblowing policy and guidance for staff on how to raise concerns. The registered manager said, “They know I’m here and they will be listened to.”

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 stable workforce at Greystoke Manor with many staff having completed many years of service. This meant people received consistent care from staff who they knew well.

The Provider’s Information Return stated, ‘We have a diverse staff team and have adapted roles to suit the needs of some staff allowing extra support to be available. Characteristics such as age, disability, hearing impairment, ADHD and autism [acknowledged and catered for].’

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

Staff were not always deployed to ensure people’s immediate needs were addressed. Whilst acknowledging that staff were kind and caring, many people, including their relatives, commented on staffing levels. One relative said, “You can always tell when it’s understaffed because they get very fraught. My mum will keep pressing the button if she wants something. She wants things done now.” We observed several occasions when staff were not available to meet people’s needs in a timely manner.

People commented on the quality and quantity of food at mealtimes and, whilst acknowledging a new chef was in post, this is still an area for improvement. People were not aware of their care plans or how they could review these with staff. The registered manager later sent us some information to show actions they would be taking in this regard. Residents’ meetings were organised. One person said, “They have informal ones, not on a regular basis, every six weeks or one a month. People say what they’re not happy with. We are asked about certain things like the food or the activities.”

Recruitment systems were not sufficiently robust. A member of staff had commenced employment without sufficient pre-employment checks being completed. Although references and a copy of this staff member’s Disclosure and Barring Service (DBS) were sent to us when we requested them, there was no documentary evidence or risk assessment to show the suitability of this person, and that they were safe to work in a care setting before they commenced employment.

A range of audits monitored safety and quality across the service and were used to drive improvements. We reviewed audits relating to health and safety, accidents and incidents, care plans and the business contingency plan. Whilst these audits supported the delivery of safe care overall, apart from the quality of the food, which was a known issue, they had not identified the issues found at this inspection.

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.

We asked for feedback from 2 healthcare professionals whose details were given to us by the provider, but this had not been received at the time this report was written. Nevertheless, the provider worked with a range of external professionals to support people’s care. This helped ensure people received appropriate care and support from relevant services.

The provider supported learning and development for staff and engaged with external networks to share information and good practice.

Staff were encouraged in their continual professional development through vocational qualifications and ongoing training. Staff were treated with dignity, fairness and respect, and an inclusive working environment was evident, where diversity was valued.

We identified several areas of concern through this inspection. We acknowledge the registered manager and senior management team have worked with us and taken some actions to address these. However, these concerns had not been identified by the provider before our inspection visit.