Harborne Lane 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 leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last inspection we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the service management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

Quality assurance systems had failed to identify many of the concerns raised by our assessment. The provider was in breach of regulation 17 good governance.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff we spoke with understood and supported the values and vision of the organisation. Staff understood people’s human rights and how they supported people’s diverse needs. However, in practice staff and management did not all have a clear or well developed understanding of people’s rights under the Mental Capacity act and their associated responsibilities. Processes ensured staff had a shared vision and values regarding the care and support they delivered. People and relatives were provider with clear information about how to raise suggestions and concerns about the service. The management team sought people’s views about how to improve the service, enabling them to contribute to its development. However, this process, in combination with some people’s lack of involvement in their care plans, had not always ensured care was personalised and put people at the centre of all planning. The provider’s processes and training had not ensured a clear understanding and promotion of people’s right under the Mental Capacity Act 2005. The acting manager was committed to promoting an open and positive culture across the service. They told us, “We have an open-door policy, staff members can contact me at any time”. Staff told improvements has been made and the management team demonstrated a positive, compassionate, listening culture that promoted trust and understanding. One staff member said, “Things are a lot better now with the new manager. The atmosphere has improved”. The provider had team meetings and regular supervisions where news was shared, and expectations of the team were discussed and agreed. The provider’s values were re-visited during staff supervision meetings.

The leaders at the service told us they were aware of areas for improvement within the service and felt the service would be where they wanted it to be in 6 months. Staff felt the current manager of the service was capable, compassionate, and inclusive. Comments included, “The manager wants to make improvements, and is supported by our deputy and the owner”.

Staff told us they had received relevant training and received support from the management team to enhance their own skills, knowledge and development.

The registered manager used policies and procedures to safely manage services and kept up to date with changes in the health and social care sector. They were committed to driving improvement through their own learning and experiences.

Staff told us they felt confident to speak up if they had any concerns. One staff member told us, “If I had any concerns, I would raise them. I believe now the concerns would be acted upon.”

There was a whistle blowing policy in place. Staff were informed about this as part of their induction. Staff could access the policy electronically if needed.

The provider was confident staff would raise any issues with managers and senior leaders. They encouraged openness and transparency within the staff team and encouraged staff to speak up and raise concerns during supervision meetings. Staff confirmed they were reminded of being able to raise concerns during meetings or supervisions.

Staff were aware of the whistleblowing policy and who to contact.

A number of staff told us they were supported to work flexibly, which supported their work life balance.

The management team told us how they promoted workforce diversity and had systems to support any protected characteristics staff may have. The diversity of the workforce reflected the diversity of the people they supported. Staff spoken with were positive about the support they received and gave examples of when additional support had been given to meet their individual circumstances.

The provider had policies and procedures in place regarding equality, diversity and inclusion. Staff were provided with contracts of employment which gave them information about their rights. Training was provided for staff on equality and diversity.

Systems to ensure care plans contained consistent, up-to-date and accurate information about their needs, risks and mental capacity, were not always effective. This meant some people were at risk of receiving inconsistent care. Audits of people’s care did not always identify when referrals to other health and social care professionals had not been made or did not include sufficient information about their needs and risks. This meant some people were at risk of not having their care needs met.

Care plan reviews did not always identify gaps in risk assessments or care plans. Although some of the provider’s audits had found some of the issues we identified, some issues we raised with the provider had not identified such as the concerns with the stairgates in people’s bedroom doorways.

People and their relatives told us they received support to access services from other health care professionals as needed, such as their GP, dentist or chiropodist.

Staff and management told us they collaborated with all the relevant professionals’ stakeholders and agencies, such as occupational health therapists and community mental health professionals.

Commissioners told us the management and staff team had been working hard to address issues previously identified from their monitoring visits. An action plan was in place and the provider was making progress.

The acting manager told us they worked closely with the local authority and other key stakeholders to build relationships. The acting manager, deputy manager and nominated individual were very receptive to our feedback about some of the issues we identified on inspection, such as accident and incident records and medicine management records. Staff told us they were always learning and had good support teams who helped each other.

The provider training matrix showed staff compliance with mandatory areas of training. The system enabled staff to be aware of overdue or upcoming training. Training and development was discussed in supervision meetings and recorded.