The Glen Private 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 good. At this assessment the rating has changed to outstanding. This meant service leadership was exceptional and distinctive. Leaders and the culture they created drove and improved high-quality, person-centred care.
 

This service scored 93 (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 very clear shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the challenges and the needs of people and their communities. Without exception staff at all levels worked together to promote quality care that was truly person-centred. Staff and managers at the service had been in post together for many years and in this time had fostered a culture that promoted people’s well-being, independence and choice. Staff were empowered to become experts in their roles and had responsibility for oversight and training in their specialist areas. Staff worked proactively to problem solve and mitigate future risks and were supported to do so by the registered manager. Staff spoke with pride about their roles. Staff members told us, “I think because it’s a small service we get to know our residents, really, really well, It feels more like a family than a clinical setting” and “I am so proud of the team.” The registered manager was knowledgeable and supportive and promoted the values of person-centred care. People using the service benefited from staff who took time to reflect on their work and learn from experience. When things went well or when incidents occurred, staff worked together to think about what happened, what they could do differently in the future, and how to improve care. This approach helped ensure people received safer, more effective and continually improving support. People and their relatives were actively involved in care planning and their views were respected. Relatives told us, “They [staff] are so mindful about what people are trying to achieve, they think about what is right from an ethical and healthcare point of view” and “They [staff] clearly take pride in what they do, and this is reflected in the dignity and respect shown to all residents.”
 

The provider had exceptionally 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 always did so with integrity, openness and honesty. The registered manager demonstrated a commitment to high-quality person-centred care. The registered manager worked with people, staff and professionals to continually improve the service and care delivery. For example, the registered manager was undertaking training and research in partnership with local health professionals to improve prescribing within care homes. They encouraged staff to become experts in their field by assigning staff members champion roles and promoting staff knowledge and skills through regular training which adapted to the needs of people being supported. People and their relatives had confidence in the leadership of the service. A relative told us, “The management team have been exceptional, the home is genuinely warm and homely and staffed by a happy and consistent team. The management have created an exemplary standard of care.” People using the service experienced exceptionally open, honest and accountable care. The registered manager and staff team demonstrated a strong and embedded understanding of their responsibilities under the duty of candour. When things went wrong, staff were consistently transparent and proactive. They communicated openly with people and their families, took swift action to put things right, and used every incident as a learning opportunity. This outstanding approach ensured continuous improvement and reinforced a culture of trust, learning and high quality care.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Staff without exception told us they would be confident raising concerns should they need to and felt they would be listened to. The service provided training to staff in relation to whistle-blowing.

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. Staff without exception told us they were happy and felt supported in their roles. Thoughts and ideas from the staff team were welcomed and respected, staff at all levels and managers worked together as one team to promote person-centred care. Staff were empowered in their roles and supported both professionally and personally if required. Staff told us, “I am confident that the registered manager would act on any concerns. We come to conclusions together to make things work” and “I feel wanted by the registered manager.” People using the service benefited from a well supported and confident staff team. Staff were encouraged to develop in their roles and build confidence in their practice, creating a positive and supportive working environment. This was evidenced by high staff morale and a consistently low turnover of staff, which helped ensure people received stable and consistent care. This enabled people to receive high quality care and consistently positive outcomes. This ensured that there was consistency of skills and care. Most staff at the service had worked there for many years and spoke positively of their feelings towards their work. Staff told us, “Its great here, I love the staff and the residents, I was going to retire but I don’t fully want to leave” and “I really love it here, I like everything about it, it has a nice family feel.” Staff had access to regular supervision and training opportunities and could become champions of specific areas within the service, and staff spoke positively about this. A staff member told us, “I do like the extra responsibility (of the champion role), there’s lots of support too.”

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. Governance and auditing systems within the service were effective, robust and well organised. Where issues were identified records evidenced that these were addressed quickly. The registered manager had ensured that clear roles and responsibilities within the service were established, and staff champions took ownership of specialist areas to oversee and audit. This allowed staff to become specialists on their areas of expertise and to proactively identify where improvements could be made. For example, the fire champion had recognised that due a change in a person’s mobility the service’s fire evacuation procedure required updating.

The provider clearly understood and carried out their duty to collaborate and worked in partnership, and services worked seamlessly for people. They always shared information and learning with partners and collaborated for improvement. Staff and leaders had over many years built up strong and trusting relationships with local health and social care professionals and community services. Professionals without exception spoke highly of their experiences of working with the service. Professionals told us, “I have always found staff are open and transparent and seek our advice and support. They value our advice and support, they are doing a great job caring for residents. We have a close and positive relationship with the service, the experience of its senior nursing team is above expectations, and this allows us to be certain and confident in their clinical decision making” and “We have a fine tuned system in place with the registered manager, built over a decade. I genuinely feel this is the best nursing home we have ever worked with.” People using the service benefited from strong links with the wider community. Staff and managers demonstrated a clear understanding of the community services available and had built positive, well established relationships with them. For example, the service worked regularly with a local toddler group that visited the home to promote meaningful intergenerational activities. The service had also developed strong relationships with local spiritual and religious organisations representing multiple faiths. Staff and managers understood who to contact and when, and ensured people were supported to access spiritual or religious support in line with their individual wishes and changing needs. Strong partnership working ensured that people’s independence was continually promoted, for example people had achieved improved mobility and positive weight gain at the service.

The provider had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research. Accidents and incidents were thoroughly analysed and steps put in place to mitigate future risks. When incidents occurred, staff were supported to take time to think about what happened and what could be learned. This helped staff at all levels improve their understanding and gave everyone the chance to share their views and ideas on how similar situations could be prevented in the future. For example, the mobility champion spent time with a person who was struggling to use a piece of equipment following a minor incident. The persons preferences for equipment use were shared with the rest of the staff team immediately to ensure the care remained at a level the person was comfortable and confident with.The registered manager demonstrated a commitment to ongoing learning and development and was undertaking a master’s degree in conjunction with the Department for health and Social Care (DHSC) and local health providers. This was with the aim to reducing the time taken to prescribe common medicines within the care home and reduce delays to treatment and the burden on local health partners. The training was taking place in collaboration with local health professionals. A professional told us, “Our goal is having an experienced non-medical prescriber embedded in the care home allows for more efficient prescription saving time for both patients and the practice by reducing workload and empowering staff with a greater understanding of medication safety which in turn improves safety for the residents and provides a greater level of care.”