Fernhill Neurological Centre-Inspire Neurocare (Farnborough) Limited

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• 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 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 management team told us they ensured the staff were valued and promoted people’s individuality, protected their rights and enabled them to thrive. Staff told us there was a good and positive culture within the home where people and staff had a good rapport, and the atmosphere was one of respect and care. A staff member told us, “[Registered manager] has an open-door policy. [They] listen and act on things. I cannot fault [them] as a manager.”

The provider set a culture that valued reflection, learning and improvement. The registered manager effectively used staff supervision and regular team meetings as a platform for staff to raise any concerns and an opportunity to share their views and opinions. They had introduced “Thank you Thursday”. This was to encourage staff to write on a board in the staff room something nice about someone. The registered manager told us this was to “Try to create a positive culture.”

The registered manager was passionate and committed to developing the service for the benefit of people who used it. They explained, “I have a strategy which I am developing. I have drafted an outline and consulted with staff. There is a vision in terms of how we are going to develop. It’s about establishing a reputation.”

The provider had recruited a full therapy team. They had recently appointed a therapy lead with whom the registered manager planned to work closely.

The registered manager told us they planned to involve people in future recruitment of staff. They also planned to develop a family and friends’ group to develop further positive relationships with them. They said, “The service is evolving."

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 we spoke with knew who the registered manager was and were positive about them. Their comments included, “There's always a friendly welcome, and when I arrive [Registered manager] usually pops out and welcomes me”, “[Registered manager] couldn't be nicer or more helpful” and “[Registered manager] is the best I've ever come across, [they are] open to any issues. [They] set the tone for the staff, and lead by example.”

Staff found the management team to be visible and supportive. The registered manager was a strong leader who was experienced and respected by the staff and people alike. They put people at the centre of everything they did and led a staff team by example.

In addition to monthly staff meetings and quarterly heads of department meetings, there were daily handover meetings to discuss important information, and any risks to service delivery. There were processes to support managers and senior staff in meeting their responsibilities.

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

People were given information when they moved to the home about how to raise a concern and said they knew how to make a complaint. The registered manager told us, “I listen to people. I am approachable and they know they can talk to me.”

Staff told us they knew about the provider’s whistleblowing policy and would not hesitate to use this to benefit staff and people living at the home.

The provider had some processes in place to support staff to speak up. This included supervision meetings, handover meetings, staff meetings and a whistleblowing policy. Staff had also received training in safeguarding to reinforce their understanding and their responsibility to speak up.

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 told us they enjoyed working in a diverse team. However, all staff spoke good English and there were no language barriers.

The provider had policies to promote equality, diversity and inclusion and to protect staff from discrimination and harassment. The staff handbook given to all new staff at the start of their employment provided guidance on their implementation within the home. The registered manager told us, “We have no culture tension here. We have people, both residents and staff, of multicultural background. This has grown organically, as we are all inclusive. Diversity gives us strength. As long as we all have the core values, it does not matter where you come from. What we don’t have yet is a multi-purpose faith room, but we are planning this to be developed. We have a lot of space here so that can be done."

The provider had clear responsibilities, roles, systems of accountability and good governance. They always acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

Staff told us they felt supported and valued by the registered manager who was available whenever they needed them. Staff said they were supported to keep up to date with the care people required.

The provider had processes to monitor the quality of the service and these were mostly effective. Although medicines audits had not identified the minor shortfalls we found during the inspection, this was promptly rectified and appropriate actions were taken to make the audits more robust.

The provider undertook regular audits of all areas of the service. Audits included, accidents and incidents, Deprivation of Liberty Safeguards (DoLS), health and safety checks, fire checks, medicines and care plans. DoLS ensures people who cannot consent to their care arrangements in a care home or hospital are protected if those arrangements deprive them of their liberty.

The service manager regularly visited the service and worked alongside the registered manager to undertake visual checks of every area of the home. They also supported them with any areas for improvement.

The registered manager was passionate about their role. They worked well with their colleagues and other partners to develop the service, build a team and work together to meet the needs of people who use the service. They told us, “This is at least a 5-year project to build a team and all the strands to achieve and develop the service. I want it to be the best it can be. It’s a privilege for me.

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.

Staff told us they worked well with healthcare professionals to ensure people’s needs were met. The registered manager confirmed they had a good working relationship with a range of external professionals.

The provider had systems and processes to ensure people’s needs were reviewed with external professionals. The provider listened to feedback from them and where a need was identified, amended their policies and procedures to promote effective communication and partnership working.

The registered manager told us they ensured the staff learned from healthcare professionals involved in people’s care to help understand people’s needs better.

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 told us they were consulted individually during a review or regular conversation, to find out if they had any concerns or requests. We saw people’s opinions and requests were taken seriously. The registered manager was planning to improve this further by introducing community meetings. A form had been devised to help people with their feedback using their preferred communication needs.

The registered manager was developing a social committee in relation to planning activities for people, such as visits to seaside. They were also introducing a vocational role to support people with their confidence and independence. One person had been helping with the laundry, the environment and working at reception. This had helped improve their mental and physical health. The registered manager told us, “I am hoping to develop people to work in maintenance or in the café. I would like to develop a community café.”

Staff told us the managers were always aiming to make improvements to the service in order to benefit people and they enjoyed being part of this. The provider had put in place a quarterly staff engagement forum run by staff, to give them a constructive voice.

The registered manager was committed to developing the service to benefit people and the staff team. They had introduced a monthly newsletter which kept everyone informed of news and development within the service.

The registered manager had introduced a ‘management open forum’ whereby they would be in an area of the home for staff to come and talk about anything they wished to discuss. They also planned to introduce a ‘friends and family’ forum now there were enough people using the service.

The registered manager was keen to demonstrate they valued the staff team. They told us, “I have come in and cooked breakfast for everybody at times to reward staff. We are going to introduce a ‘celebrity chef’ scheme, where a member of staff will cook their signature dish for people and staff."