Swarthdale 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 the last inspection this key question was rated inadequate. At this assessment the rating has been changed to requires improvement. This meant there were still some shortfalls in leadership and oversight of the quality and safety of the service.

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.

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 new leadership and staff team had driven improvements in the service since the last inspection. Staff, people and their relatives all spoke about positive improvements made in the service. One person told us, “The new team have made some good changes to the home. The staff being one. They are much happier, and I think the team spirit is better.

A new leadership team had been established and were still embedding their skills, knowledge, experience and credibility to lead effectively. A new manager was in post and was in the process of registering with us. We were told by management and staff that provider support was accessible, and they visited the home regularly. The processes used and the oversight of recruitment procedures needed to be improved. The 3 senior management team members were seen to be present frequently in the home and delegation of responsibilities were clear for the day to day running and oversight of the service.

The provider and management team fostered a positive culture where people felt they could speak up and their voice would be heard. Regular meetings between the management team and staff took place. Staff were given opportunities to discuss performance via a supervision & appraisal process. Staff told us they could speak up about anything and were listened to and things acted on. One member of staff told us, “I have previously worked with the new manager and since working here the changes made have been for the better.”

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 staff we spoke with spoke positively about their experiences of being recruited and working at the home. Staff told us they felt very supported by management team.

The provider did not always have clear systems of good governance. Processes in place for the provider oversight of the quality and safety of the service were not always effective. Regular medicines audits were completed but were not fully effective in identifying and addressing identified shortfalls. For example, a recent audit identifying gaps in some medicines administration records did not further explore the reasons or identify if doses had been missed. This meant that some opportunities for learning were missed. We also found examples where eMAR reports showed doses had been missed but an error report had not been made. In general, the oversight and monitoring of the service was seen to have improved. However, there were still areas where further work was needed. Implementation of a variety of audit tools had been put in place and some tools were not always completed consistently leaving the process ineffective for some areas and other areas they were seen to be needing to be streamlined.

The management team spoke positively about the collaborative working with the local authority quality team in making improvements in the home.

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. After the last inspection the provider worked collaboratively with the local commissioner’s quality improvements teams. The home had developed good relationships in the local community with the primary schools who visited and participated in activities with people regularly. People told us their social needs were being met.

The provider and management team 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. Staff and leaders had a good understanding of how to make improvement happen. There was an ongoing commitment and engagement with the local authority and commissioners and work had been completed with their quality improvement process. The elearning training matrix showed gaps in some staff training. The manager told us staff needed to prioritise time to develop their online training. Management encouraged staff to speak up with ideas for improvement and innovation. Where lessons needed to be learned information was shared with the staff team. There was a process in place for overseeing themes and trends for accidents & incidents that promoted learning from incidents and the implementation of better practices.