Finch Manor 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

Our rating has changed from inadequate to requires improvement. We identified one breach of the legal regulations. Since our last inspection the provider had sought external support and introduced several new systems and audit tools to improve the overall governance and oversight of the quality of the service. Whilst this addressed many of the significant shortfalls we identified last time, we found some systems had either not yet been embedded or were not fully effective. Several management changes within the service had impacted on this. Examples can be found in the safe and effective key questions. Staff did feel there was an open culture where they felt they could speak up about any concerns about peoples care and felt able to whistle blow on poor practice. Staff described the morale within the team as more positive and most professionals who regularly engaged with the service shared similar feedback. Systems were in place to ensure staff were treated fairly and equitably within the workplace.

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.

Staff were unable to fully describe a shared direction and culture they worked towards. This was in part, due to inconsistent leadership within the service. Staff did tell us they felt it was important to ensure people were safe and to treat people with dignity. Staff described an improved sense of morale in recent months, however, feedback we received was inconsistent. For example, one staff member told us, “Morale is very good at present. Staff are hoping things will continue to improve, it feels like we have come along way.” However, another staff member said, “Some [staff] do care, but some frustrate me because they don't want to work.”

There were processes in place to ensure a shared direction between the provider, staff and the people using the service. For examples, clinical and wider team meetings, staff supervisions and there had been a drive to recruit to any vacancies at the service. However, leadership had been inconsistent which meant we were unable to see how the systems had fully embedded an improved culture at the service.

In general, staff told us they felt supported by the leadership team. Comments included, “[Name] is good, here regularly. They ask staff how we are and is always smiling. They ask my opinion” and “Yes, they are really good. The home manager is good, introduces themself and asks how we are and tries to support us.” Throughout our assessment we found the management team were committed to improving the quality of the service and eager to demonstrate the improvements they had made since our last inspection.

Since our last inspection the provider had sought advice and support from an external consultant. New systems and processes had been introduced. However, not all processes were fully embedded to ensure changes were made and developed as there had been inconsistent leadership.

Staff felt confident in speaking up about any concerns they may experience and told us they felt they would be supported, and the manager would take appropriate action.

The provider had policies and procedures in place which guided staff through the process to speak up. Staff could raise concerns through team meetings and supervisions.

Staff were employed from a wide variety of backgrounds. Most staff told us they felt treated fairly. We were told, “Staff are treated fairly as far as I am aware” and “Yes, there is a good atmosphere. [Name] and [Name] are my managers. Any issues they support with. If I need something, they give me the support.”

Policies and procedures were in place to ensure people were treated fairly and equitably. This included when staff had protected characteristics under the Equality Act 2010.

Staff described the different processes in place to review risks to people and provide assurances about care. One told us, “We have flash meeting and daily huddles in place.” The nominated individual described the auditing systems they had put in place since our last inspection to address the failings identified. This included the support from an external consultant. However, the manager told us they were aware some audits were not yet fully embedded into practice and further work was needed in this area.

There was a range of policies in place for staff to follow. Systems were in place to enable audits to be completed however, were not always effective as they had not picked up the issues we found at this assessment or issues other agencies had identified. For example, the providers kitchen audit completed prior to a recent food safety visit failed to identify the issues which resulted in a poor compliance score. Audits of care plans and care monitoring records did not always identify shortfalls in accuracy or quality. Medicines audits had failed to identify the issues we found. The provider had an overall improvement plan which had identified some of the issues we found but systems to drive continuous improvement were not yet embedded.

People told us they were supported to access support from other services and agencies when they needed it. One person told us, “They will get the doctor if I need to see someone.”

Both the care staff and management team were able to demonstrate how they worked collaboratively with health professionals. For example, making referrals to community health teams and working with professionals to meet peoples care needs.

Partner agencies fed back that staff worked well with them to meet people’s needs, however, one visiting professional expressed frustration and the frequent management changes at the service which they told us was impacting on consistency of some people’s care.

There were processes in place to support oversight of people’s needs and ensure appropriate referrals were made where needed. At the time of the inspection there was a new management team and evidence the processes for good partnership working needed embedding further.

Systems were in place to learn and improve following when events occurred. A staff member told us, “Meetings are once per month, but we have daily huddles too. They are useful sometimes and things do see to be changing for the better.” Another staff member told us, “We do learning on my unit, if something goes wrong, say someone falls and sensor mat wasn’t plugged in. However, not all staff could recall being involved in these processes.

There were systems in place to ensure learning and to drive improvement, however, not all had been fully embedded into practice. Family and ‘resident’ meetings focused on feedback about food. Until recently, feedback was not sought on other areas of the service. Team meetings, clinical governance meetings and reviews of accidents and incidents were completed but these had been inconsistent due to changes in the management team.