Bracebridge Court

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 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 leadership at the home and staff contributed to a culture at the home which was focused on providing good care to people.

Staff told us they enjoyed their work and felt very supported by managers and their colleagues. One staff member told us, “I have enjoyed every single day since I have been working here. To speak to the residents and to see the things the residents get up to. It is generally a really nice welcoming building from staff, residents and families." A new member of staff told us how they had felt welcomed and supported in their first days of working at the home and commented, “It is really friendly, and everyone is really helpful. They have said if you are stuck for anything, just ask, we are here to help." Staff were encouraged to reflect on their practice at regular meetings with their line managers.

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 had been recent changes in the management of the home. There was a new deputy manager and an interim home manager in post. A new permanent manager had been appointed and was due to take up their role in 3 months’ time. Not everyone living at the home or their relatives, knew who the manager was.

Staff acknowledged the management changes but spoke positively about the interim manager and new deputy manager. One staff member told us, “There have been a few changes, but it has been fine. Everyone struggles with a big turnaround, but [deputy manager and interim manager] have been really good.” Staff told us the provider’s senior management team had provided continuity and consistency during the management changes. Staff with extra responsibilities told us they had recently had more training to improve their practice and to give them the competencies and increased confidence for their role.

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

Staff told us they felt confident to speak up and share concerns and suggestions. One staff member told us about the whistleblowing policy and their confidence to use it if they felt it was needed.

The regional operation director said staff could use their own personal email contact details which could provide the person with some anonymity. They said, “We promote staff to call CQC ‘good care, poor care’ as well as the local authority safeguarding teams.” This process was anonymous to protect the staff member. The regional operation director also said they encouraged staff to raise their concerns as an anonymous whistleblower to protect them. There was a suggestion box in the communal hallways for people, relatives and staff to share any feedback they wanted.

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.

The regional operations director told us they valued diversity and inclusion by celebrating through cultural days, which meant staff brought their individual cultures into the home. They said, “Residents enjoy this, we use food, clothing and have dancing. For residents we held a festival of lights for Diwali.” The provider offered staff access to an employee assist programme. We were told staff could scan a code to access to a number of services that offered support, such as support with mental health. We were told this was a confidential service.

The regional operations director told us they could signpost staff to support services. They spoke proudly of how they had won an award for Mental health support for staff. They said, “I won an award for Women achieving greatness in social care for staff wellbeing.” In addition, the provider offered additional training to support with ‘PRIDE’ which means staff could ensure the home was inclusive for all residents. The regional operations director said, “When we do a sexuality care plan, it’s an important process to ask. We understand when people like to keep things quiet, we respect that and follow their wishes.”

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

The provider had a system of quality assurance that included regular checks on the quality of service. This included checks of medicines administration, care records, equipment, environment, infection control and incidents and accidents. Part of the provider’s quality assurance system included further assurance checks by senior management. Some audits and checks were delegated to others, with oversight from management. We found some of these checks needed to be developed further to become effective when identifying improvements. We reviewed examples of audits and found they did not always identify the specific issues we found, such as concerns with medicines, daily record completion and care planning. If issues were found, there was limited evidence to show how those actions were continually managed to drive the improvement needed.

People and relatives said they were not included in care reviews and were not always asked to provide feedback that could feed into driving improvements. However, people and relatives felt confident to raise any concerns that would lead to improvements. Displayed in the home we saw a ‘You Said, We Did’ board. This showed where suggestions were made, the provider had acted.

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.

Processes for working with and alongside other health and social care professionals showed how staff supported people to achieve good outcomes, and their overall health and wellbeing was maintained. During our visit, relatives visited family members and relatives said they could visit without restriction.

Managers and staff had established links with community partners to improve people’s lives, including local shops, public houses, schools and scouting groups. Many events at Bracebridge were organised to raise funds for other charities and encourage community engagement within the home. Staff worked alongside other healthcare professionals to ensure people’s needs were met.

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 director of care told us the provider looked across the organisation to learn and improve, especially from CQC inspections. There was evidence of changes that had been made to the service to make improvements through the ‘You said, we did’ board displayed in a communal area. There was transparency in displaying improvements as well as completing regular audits on aspects of the service provided. However, we identified further improvements were needed in areas, which we have described in parts of this report. The regional operations director had already begun to address those improvements. One discussion was about how environments can support people living with dementia. We discussed 1 example in the home and the regional operations director said, “It’s what we have always done.” From this conversation, the regional operations manager said they would begin to question this and if it was right for now. This showed a willingness to continuous learning. The provider had their own managerial responsibilities to oversee governance through their internal governance which could help identify learning opportunities.