Esmere Gardens

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.

This is the first assessment for this newly registered service. This key question has been rated 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 very clear shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the challenges and the needs of people and their communities.

There was a positive approach to fostering a shared commitment to the service and embedding the provider’s values. The core values were displayed in lifts and staff areas to ensure these remained a focal point during the working day. A small group of staff had also being involved in reviewing the organisational values which had encouraged ownership and accountability. One staff member said, “We are building relationships with the residents, making positive differences in their daily life and seeing progress and happiness with our residents.”

Staff spoke positively about the culture of the service and comments included “The environment, staff and manager, they are supportive”, “Good support from the management. Good team. Teamwork is very important, the first is communication” and “The home is built for purpose using high tech to mitigate risks. The management team is very supportive, approachable and knowledgeable.”

The registered manager spoke to us about an observation tool they had implemented to further help understand people’s experiences and ensure a healthy culture was fostered. This explored the interactions between staff and people to improve wellbeing, communication and ensure activities were person centred. Feedback was able to be given to staff on the same day so any changes to practice could be adopted in a timely way. One staff member said, “I do enjoy my job, this job gives me more of a purpose. It is rewarding and makes me feel good about myself if I’m making other people happy.”

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.

There was clear and visible leadership within the service. People, relatives and staff knew the registered manager and felt comfortable in their presence. One relative said, “It is always very friendly when you come here, all the people here, including the registered manager, the staff, are always available. They often sit down with me and ask what I want and how they can do it.”

The registered manager told us they were well supported by higher management who would regularly visit the service. One relative said, “The people here are very friendly, from the top to the bottom and you find that they are responsive and that you never end up having to chase them all the time”.

Staff were aware of who they could report to and there were positive relationships between management and other staff roles. One staff member said, “Approachable management, [registered manager] spends time on the floor and checks we are ok.” A health and social care professional told us, “The manager is brilliant, I can contact her any time and I know I will receive a response from her directly.”

The leadership team were open during discussions about the service and responded positively to feedback. There was a range of policies and procedures to guide staff on what was expected of them in their roles.

The provider fostered a positive culture where people felt they could speak up, and their voice would be heard. Staff told us they were confident to speak up where required and felt they would be listened to and taken seriously when they did.

People felt no hesitation in being able to speak up where needed. The provider had implemented an initiative in the home called ‘Bring it to light’. This created a safe and confidential way for people, relatives and staff to raise concerns and shed light on things whilst offering them further protection. The registered manager said they shared the ethos among staff of ‘see it, say it’ to ensure that speaking up was everyone’s responsibility.

Staff told us they would be confident to speak up and that they would be heard. One staff member said, “In our discussion, management are always there for us, it’s a free discussion, we all decide together. We raise concerns and then they ask what we would like to do. No one is restraining us to speak our voices. Sometimes new people are afraid to talk but we remind them it’s ok and easy to raise concern.”

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 all told us they felt valued by their employer and were treated fairly in their day-to-day work. Staff had received training in equality and diversity and human rights, which included training components around LGBTQ people (lesbian, gay, bisexual, transgender, or queer). One staff member said, “The team culture, we are very diverse. We have different backgrounds, but we share the same values..” Another staff member said, “One of the nicest home’s I have worked in.”

The service took account of reasonable adjustments that staff may need. This included making available a quiet room for prayer, flexibility in work patterns to accommodate pregnancy or fasting or family needs. The service had an equal opportunities policy that stated the service ‘Recognises that people from different backgrounds can bring fresh ideas and a different approach, which can make the way we work and learn more fun, more creative, more efficient and more innovative and more beneficial to our nursing Homes.’

Staff feedback responses were positive and all staff we spoke with were happy in their roles and working at this service. One staff member said, “I feel welcome here, I am not a second-class citizen, we are treated well. I don’t feel discriminated, I feel welcome. I could speak to the manager.”

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 was responsive to working to continually improve the service, and areas of shortfalls shared were listened to and assurances given as to how these would be addressed.

The service had a clearly organised system to monitor and oversee the quality of care people received. There was a team approach to completing audits across the service which included the registered manager, deputy manager, clinical lead and head chef. All areas of the service were reviewed and any actions identified were recorded and monitored by the registered manager. Spot checks on audits were also completed by the registered manager to ensure they retained oversight of these areas.

Internal monitoring visits were completed, and senior leadership would regularly visit and spend time speaking to people and staff. The registered manager had a monthly manager meeting with senior leadership who would review the governance across the service and any outstanding actions. The registered manager told us they felt well supported and was able to raise concerns and make suggestions where needed.

Information was shared with staff where appropriate, so they all took accountability in meeting people’s needs. For example, any concerns highlighted from weight management were incorporated into action plan that staff could then follow to support the person. This would then be shared with the kitchen team also and all actions included, such as any referrals to the GP or Speech and Language Team (SALT).

At the time of our assessment, no one was living on the first floor. The registered manager said they were slowly growing the service but that it was financially sustainable at this time.

However, the providers registered office address had changed, and this had not been notified to CQC. In addition to this, the provider’s statement of purpose had not been updated to reflect current service changes. The registered manager told us this had been an oversight. The provider took appropriate action when we raised this with them, to ensure these changes were notified and amended.

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 provider was involved in their local community and encouraged visitors into the home and sponsored events that needed support. This included a local children’s rugby club during a tournament which families across the region were part of.

Links were being built and developed with external professionals. This included meetings with the GP, pharmacist and providing a meeting and training space for the Frailty Team, which staff could then attend some of the sessions.

Visiting professionals were encouraged to have a break and were offered drinks and snacks. One health and social care professional said, “I think they are doing a fantastic job overall, a new care home I can imagine would be very challenging to make everything run effectively and well for all the residents and guests. From what I know they are all doing a great job.”

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.

People, their relatives and staff were actively encouraged to share any improvement ideas they had to develop the service. The registered manager said the next area of focus was developing skills within the home saying, “We are a young team and that’s good and bad, we are supporting our staff and supporting them in an individual team and to specialise a bit more.”

Staff told us their contributions were valued with 1 staff commenting, “I feel like in meetings, it is a very nice open discussion, everyone speaks, there is also an email if you want to speak and suggest changes, or any responses. If they accept your suggestion, then you get more of a profit share.” Another staff member said, “[CEO] is open to ideas which is great. They are good people and giving me new challenges.”

The service had invested in technology to improve people’s care experience. This included the fall prevention system which was able to discretely monitor movement and detect potential risks. This enabled staff to offer support in a timely way and reduce the potential of an incident occurring. The registered manager spoke positively about the benefits of this system and the continuous improvement it enabled the service to make.