Silver Birch 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.

Improvements were needed to address the workforce inconsistencies which included the approach of some staff and management, morale, culture and team working. Some staff described an ‘us and them’ approach of management and leaders and not a ‘whole home approach’ within the workforce.Not all leaders understood the context in which the provider delivered care, treatment and support. They did not always embody the culture and values of their workforce and organisation. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively, or they did not always do so with integrity, openness and honesty. There was mixed feedback from staff around the leadership style in the service from management and colleagues in a senior role. One staff member said, “Not all shifts are the same. Some [senior staff] are really good, respectful and professional and we all work as a team, but some can talk down to us carers and don’t manage the workload fairly.” Another member of staff described encouraging changes they had seen within the management approach, “The deputy manager and director are approachable. Initially the manager appeared to be extremely busy and quite blunt and sharp with carers. [They] have become a little softer in the last couple of months.” The provider was receptive to our feedback and gave assurances that the inconsistencies described would be addressed, this included a review of their exisiting processes to consider what further support for the workforce was needed including external input if needed.

Improvements were needed to address the workforce inconsistencies which included the approach of some staff and management, morale, culture and team working. Some staff described an ‘us and them’ approach of management and leaders and not a ‘whole home approach’ within the workforce. Not all leaders understood the context in which the provider delivered care, treatment and support. They did not always embody the culture and values of their workforce and organisation. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively, or they did not always do so with integrity, openness and honesty. There was mixed feedback from staff around the leadership style in the service from management and colleagues in a senior role. One staff member said, “Not all shifts are the same. Some [senior staff] are really good, respectful and professional and we all work as a team, but some can talk down to us carers and don’t manage the workload fairly.” Another member of staff described encouraging changes they had seen within the management approach, “The deputy manager and director are approachable. Initially the manager appeared to be extremely busy and quite blunt and sharp with carers. [They] have become a little softer in the last couple of months.” The provider was receptive to our feedback and gave assurances that the inconsistencies described would be addressed, this included a review of their exisiting processes to consider what further support for the workforce was needed including external input if needed.

People did not always feel they could speak up and that their voice would be heard. There was mixed feedback from staff about being able to voice their concerns. Some staff felt able to share their views and that they would be listened to and their experience of working at the service was positive. Examples included, “My supervisor and manager are supportive and have an open-door policy,” and “I have no issues, can speak as I find, it’s safe to do so and I am respected.” However, this was not everyone’s experience, for example, “I don’t feel able to speak freely, management have their favourites.” And “I personally speak freely, whether or not management like what I’m going to say I tell them, they don’t listen and act on it, but they sure know what I think.” The provider had systems for gathering feedback, such as staff satisfaction surveys, staff meetings, a suggestion box in the staff room and visits from the provider team and the findings from these had been positive. However, further work was needed to embed a positive culture where all staff felt they could speak up and their voice be heard. For example, the documentation of staff meeting minutes could be more collaborative to better reflect a two-way conversation. One staff member shared, “Team meetings are very much the managers will tell us what’s what and when anyone tries to voice anything your shut down.” The registered manager and provider were receptive to our feedback and advised they would review their systems and processes to make the improvements needed particularly within the workforce and culture. The provider had recently introduced a confidential employee assistance helpline for staff to access providing both professional and personal advice and links to relevant support including external agencies. Not all staff were aware of this when we spoke to them and the provider advised they would promote this further with staff.

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. A diverse workforce was present. Staff progression was encouraged, and support provided to enable staff to achieve professional qualifications in care. The provider’s policies and procedures included ‘making reasonable adjustments’ for a prospective employee if they had protected characteristics. The registered manager shared examples of how they were able to be flexible in areas to support staff with disabilities, by offering training in a different format that was more accessible to the person.

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. An audit schedule covering all aspects of the service provision was in place. This detailed what checks and monitoring was to be completed, by whom and the frequency. These audits were signed off by management and fed into the provider’s overarching governance systems. Where inconsistencies and areas for development had been idenitified, a supporting action plan was in place to drive the improvement needed and deliver positive outcomes for people and staff. Other governance processes were in place to underpin the monitoring of care delivery and contribute towards positive experiences for people. These included ‘resident of the day’, daily walk rounds and out of hours visits by management. The provider had ongoing oversight of the service, with regular visits to the service from the provider’s operational director and nominated individual. They completed their own checks to ensure compliance with regulations.

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. People and relatives confirmed they were supported to access visiting healthcare professionals and to attend hospital appointments where required. Processes were in place to refer people to external professionals when people’s needs changed. Staff and the registered manager understood their duty to collaborate and work in partnership, sharing information and learning with relevant professionals to improve outcomes for people. The registered manager networked with other health and social care professionals to support learning and development for the service. A local authority contracts manager involved with the service described a positive working relationship, “The manager and the deputy manager, are always engaging and proactive. They also maintain excellent communication with me regarding any concerns they have and [have contacted the relevant professionals] when ascertaining Safeguarding advice to ensure appropriate referrals are made.”

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 registered manager completed daily walkarounds of the service and explained how any issues identified were discussed in stand-up meetings. These meetings were attended by senior care staff, nurses on shift and heads of departments. Where further actions were identified these contributed to the management audits and governance processes supporting the ongoing monitoring and development of the service. Any lessons learnt were cascaded across the staff team and across the provider’s wider organisation. For example, following an incident, staff received refresher training to ensure that all staff knew their roles and responsibilities, and this was shared with the provider’s other services to support safe practice.