Melwood Grange

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 inspection for this service. This key question has been rated requires improvement. This meant the governance and oversight was inconsistent and did not always support the delivery of high-quality, person-centred care.

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

This service scored 61 (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.

New staff received support and training which helped them to demonstrate the provider’s values in their daily work with people. Some staff felt that there was a culture of “them and us” and some staff were favourited over others. However, other staff did not feel this. This was fed back to the managers, and they recognised further work was required to ensure all staff felt supported and valued.

Care staff were dedicated and encouraged to give ideas to produce better outcomes for people and to achieve some aspirations. The ethos of the service was believed in and followed by all staff to help people develop and realise their potential, whatever the level of need.

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.

Staff found the management team supportive and approachable with an open-door policy. One staff member said, “The new manager has made a big improvement, things are much better now. Also, the clinical manager has been very helpful and supportive.” Another staff member said, “Their door is always open and they listen to ideas.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. People were encouraged to share feedback, raise concerns, and contribute to decisions about their care. Staff we spoke to told us they knew how to raise concerns.

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. Efforts were made to improve equality and ensure fair treatment for all staff, regardless of background or protected characteristics. Staff all received the same opportunities to train and develop themselves. Staff were encouraged to contribute to service development through regular staff meetings and events. Senior staff told us after incidents occurred there was always reflective practice session, we asked staff about this, and we could see no evidence of this practice being embedded into the home.

The provider had established governance systems aimed at identifying and addressing issues within the service. Responsibility for responding to identified concerns laid with the management team. However, it was evident that some issues were not effectively addressed. For example, although senior staff were aware that staff were manually crushing waste with their hands, which posed an infection risk, and staff had reported this to senior managers, no action had been taken. Additionally, some food in the kitchen was not stored appropriately, and remedial action only occurred following a site visit.

The provider did not ensure residents who self-administered medicines had access to thermometers to monitor storage conditions. Furthermore, there was no evidence of documented risk assessments or consultations regarding the crushing of medicines, nor were best interest assessments carried out for covert administration. These omissions meant the provider was not adhering to their own policies and procedures regarding the safe management of medicines.

When we conducted random medicines check on 3 people’s medicines, we found that stock counts did not tally for 2 people despite weekly and monthly audits. Some staff did not know how to access critical protocols for PRN (as needed) medicines.

Feedback from people using the service indicated that there were occasions where they felt there were not enough staff to care for them. Some staff also reported that they did not always feel supported in their roles.

Staff at the service understood their duty to collaborate and work in partnership. The home had recently opened in a new housing development, and the registered manager told us they were building partnerships with the local community and schools.

The service focused on continuous learning, innovation and improvement across the home. We found there was systems in place for monitoring accidents and incidents, these records were well maintained with details of what happened and actions, for example, updating the risk assessments and care plans, providing and encouraging the use of walking aids, referrals to GPs or physiotherapists, reviews of medication, use of sensor mats. Daily logs mentioned using the least restrictive measures to support people to maintain their independence whilst also keeping them as safe as possible.

Staff said they had regular supervision sessions, for care workers, this was usually done by a senior care worker. Staff reported these as two-way conversations, where they had an opportunity to raise any concerns they had as well as take feedback from the supervisor about their performance.