Sandstone Brook

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 86 (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.

People benefited from a positive, inclusive and person-centred culture where staff shared a clear commitment to achieving the best possible outcomes for people. One person told us, “The best staff I have known, near as perfect as it could be. The staff are amazing and I have not met a bad one.”

We found a strong culture of learning, reflection and continuous improvement. Staff consistently spoke about being supported to provide high-quality care and of the whole home working as a team. One staff member told us, “I wouldn't change anything about the home, it's a really nice environment, people are well cared for. It's a nice place to work or live.” Staff spoke highly of the leadership team and told us they felt empowered to contribute to the development of the service. One member of staff said, "I feel able to make suggestions or raise concerns to management. We have lots of opportunities to raise issues, concerns or compliments." Staff described managers as approachable and supportive, and told us they could share feedback through supervision, staff meetings and surveys.

Visiting healthcare professionals told us they were treated with kindness and respect, and there were examples of staff responding appropriately to concerns with people’s health, undertaking reviews and demonstrating learning.

The registered manager expressed pride in the service and the atmosphere within the home. They told us caring had become such a normal part of staff’s daily role they sometimes overlooked the positive impact they had on people. They described humility as a core strength of the organisation, recognising the importance of celebrating the positive impact staff had on people's lives while maintaining a focus on learning and improvement. They said, “We are humble. We don’t shout enough, but we are making a difference every single day.” We observed a warm, relaxed environment where staff used humour appropriately and interacted positively with people and one another. This created an inclusive culture where people appeared comfortable, valued and at ease.

The provider actively promoted its values and culture through induction, supervision and ongoing staff development. New staff were supported by induction buddies, and expectations about the service's values were clearly communicated to both staff and people using the service.

This shared sense of purpose was evident throughout the service and supported a culture where people, relatives and staff were valued, listened to and motivated to achieve the best outcomes possible for the people who lived there.
 

The provider had exceptionally 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 always did so with integrity, openness and honesty.

Leaders demonstrated an excellent understanding of people's needs, service performance and areas requiring development. The registered manager maintained a strong presence within the service and knew people, relatives and staff exceptionally well. One person told us, “Yes, I know who they are. They were here when I arrived and made sure I was supported.” Families consistently described leaders as approachable and helpful.

Leaders had created a strong, values-driven culture that placed people, staff wellbeing and continuous improvement at the centre of the service. The registered manager was highly visible and led by example, fostering an open, inclusive and supportive environment where people and staff were valued, respected and encouraged to succeed. They undertook daily walkarounds and told us, "Being out there, walking the floor and actively talking with the team and acknowledging them is how I get a feel for the culture here." Staff and people knew the management team well, and we observed leaders engaging positively and respectfully across the service.

The registered manager emphasised the importance of maintaining a visible presence within the home and understanding the lived experience of people and staff. Alongside formal audit processes, leaders regularly spent time observing practice and engaging with people across the service. Monthly unannounced night audits were also completed to ensure standards of care were maintained consistently across all shifts.

Staff told us managers were approachable and responsive to feedback. One staff member described how concerns about the quality of bedding were raised with management and acted upon, resulting in alternative bedding being purchased. This demonstrated leaders listened to staff and were willing to make changes to improve the experience of people living at the service.

Leaders recognised and developed people's strengths throughout the workforce. Staff spoke exceptionally positively about the registered manager and consistently described them as approachable and supportive. They told us they felt comfortable to raise concerns, share ideas and contribute to service development, confident that their views would be listened to and acted upon. One staff member said, "Management are really good and supportive."
 

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

Staff felt able to speak up and were confident their views, concerns and suggestions would be listened to and acted upon. Staff consistently described leaders as approachable, visible and supportive, and told us they could raise issues at any time without fear of adverse consequences.

One staff member told us, "Managers are always in the units and I feel comfortable approaching them if I have any concerns. The registered manager's door is always open, and we are encouraged to share any concerns." Staff said there were multiple opportunities to provide feedback, including through team meetings, surveys, supervisions and appraisals. One staff member said, “I have regular supervisions where I can raise issues privately or I can raise them in staff meetings or staff surveys.” However, they also told us leaders encouraged open dialogue on a day-to-day basis rather than waiting for formal processes.

The positive feedback from staff demonstrated an open and transparent culture where people were encouraged to speak up, share ideas and raise concerns. This helped leaders identify opportunities for improvement and ensured staff felt valued, listened to and supported.
 

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.

