Carpathia Grange

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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

We assessed 2 quality statements in the well-led key question. There were clear and effective systems in place to monitor performance, mitigate risk and deliver improvements. Staff understood their roles and responsibilities and were supported to deliver high quality care and support. The service had achieved accreditation and recognition through internal and external awards. Leaders fostered an inclusive culture and had the skills, knowledge and experience to lead effectively. Leaders at all levels were well-regarded by staff within the home and were role models for acting with integrity and openness. Staff spoke of receiving extremely good support as well as opportunities to further their careers.

This service scored 82 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Leaders at all levels were well-regarded by staff within the home and were highly visible. One staff member said, “The management are very good, this place has changed my view on care homes.” Staff spoke of a high level of support. One staff member said, “[Registered manager] is so approachable and friendly. Always smiling. Even if you get something wrong, she is very supportive.” Another told us, “Management are always there to listen if I have any issues. When I have raised any concerns to them, they have always been happy that I have gone to them about it. They take action with anything raised.” Staff told us their seniors would step in if additional support was needed on the floor. The senior team was alert to issues of perception and of ensuring staff were treated fairly. This meant they had high levels of credibility with the staff team. They shared examples of how they had taken prompt action to maintain cohesion in the team, even when this appeared to be the difficult path.

Leaders fostered an inclusive culture and had the skills, knowledge and experience to lead effectively. Staff were supported to develop and progress in their careers. At each level, staff spoke of completing training to fulfil the level above their current role. Staff had been promoted internally and demonstrated the culture and values of the service. Processes were in place to recognise performance and to celebrate staff achievements. There were monthly staff recognition awards and nominations for the provider’s internal Star Awards. For example, the deputy manager had been nominated as deputy manager of the year and dementia coach of the year within the provider. Leaders worked collaboratively. Each morning leaders from each section of the home met together to discuss the day ahead and to review any incidents or issues that had occurred in the previous day and night. This fostered a culture of support and challenge, promoted teamwork and enabled prompt action to be taken to address any issues or concerns.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

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.

Staff understood their roles and responsibilities. They spoke of receiving a high level of support from their seniors. One member of care staff told us, “Nurse Managers listen to feedback and ask us to tell them.” Another staff member said, “[Registered manager] is always there, and we are encouraged to speak with her. The deputy is also very approachable, willing and ready to listen.” Staff had confidence managers would consistently take action to address any issues and share the learning to improve outcomes for people. One staff member said, “I have seen them resolve problems. They will communicate with staff what the problem is and keep us updated with any actions or feedback, they’re very transparent.”

There were clear systems and processes in place to monitor performance and deliver improvements. Audits included monthly home manager self-assessments, each with a different area of focus such as clinical care or fire safety and winter preparation. Further audits and observations were conducted by members of the team, including staff appointed to champion roles, and reviewed by the registered manager. The safety of the environment and equipment was monitored with regular checks, including by external companies. Actions arising were clearly documented and reviewed through to completion. The provider had oversight of the service, with support from a representative of the provider who completed a detailed audit of the service and sought feedback from people and staff. Regional meetings of home managers included discussions on quality, best practice and learning. Feedback was sought from people, relatives and staff through surveys and meetings. Recent surveys demonstrated an improvement on already high scores, for example relative feedback on ‘staff responsiveness to matters of concern’ showed an increase of 4%, up to 94%. The service had worked towards accreditation and recognition through internal and external awards. These included internal accreditation under ‘Care Fit for VIPs’, a programme focused on achieving excellence in dementia care, being shortlisted for the Care Home Awards 2024 under ‘best for nursing care’ category and achieving the GSF quality hallmark accreditation award 2024-2027 ‘for the high quality of care provided for people in the final years of life’.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.