Royal Leamington Spa 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

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. At our last assessment we rated this key question requires improvement. At this assessment 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 75 (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.

There was a positive culture across all teams, with staff working together to provide good quality care and support. Staff were committed to achieving positive outcomes for people and spoke proudly about teamwork within the home.

The registered manager encouraged staff to take ownership of specific areas of practice and service improvement. They told us, “We have a very hardworking, reliable team. We have champions and they are given responsibilities which they take seriously.”

Staff expressed pride in their work and were involved in achieving the home's vision and objectives. One staff member told us, “I'm proud to be a part of the Royal team.” Another member of staff said, “Managers write it down and give us feedback. Keep doing the work that you are doing very well. Or they will send us a message to make us appreciated. That keeps us wanting to do our job even more.”

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.

The provider and the registered manager had acknowledged previous complacency and were committed to making the required improvements to meet the regulations. The registered manager told us, “I believe there is room for improvement. We have achieved where we want to be to this point, but we are going to do more.”

All staff told us that the nominated individual, registered manager and other senior leaders in the home were supportive, understanding and fair. One staff member described how reasonable adjustments had been made to allow them to continue working, another staff member described how managers allowed them to work flexibly when required to fulfil personal commitments.

The registered manager told us they always had ‘an open door,’ and strived to support the wider staff team. The culture in the home was upbeat and positive, and the staff team were committed to supporting the registered manager to further improve the home.

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

People felt confident raising concerns and were assured that these would be listened to and acted upon. People told us they could approach staff and managers if they had any worries. One person said, “If there’s any concerns, they deal with it straight away.” Another person told us, “I could speak to any of the staff, or the managers, they would all listen and try to help.”

Staff also described an open and supportive culture where they felt able to share concerns and discuss issues. One staff member said, “We talk about our concerns, and they (managers) say how can we manage these things differently?”

When mistakes occurred, staff told us they were supported to learn and improve rather than being blamed. One staff member said, “If I made a mistake, the manager would talk to me, figure it out together and see if I need more training. It's encouraging, if you didn’t know something, you learn from it.” The registered manager told us they wanted to promote a culture where people felt safe to speak up, concerns were addressed constructively, and learning was used to improve practice.

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.

There was a diverse and inclusive staff team. Staff told us they felt valued, supported and treated fairly by managers. One staff member said, “From the day they interviewed me, they gave me an opportunity and now they give me support. My whole life changed. That’s why when I come here, I make a difference to each and every one.” Another staff member described the culture as, “Like a family,” explaining that the service provided a welcoming and supportive environment for staff.

The registered manager told us how they planned events to celebrate staff’s diverse cultures and backgrounds, this included a day where staff wore traditional clothing and shared food with people living in the home, their relatives and each other.

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.

At our last assessment we found a breach of the legal regulation relating to governance at the home. Since then, the provider and the registered manager had responded positively to feedback and made significant improvements to governance and oversight arrangements.

The registered manager had introduced a range of audits, monitoring systems, quality checks and action plans to identify and address issues in a timely way. Accidents and incidents were reviewed to identify trends and themes, and there was increased oversight of clinical care. Where responsibilities such as daily checks and monitoring activities were delegated to staff, the registered manager maintained oversight to ensure these processes were completed effectively.

The provider had also commissioned support from an external consultant to provide additional oversight, support improvement work and ensure progress was sustained and aligned with regulatory requirements. The registered manager actively sought opportunities to learn from other services, including visiting peer providers to share good practice and identify further improvements.

These changes had strengthened governance systems and provided greater assurance that risks, quality and safety were being effectively monitored and managed.

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 registered manager and senior team, worked in partnership with people, their representatives and other professionals to promote positive outcomes. Care plans were reviewed regularly and records demonstrated that people, and where appropriate those important to them, were involved in discussions about their care and support. This helped ensure people were treated as partners in their care and their views informed decision-making.

Staff worked collaboratively with a range of health and social care professionals to support people's wellbeing and ensure their needs were met. Information was shared appropriately, and professional advice was used to plan and deliver care.

The provider worked in partnership with external organisations to support learning and development within the care sector. University students completed placements at the home, and the registered manager had recently attended an event aimed at encouraging people to pursue careers in care.

People were encouraged to take part in community events. Local churches visited the home, and a church group was established, enabling people to maintain their faith and community connections. Additionally, the service had recently received a gold award in a local 'Garden in Bloom' initiative. People had been involved in developing and maintaining the garden.

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.

The provider demonstrated a commitment to learning and improvement.

There were opportunities for staff learning, development and career progression. Care staff were encouraged to complete qualifications to become senior carers, with senior carers taking on additional responsibilities such as administering medicines and overseeing shifts. This helped staff develop their skills and knowledge while supporting the effective running of the service.

The provider also encouraged staff to take on champion roles in areas such as end of life care, Infection Prevention and Control (IPC) and COSHH. These roles promoted ownership and development in specific areas of practice while supporting quality and compliance within the service. Staff told us they felt listened to and recognised for their contributions. One champion said, “It’s nice to be able to give an opinion or an idea. I spoke to the nominated individual who gave me recognition for the work I had done.”

The registered manager actively sought opportunities to improve their own knowledge and share learning with others. They attended local care sector forums and engaged with other registered managers to exchange ideas and good practice. They had also recently completed further training in health and safety to enhance their knowledge and support improvements within the service.

Learning was also shared beyond the service. The registered manager provided support to other managers and was due to speak at a local forum about the service's recent experiences of working with CQC and the fire service. This demonstrated a willingness to reflect on experiences, share learning and contribute to improvements across the wider sector.