Archived: Summerhill Care 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 good. At this assessment the rating has remained good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

The service was in breach of legal regulation in relation to good governance as the systems in place to assess and manage the quality and safety of the service were not always effective.

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.

Staff understood about equality and diversity and wanted to provide compassionate care.We observed staff demonstrating respect for each other and the people they were supporting.

The registered manager told us, “We are very focussed on our residents’ wellbeing. We have a lot of links with the community and want our residents to feel a part of that. We want to be at the heart of the community.”

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 management team consisted of people who had worked at different levels in the care home and whose skills had been nurtured and developed by the organisation. They embodied the organisation’s values and culture which was shared by their staff. The registered manager told us, “I myself have felt very supported by the organisation and benefitted from leadership and management training. We have a nurturing approach and staff can progress. We are very careful about who we recruit and currently have a very good staff team.”

Staff felt the management team were approachable, inclusive and supportive. One member of staff told us, “Even the area manager is great. They were really good with me during a difficult time in my life. And they listen to our suggestions and follow things up.”

One professional visiting the service told us, “The management team must be good as the nurses know what they are doing and provide a good service.”

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

The provider had a whistleblowing policy which staff understood. Staff were able to report concerns in one-to-one meetings and the registered manager had an open-door policy. One staff member told us, “I would report concerns to a manager. If I wasn’t confident they would do anything, I would whistle blow. We have a phone number we can contact.”

The provider strongly valued diversity in their workforce. They had an inclusive and fair culture which had improved equality and equity for people who worked for them.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes.

Medicines audits had not identified issues with recording of medicines administration, administration of time-based medicines, lack of information about as and when medicines and covert medicines in people’s care plans, and storage of medicines.

Audits did not always identify when care plans included inconsistent information or a lack of information about people’s risks and how staff should support them or escalate concerns when needed.

Audits did not always identify when monitoring records were not effective. For example, when recording people’s thickeners, oral care and tasks associated with a person’s complex health need.

Audits and checks were carried out to ensure the building and care home environment was safe. For example, fire, gas, electrical and water safety checks were carried out in line with guidance and issues identified were resolved.

Audits and checks carried out on equipment used to support people with their care were effective.

Audits of safety incidents and complaints were effective, and issues identified were addressed in a timely way.

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 worked closely with other agencies to ensure people's needs were met.One professional visiting the service told us, “We work well with the care home. They are very good at ringing us and telling us about people’s health issues and they look after people well.”

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 provider and registered manager worked well together with a focus on delivering good care and improving systems. The registered manager told us, “Care home managers in the organisation work together to improve practice. I carry out audits for other homes and vice versa.”

Staff spoke of their confidence in the management team and their ability to continually improve the service.

The management team had put in place an action plan straight away to ensure feedback from the inspection leads to improved practice.