Heanton Nursing 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

At our last inspection we rated this key question outstanding. At this inspection the rating has changed to 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 provider, management team and staff had a positive, compassionate culture that focused on people living at the service. The PIR stated, “Heanton is built on 4 values, Empathy, People drive, Integrity and Compassion.” We found staff understood and worked towards these values.

People and their relatives felt the service was meeting people’s care and support needs. One relative told us, Comments included, “I think the things they (staff) do well are that they are personable and interact with my relative well.” Another relative commented, “The carers have been wonderful. They are good with him and with me as well.” We were also told by relative, “I would have no hesitation in recommending the home”.

There was a strong sense of team spirit within the service, and staff described feeling well-supported and expressed how much they enjoyed working at the service. They spoke about people living at the service with understanding and compassion. Comments included, “I really enjoy it… and it is a good atmosphere with everyone and we all a have good team ethic” and, “The staff team are really caring and show a lot of love to the family members (residents) which is great and…the managers are very supportive towards staff when they are having difficulties, which is great.”

The provider promoted a positive learning culture at the service and ensured staff and management had the same shared direction. Staff were supported to gain qualifications and extend their role. For example, obtaining recognised health and social care qualifications and becoming a champion of different areas of care such as oral health. This helped to develop staff knowledge, and promoted the needs of people using the service.

The service 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 were positive about how the service was managed and about the support they received from the management team. Comments included, “The manager is a fantastic person and (they) really listen to staff and (they) are always ready to support you as staff. I do feel confident (they) can resolve issues”, and “I think it is managed well. There is no problem… when things do go wrong, they go through it with staff and every day is a learning curve”. The registered manager had regular leadership meetings with heads of departments to understand any challenges or risks in delivering care and support. This allowed them to work together and reduce risks.

People and their relatives were generally positive about the leaders of the service. While people told us the registered manager was not always very visible around the service, they felt they were approachable. Comments included, “I know them in the office, and I do speak to them, they are very helpful, they will ring if they need anything or if anything has occurred” and, “I will speak to the people in the office every time I go to Heanton, they are all very friendly and helpful”. One relative said, “I have seen the manager muck in and help as and when needed which is good to see”.

Some relatives said they would like more regular communication with the service. One relative said, “We don't get updates and no notification of what's going on with events etc. I do think that communication could be better” A relative’s group did meet regularly, sometimes at external venues. However, not all relatives were aware of the meetings. The registered manager had plans to improve communication with relatives, including a regular newsletter.

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

Staff said they were able to speak up freely and were aware of and could access the provider’s whistle blowing policy and procedure.

Staff knew how to raise concerns. Staff meetings and supervision offered opportunities for staff to share and discuss any issues. Staff explained if they raised a serious concern and it was not dealt with by the management team, they would contact the Care Quality Commission (CQC) for advice.

People and their relatives said they were comfortable raising any concerns they had, and were confident these would be listened to and acted on. The provider had arrangements in place to capture the views of people using the service, relatives, professionals and staff.This included meetings, care reviews, questionnaires and the complaints process. Relatives said, “Any concerns, I see (staff member) … and she's great and deals with things straight away” and “If I’ve had a concern, they’ve dealt with it”.

The service valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who work for them. Staff did not highlight concerns around discrimination or bullying within the service.

The staff team was diverse with many staff from overseas. The provider’s recruitment procedure helped ensure equality of opportunity for applicants. Staff benefited from a working culture in which equality, diversity and inclusion was promoted. Staff told us they worked as a team and the team flet like a family. Overseas staff described the support and guidance for them when first in post as “excellent” and “very helpful.” Not only were they supported with induction training but existing staff supported them to integrate into the local community; showing them the local area and generally helping new colleagues to ‘settle in’. One staff commented, “We are a family environment”.

Staff told us they were treated fairly and felt included and valued by the management team. Staff reported good morale and team working. They told us the management team were supportive and understanding of their needs and situations. One staff member said, “We have great leaders. I learn something new every day” and “When I’ve had personal issues, the management team have been very supportive and approachable.”

The service did not always ensure good governance was in place. The service had a range of audits across a number of domains and there was evidence that where shortfalls were identified plans were in place to address these. However, they were not always effective in identifying all issues found during the assessment.

We walked around the service with the provider’s representative and registered manager to point out issues such as fire safety risks, infection control risks, hazards and furniture that needed replacing or securing. The provider addressed most of the identified shortfalls during the site visits. Some issues, such as the replacement of fire safety doors were recorded in the service improvement plan to ensure these were addressed and resolved in a timely way. There were plans in place to support the management team in taking actions to address the identified shortfalls.

The provider had an extensive audit system in place which looked at a range of areas, including clinical oversight, infection control, health and safety, record keeping and mealtime experiences. Where shortfalls were identified action plans were produced. However, the management team, staff, and audits in place had not recognised the safety and quality issues we identify during these site visits.

The provider and management team understood their responsibilities to inform the CQC of notifiable events. Statutory notifications were submitted when required and safeguarding alerts raised to the local authority where necessary. The provider had taken action to respond to concerns identified by partner agencies. We found the leadership team open and honest about the challenges they had faced, and they demonstrated a commitment to provide a quality service for people who lived at Heanton.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

People received support and advice from various external health and social care professionals who represented them. People’s care and support records confirmed the service made appropriate contact with a range of health and social care professionals when required and in a timely way.

The management team and staff understood their responsibilities to work in partnerships with external care professionals to ensure people received joined up care. The provider was working with external professionals to improve communication, joint working and a shared understanding of how to work respectfully together.

The service 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 provider, management team and staff aimed to provide care with a focus on person-centred approaches. The service used a “household” model of care. This is an approach that seeks to create an environment and care support that closely resembles a traditional home setting for individuals no longer able to live on their own. The provider had also developed bespoke dementia training for staff based on acknowledged best practice.

The provider and management team responded quickly and positively to our feedback and were keen to ensure things were put right for people straight away. They worked in an open and transparent way with us. A service improvement plan was in place to address areas needing improvement identified through feedback, complaints, audits and reviews. Where incidents or concerns had been raised, investigations into these and lessons learnt were shared with the staff team to improve care going forward.

Staff were encouraged to contribute to the running of the service and put forward any ideas to improve service delivery through regular meetings and supervisions. Daily meetings were attended by the heads of department to share updates, feedback or concerns.