Larchwood 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.

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.

The registered manager told us that they had undertaken significant work on the culture within the service and there had been a focus on the fundamentals of care to ensure a shared direction. As part of the changes additional training had been provided, both in house and sourced from local partners including the local authority prosper training and dementia support team. Staff were positive about the changes in the service, and one told us, “The culture has changed, I wasn’t sure at the start. Some carers have left but it is happier, and staff are caring.” A relative told us, “The registered manager has changed the atmosphere here, the way in which staff interact with residents…. They have introduced additional training around dementia to increase staff skills, staff are more empathic which is a real positive.”

People and their relatives had opportunities to give their views and opinions during meetings with staff and management. They were kept up to date with the events within the service through newsletters. Relatives told us that they were kept up to date with changes in their family members needs.

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.

There was a clear management structure within the service and the registered manager was visible and had an ‘open door’ policy whereby they encouraged people using the service, relatives and staff to speak to them about any issues or concerns. The relatives we spoke with all knew the registered manager by name and were complimentary about the leadership and care people received from the service.

A member of staff told us, “The manager has worked hard to improve the home. There is excellent team work now. I am part time, but I work extra if I’m asked. I’m very happy to help out on the other units and I like being at work. The manager is very supportive, she is on point and really cares about the residents.” Another told us, “I love it here, the manager is honest and fair. They have introduced lots of structure, before no one was on the same page. Its 90% better and the manager is approachable. We have staff meetings every few months and things are coming together.”

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

There had been historical concerns at the service about issues not being reported or always acted on. The registered manager told us that they had worked hard to change the culture of the home and ensure that concerns are taken seriously. Staff described improvements in the support they received following the appointment of the registered manager and told us that they had confidence that they would be listened to if they raised a concern.

People and relatives told us that the registered manager was approachable. Those who had raised concerns told us that there were systems to investigate issues. One relative told us, “They are approachable, there is no need to escalate and complain, they are very accommodating.”

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 described an inclusive culture, where they were treated fairly. A number described team working and how this had been strengthened over the last year. Regular staff meetings are held with each of the staffing groups and minutes maintained to ensure that all staff had access to the information they needed.

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.

The provider’s quality assurance arrangements monitored the quality of care and people’s experience through its internal auditing processes. A wide range of audits were undertaken including checking infection control, health and safety and care plans. Unannounced night visits were undertaken by the management team and data was used to identify trends and patterns in key areas such as accidents and incidents. This information was used to help the management team, drive improvement. Satisfaction surveys were also undertaken along with observations of practice. For example, their review of people’s mealtime dining experience had identified that further input was needed, and the registered manager told us they were introducing a new initiative with the appointment of a mealtime coordinator.

As part of our assessment, we identified some shortfalls in the recording of behavioural monitoring charts and other records, but we saw that issues with recording had already been identified by the providers quality system. We were assured that the provider had a plan to move records to an electronic system to ensure more timely input and in the interim reminders were being given to staff about the important of robust recording systems though training and staff meetings.

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 and managers told us about positive working relationships with health and social care professionals, we saw referrals has been made appropriately and professional advice was updated in people’s care records for staff to follow. Health and social care professionals gave positive feedback, and we saw that meetings and reviews had been held to discuss people’s needs and plan how best to meet them.

The service was well integrated in the community and people had access to a wide range of activities such as crafts, visits by therapy dogs and music sessions. The activity organiser was proactive and welcomed groups such as the local preschool group and church representatives. The service has its own minibus and staff member told us about recent visits to the local dementia choir and places of local interest such as garden centre and cathedral.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. There were processes in place to ensure that learning happened when things went wrong. Route cause analysis was undertaken, and the focus was on reflection and making changes to ensure that issues were not repeated.

As part of the assessment, we identified some shortfalls in record keeping. The registered manager was able to demonstrate that frequent discussions and meetings had and were continually being undertaken with senior staff about the importance of good record keeping and ensuring information was up to date.