Hylands House 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 requires improvement. At this assessment the rating has changed to 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 64 (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.

Many of the people we spoke to talked about the registered manager by name, and how she was present in the service and knew people well. One relative said “[Registered manager] is one hundred percent consistent and is always there to provide reassurance.”

The provider’s mission statement and values were displayed in the entrance to the home. Staff demonstrated a commitment to providing good standards of care through effective communication and shared values. They appreciated working in a small home where they had time to get to know people well and provide care that reflected people’s individual needs and preferences. When we asked 1 staff member what made them proud of working at Hylands House they responded, “I think everyone's work ethic. Everyone (staff) really tries every day." Another member of staff told us, “I think we are a nice home, a nice friendly team and we all do a good job."

There were regular staff meetings in the home and staff were invited to share their thoughts.

Not all leaders understood the context in which the provider delivered care, treatment and support. Leaders did not always have the skills, experience and credibility to lead effectively.

The provider was not always aware of relevant legislation, for example, that related to window restrictors, fire drills or medication records. Internal quality assurance processes had not highlighted the areas for improvement in the service which we identified. However, the registered manager was responsive to our feedback and implemented immediate improvements to respond to any concerns we found.

The registered manager had worked at Hylands House for over 20 years and was very dedicated to the home, the people who lived there and the staff team. The registered manager was supported by the provider’s operations manager who was based at the service and was previously the registered manager. The registered manager had a recognised qualification in leadership in health and social care. Staff described the registered manager as being very visible in the service and available to them for guidance and support.

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

Staff felt confident to speak to their managers and share any feedback or concerns. The registered manager was supported by the provider’s operations manager and all staff we spoke with said that both were present in the home and promoted an honest and open culture of transparency.

Processes were in place to support staff to reflect on their practice through regular meetings with the registered manager. One staff member told us the meetings were useful and commented, “We discuss if I have got any problems, any areas I think I do well on and where I see myself in a year’s time." Staff also had staff meetings where they could share their views and opinions about the service.

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.

There was a diverse staff team at Hylands House who said they felt valued and supported in their roles. They told us they had not experienced or witnessed any inequalities or discrimination and enjoyed working together. One staff member told us, “We are all treated fairly and equally here. Not the same because we are different people, but fairly. I can share how I feel at any time.” Another staff member told us, “[Registered manager] is lovely. If you have got a problem, she will say ‘my door is open’. If you have got any concerns she will get straight back to you." Another staff member described how the registered manager had supported them when they had a personal issue.

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, or share this securely with others when appropriate.

Some audits and checks needed to be more robust to ensure they identified where improvements were required. For example, medication audits had not identified the issues we identified in the management of time specific medicines and medicines administered through a patch.

Audits of window restrictors had not checked their effectiveness or whether they met legislative requirements, and when fire drills had taken place, key details were not captured. Some of the audits we reviewed, for example the checks on window restrictors, did not evidence what was being checked, by who and whether the person carrying out the checks had the skills and knowledge to be able to do so competently.

On the day of our inspection, we found that some paper records were accessible to others. This included archived care records and staff files. We informed the provider who took immediate action to ensure records were stored securely.

Processes to quality assure the service needed to be further developed to drive improvements at the service.

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’

Each person’s care needs were reviewed each month through a ‘resident of the day’ process. Care plans were updated by the registered manager who ensured information was reflective and accurate. Whilst most relatives said they had not seen their family member’s care plans they felt there was good communication about care received and they were updated regularly if anything changed. A monthly newsletter was circulated to relatives with key information about the service, photos of events, birthday celebrations and other news the provider wished to share.

Information was observed in a recent newsletter asking relatives to book a care review with the registered manager if they had not already done so.

The service had good working relationships with other health care agencies who felt welcomed into the home and felt the service listened to their advice to improve outcomes for people. The provider linked in with external organisations, such as dentists, district nurses and speech and language teams to improve learning for staff.

The provider accessed additional training for staff through Skills for Care. Skills for Care is a charity organisation dedicated to supporting the adult social care sector in England.

The manager had worked with a local university to provide placements for medical students and helped to improve their learning of residential care.

Local schools, youth groups and the town mayor had spent time in the home, providing engagement to people at various events throughout the year.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people.

Despite being responsive to the concerns we found during our inspection,there was missed opportunities by the provider throughout their own governance processes for leaders to identify areas where improvements could be made.

Processes to quality assure the service, needed to be improved to identify areas for development and then used to create an action plan to further drive improvement at the service.