The provider promoted an inclusive culture where diversity was valued and celebrated. Leaders and staff recognised the benefits which a diverse workforce brought to people's experiences and actively used staff knowledge, cultures and backgrounds to enhance life at the home. The registered manager told us, “The multi-cultural environment is a very healthy one and we want to use the staff’s diversity to enhance people’s lives, and we like to express this, share this and celebrate this in any way and wherever we can.” For example, a recent multicultural food festival had been organised to celebrate the different cultures within the service and create opportunities for people, relatives and staff to share and learn from each other's experiences.

Staff consistently told us they felt respected, valued and treated fairly. One staff member said, "I feel valued working here. We have a really good team, and everyone is treated equally." Another told us, "We have a great staff team, everyone is treated equally and I have never been made to feel otherwise."

The positive feedback from staff demonstrated a culture where equality, diversity and inclusion were embedded in daily practice. Staff felt able to be themselves at work and were supported to contribute their skills, experiences and perspectives. This inclusive approach helped to create a positive working environment and enriched the experiences of people living at the service.
 

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.

Leaders maintained oversight of care records and responded promptly when shortfalls were identified. During our assessment we found some information missing from sections of care plans; by the second day of our visit these records had been reviewed and updated. One person had their medicines crushed and although these were administered safely the hospital discharge summary which contained the clinical authorisation had not been scanned into the person’s care records. No harm had occurred and the registered manager assured us this would be rectified promptly.

The provider operated effective governance systems which supported the delivery of safe, good-quality and sustainable care. Clear management and staffing structures were in place, with defined responsibilities and oversight arrangements to monitor performance, drive improvement and support positive outcomes for people. The service worked collaboratively with external healthcare professionals to support care provision and service development.

The registered manager understood their regulatory responsibilities and submitted statutory notifications when required. Systems were in place to promote effective communication across the service, including daily “huddles” where departmental leads shared information, reviewed priorities and coordinated actions. Managers also used a secure electronic system to communicate updates and key messages to staff.

Quality assurance processes were embedded throughout the service. Regular audits of medicines, care records, the environment and night-time practice were completed by the registered manager and deputy manager. Where issues were identified, actions were assigned to named staff, monitored for completion and formally reviewed before being closed. The provider also used a care plan tracking systems to monitor reviews, actions and audit completion. The registered manager used audit findings to identify themes and drive improvement. For example, following medicines errors, staff received additional competency assessments, reflective discussions and further training. Learning from audits had also led to enhanced oversight of weights and monitoring of nutritional risk.
 

The provider clearly understood and carried out their duty to collaborate and worked in partnership, and services worked seamlessly for people. They always shared information and learning with partners and collaborated for improvement.

The registered manager demonstrated a clear understanding of the importance of community inclusion and had created an environment where the boundaries between the home and the local community were significantly reduced. The registered manager and staff had developed a range of innovative and sustainable partnerships which enhanced people's wellbeing, reduced the risk of social isolation and promoted a strong sense of belonging.

The service actively contributed to the wider community and encouraged people to participate in initiatives which benefited others. For example, fundraising events were held to support the local charities, enabling people to make a positive contribution to their community. The service had also established links with local businesses and organisations, including transport providers, digital learning services and will-writing services. This helped people access opportunities, information and support which promoted independence and improved outcomes.

A particular strength of the service was its success in creating a community hub within the home. The on-site café was actively promoted to local emergency service personnel and provided a welcoming space for 999 staff, local residents, relatives and visitors. The registered manager had invested time in developing relationships with neighbours following the home's opening, which had resulted in members of the local community visiting the café. These relationships created natural opportunities for people to develop social connections, maintain community links and engage with a diverse range of people.

The service further strengthened community links through the involvement of volunteers, including relatives of people living at the home. Appropriate recruitment and DBS processes were followed to ensure volunteering opportunities were safe and well managed.

These approaches demonstrated a culture which valued community participation and created opportunities for people to remain active, connected and valued members of their local community.

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.

The registered manager demonstrated a commitment to continuous learning and improvement within the service, such as with improving the induction experience for staff which would ultimately improve people’s experiences. The provider and registered manager used information from audits, incidents, complaints, feedback and professional reviews to identify opportunities to enhance care and improve outcomes for people. Actions arising from reviews were monitored through provider wide governance processes which helped to ensure improvement was across the whole organisation and not just the service.

People’s quality of life was enhanced through meaningful opportunities and activities tailored to their interests, helping them develop skills, maintain independence and achieve positive outcomes. This demonstrated the service’s commitment to continually improving people’s experiences and wellbeing through innovative and person-centred support.

One health professional told us, “Overall, I would describe Sandstone Brook as being willing to collaborate with us and keen to improve.”