Horsell Lodge

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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

There was a positive and inclusive culture in the service, which focused on treating people as individuals. Staff were acknowledged for their efforts which had created a positive morale amongst them, and one in which they felt able to raise concerns if needed. Quality governance audits and feedback opportunities were effective in identifying areas for improvement within the home, which were then actioned. There were close working relationships with external stakeholders.

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.

The registered manager told us, "I want to create an open and transparent culture where they [staff] want to learn and to develop, and feel able to question things." The registered manager said of their approach to leading the staff team, "It is about making them feel they can be open with me. It is about teaching them not to see feedback as a criticism, it is about taking learning. It takes time to embed that approach into staff." Staff told us there was a culture in which people were respected and valued as individuals. One member of staff said, “I think they are so respected and valued. From management down, the residents are the important people. That’s the expectation here.”

The management team awarded a staff member with a ‘caring star of the month’ on a monthly basis. This highlighted staff who had gone above and beyond in their role to provide compassionate and quality care to people. Team meeting minutes demonstrated that managers clarified the expectation that staff should support people in a way that promoted dignity, respect and independence.

Staff were complimentary about the management team. One staff member told us, “I like them both. They are strict but in a good way. Because they care about the residents.”

A ‘You said, we did’ document had been produced from a recent staff survey. This included a message from the registered manager to staff which stated, ‘Please do not forget about the open door policy, when you can come down to the office and talk to me about your role on the home, day-to-day activities, or anything else you feel you need guidance on.’

Staff said they were able to share their views at team meetings, and that these were listened to. One member of staff said, "When staff have something to say, the managers listen." Staff understood whistleblowing and their responsibility to speak up if they became aware of concerns.

Staff were given opportunities to raise concerns in both supervision meetings and team meetings which took place on a monthly basis. They were also encouraged to speak to the management team at any point thanks to an open door culture at the service.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The registered manager told us staff champions had been appointed to take the lead on areas including dementia care, medicines and continence. The registered manager described the role of a champion as, “Looking at improving our delivery of care, the wellbeing of our residents. For example, good hydration reduces the risk of falls, and therefore hospital admissions, and of UTIs."

Records demonstrated that the provider regularly audited key aspects of the service, such as medicines, infection control, call bell response times, and care plans. Action was taken where areas were identified for improvement.

People were supported to access additional health and social care through close working partnerships with external stakeholders. This ranged from district nurses to entertainers.

Staff maintained accurate records of the care people received and, where necessary, monitored people’s weight and/or food and fluid intake. Staff also regularly assessed any risks people faced in areas including skin integrity and nutrition. This information enabled healthcare professionals to assess and review people’s needs and recommend any changes needed to the care people received.

Local stakeholders were positive in their feedback for the service, commenting on the responsiveness to emergencies. We observed close and efficient working relationships with the district nurses during our onsite assessment.

Staff maintained accurate records of the care people received and, where necessary, monitored people’s weight and/or food and fluid intake. Staff also regularly assessed any risks people faced in areas including skin integrity and nutrition. This information enabled healthcare professionals to assess and review people’s needs and recommend any changes needed to the care people received.

Staff and the management team were keen to improve people’s experience of the service wherever possible. The registered manager told us, “We are doing things at the moment with the trying to improve the mealtime experience. We have identified some residents on the first floor will be very calm and some others who cannot concentrate for long and may disrupt the other residents.” The management team had decided they would utilise additional dining areas to create a less overwhelming environment during mealtimes.

The management team reviewed records of accidents and incidents to identify any emerging themes. We saw evidence that learning was taken from adverse events and shared with staff to minimise the risk of these recurring.