The Hurst Residential 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 Requires Improvement. At this assessment the rating has remained Requires Improvement.

The service was in breach of legal regulation in relation to governance at the service.

This service scored 53 (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 told us of the shared vision and culture, but improvement was required to ensure it was embedded throughout the service. The provider was committed about ensuring that people received support based on equality and human rights, and diversity and inclusion. The provider said, “No matter of their background we treat everybody the same.” However, one person told us people were treated unfairly. Another person told us they didn’t like people drinking in the house and became upset when it became noisy.

The registered manager said that the differing needs of people in home recently had changed the dynamics of the home and impacted negatively on people and staff.. Staff confirmed this. Staff also said, they needed further support and training in understanding some peoples’ needs in order to have a better understanding of their role in promoting person centred care.
The registered manager and staff understood and supported people’s cultural and spiritual needs.

The registered manager who was also the registered provider was committed to improvement and was open regarding the improvements made and those that were on going. However, they also said that admissions to The Hurst Residential Home were very different to what they used to be, and at times this had caused difficulties in the service. There had also been staff changes, resulting in new staff being employed and not quite as experienced. Whilst training was in place and staff had completed it, there was no evidence that competency checks were undertaken to improve the confidence of staff in dealing with situations in the home.

There were systems and processes in place to support staff development and progression within their roles. Staff talked of how they accessed training, gained qualifications and extend their role, for example becoming a medicine giver. Staff supervisions took place. Staff said, “He listens and takes notes, and will adjust hours if we need to, and “No problems at all.”

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

People and most staff told us they would feel comfortable to speak up and raise concerns. They stated the registered manager was approachable and felt they would act on concerns raised. We did receive negative feedback that we have shared with the registered manager regarding the concerns regarding the management of the service. Staff were not always aware of the actions taken to resolve their concerns. The registered manager confirmed this would be addressed within supervisions and staff meetings.

The provider had up to date policies and procedures in place, which provided guidance for staff on how to speak up and raise any concerns anonymously. The provider also used 1-1 meetings with people, surveys, staff and house meetings within the home, where people, visitors and staff could give feedback.

People confirmed they knew how to complain, and a copy of the complaints policy was available in the home. A record of complaints was held in the service, however there had been no recent complaints recorded and therefore the system could not be tested.

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.
All staff said they enjoyed working at The Hurst Residential Home. Staff felt they were treated as individuals and their needs were taken into consideration, such as shift times being arranged to fit in family commitments.
There was a strong ethos at the service of treating people as individuals, this extended to the workforce as well. There were robust measures in place to monitor, maintain and promote good mental well-being across the staff group. Staff were encouraged to undertake training in equality and diversity.

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

Governance systems were not operating effectively and had not identified the shortfalls found within this assessment. This had resulted in 2 breaches of legal regulation.

Processes to monitor and review accidents, and incidents were in place but were not effective. This meant people were potentially at risk. Accidents and incidents whilst documented lacked detailed description of what had occurred and lacked analysis completed to identify any trends, themes or learning to prevent a re-occurrence.

Individual risks to people had not been fully explored and lacked systems to monitor their well being and safety. For example, with fire safety concerns, people being subject to unlawful treatment, living in an uncomfortable environment and unsafe staffing levels.

Since our assessment the provider told us they had made individual agreements with people around acceptable conduct and consideration of others living in the service.

The registered provider was working closely with the local authority around governance, and we were told that improvements had been made. This was confirmed by the documents seen in respect of cleaning audits, medication audits, recruitment and processes.

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 registered manager and staff worked closely with external professionals and told us they would be confident to contact someone directly without hesitation if they needed to. We spoke with three health professionals who told us that they have a good relationship with the service and staff worked with them in a professional and knowledgeable way. A health professional told us, “I have respect for staff here, they do a good job, not easy sometimes for them but staff are knowledgeable and the person I come to visit is safe and seems content. Always staff around.” Other comments included, “They do a pretty good job despite the challenges, always talk to us truthfully” and “They do know people, it’s not easy with some but they keep us informed.”

The registered manager had close links with the local authority and utilised any additional training opportunities when they were offered and felt very supported.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not always actively contribute to safe, effective practice and research.

There was a lack of provider oversight on the day to day running of the home. Systems and processes to ensure the safe and effective running of the home were not being followed. We found some examples where lessons were not learned by the provider because they did not have the necessary information, they needed to identify the trends and themes that would make this possible. Processes to ensure that learning happened when things went wrong were not robust, and from examples of good practice. Leaders did not encourage reflection or collective problem-solving.

Staff and leaders did not have a good understanding of how to sustain improvement. Their approach was not consistent and did not include measuring outcomes and impact and sharing that information with all staff. Staff and leaders did not ensure that people using the service, were involved in developing and evaluating improvement and innovation initiatives.

The provider had not fully implemented and sustained improvements or demonstrated learning taken forward following previous inspections.