Summerfield House Nursing Home

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• 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

During our assessment of this key question, we found the rating has improved from Inadequate to good. Governance systems were in place to help monitor aspects of the service so that the quality of care provided could be continuously assessed and monitored. The manager had promoted a good culture which focused on people’s individual needs. Management had more oversight of the service and promoted an open culture. Staff spoke positively about the manager and told us they were approachable and caring. Management sought feedback from people and family members and made improvements where necessary.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff told us the provider’s shared vision and values were clearly communicated by the manager. One staff member said, “It’s all about person-centred care and involving people with everything. We don’t rush people; we do things properly. The manager tells us, ‘It’s not about what you do but how well you do it’.” Another staff member said the values were now embedded throughout the home. They said, “A lot of work has gone in to make Summerfield where it is now. We now have more oversight and knowledge about how to involve the community and families. We know our roles, and all have the same goal – to give the best we can for these residents.”

The provider promoted a shared direction and culture in the home where staff were able to speak out and share their ideas and concerns.  The management team were visible and supportive, working as part of the team. There were regular meetings including handovers which ensured good communication and promoted high quality care. Staff meeting minutes showed the manager adopted a positive focus, encouraging and praising staff, promoting teamwork and further improvements. Suggestions made by staff are taken on board and actioned. We saw actions identified at previous meeting had been addressed.

The manager started at the service in April 2024 and has applied for registration with CQC. Staff we spoke with, at all levels, were unanimous in their praise of the manager and the improvements they had made. They described the manager as supportive and approachable. Comments included: “The manager is a nurse and very involved. She’s a very strong team player and taught us to be like that” and “The manager has made a huge difference. I trust her as my leader.” The staff survey carried out in August 2024 also reflected the improvement in leadership and management. 93% of staff said they had confidence raising concerns with management, up from just under 70% in June. 100% of staff felt supported in their role.

The new manager was supported by a strong leadership team. All had the skills and experience to lead the staff team. They were visible around the home and had established good relationships with partner agencies, the staff team and people who used the service. They demonstrated a good understanding of people’s needs. The provider’s senior management team comprising of regional and specialist managers visited frequently and provided further support and guidance to the manager and staff in the home. The provider and manager told us they recognised the improvements made over the last 6 months required embedding to ensure they were sustained.

Staff were aware of the whistleblowing policy. Staff said they felt comfortable raising concerns and asking questions, and were confident these would be dealt with. The manager told us they encouraged feedback and there were a variety of routes where staff could raise concerns openly or anonymously.

The provider has a dedicated whistleblowing email and telephone number for staff to use should they need to escalate any concerns. A poster detailing these contact details is displayed in the home. Staff also have access to an external company called Wellbeing Solutions, which provides free confidential support and counselling on a 1-1 basis for staff to be able to discuss their concerns.

Staff told us the culture in the home had improved and staff morale was now good. All said they were treated fairly and felt comfortable raising concerns and asking questions. They said they were encouraged to share any suggestions they had to improve the service and felt these were listened to. The manager was supportive of flexible working arrangements. One staff member told us how they had struggled in their role, and this had impacted on their mental health and wellbeing. They had discussed this with the manager who was very supportive and acted straight away. The staff member said the changes made for them had improved their overall wellbeing.

Staff had completed equality and diversity training. All staff received regular supervision which varied in focus including training and development and areas around applying knowledge to practice, as well as the wellbeing of everyone. In July 2024, the provider organised a staff appreciation day to thank staff for all their hard work in making improvements to the service. We saw photographs of staff enjoying a barbeque, buffet, bucking bronco, and magician. The staff room has been redecorated and new furniture and equipment provided. Staff appreciation and recognition schemes have been implemented. Every month staff form each department are nominated by their colleagues as employee of the month receiving a certificate and a voucher. In addition, staff can be awarded a £20 voucher on a weekly basis if they have gone ‘above and beyond’ in their role.

The manager told us they had reviewed the governance systems and implemented more simplified processes which were monitored and reviewed by them and the provider to ensure any actions identified were completed. Staff we spoke with had a good understanding of their roles and responsibilities. One staff member said, “My role is to make sure the residents get the best care and that’s what I do. We all do it. We work as a team.”

Effective systems were in place to oversee and manage the quality of care and service provided. Audits were thorough, where issues were identified, action plans were implemented. For example - Weights monitored and reviewed monthly shows most people’s weights were stable. Any loss/low weight identified showed actions taken such as fortified meals, supplements/dietician input. Accident and Incident analysis were very detailed showing what had been put in place following any events . Any learning identified was discussed with appropriate people, for example: staff/residents/relatives through communication channels such as handovers, meetings, and reviews. We saw Monthly quality and clinical governance meetings in the home manager, deputy manager, clinical leads, unit managers, seniors, and nurses on duty. Clinical matters were discussed and reviewed, and lessons learned considered.

People and relatives told us staff worked in partnership with other agencies to ensure better outcomes for people. One relative said their family member was prescribed a food supplement which the GP discontinued. Staff identified quickly that the person was losing weight and spoke with the GP who re-prescribed.

The manager and staff understood the importance of working collaboratively with partners to ensure people received joined up care. They gave examples of referrals they had made to the care home liaison team and mental health team who had supported people who were distressed or had a decline in their mental health. One staff member told us how they had worked with the safeguarding team to protect a person who they had identified was being coerced. Dieticians and the SALT team had provided specialist advice for people who had feeding tubes in place.

Positive feedback was given from outside professionals in relation to improvements in the service. They described the provider as receptive, engaging, open and transparent and welcoming of their oversight and feedback. They felt assured the staff and management team have built and were now sustaining positive relationships. They said referrals were appropriate and timely and accurate handover systems were now in place. 

The provider worked in partnership with the LA and ICB contract and commissioning teams and health and social care professionals to ensure people's needs were met and make improvements to the service. The manager had also established links with the local community. They had worked with a local school on an Art Trail works project which had involved children and people in the home working together. They had installed raised beds and planted flowers, decorated the outside of the summer house with murals and were, also planning to do a mural on the outside wall of the home.

The manager told us how they had involved people, relatives, staff, and partners in developing and making the improvements we found. They said the provider and senior management team had supported them to make changes. They said there was a drive and commitment to continue to develop this further to enhance people’s quality of life and outcomes. All the staff we spoke with told us there had been huge improvements in all aspects of the service since the last inspection. Staff praised the training and support they had received and understood the part they played in making life better for people living in the home. They said they were encouraged to put forward ideas and suggestions which were listened to. Staff said they now trusted the leadership and management. One staff member said, “We have learnt from our previous inspection. We all have the same goal to give the best we can for these residents.”

Processes had been put in place to ensure that lessons were learned when things went wrong, and good practice was shared.