19 Stone Lane

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

At our last inspection, this key question was rated requires improvement, improvements have been made and this key question is now rated good, the service was no longer in breach of regulations. Governance processes were now in place and were effective in driving improvements and positive outcomes for people; when shortfalls were identified, these were addressed. The registered manager and staff created a culture to support the delivery of high-quality care. The registered manager was capable and compassionate and developed a culture that delivered good quality care for people in partnership with health and social care professionals. People, family members and external health and social care professionals told us they felt the service was well led. People, their relatives and staff were able to feedback about the service through quality survey questionnaires, meetings and casual conversations. Feedback was listened to and addressed.

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 they worked towards the registered manager and provider’s vision for the service. A staff member said, “The culture is great. We all care for the residents. I like to work here, everyone (all staff) knows our rules.” The registered manager told us of the importance of developing an open culture within the service. They said, “We always want to provide a home from home environment. I make sure the staff know this is their (people’s) home and we are guests in their home. They need to feel safe and comfortable in their own home at all times.”

People were now supported in line with the principles of right support, right care, right culture. The registered manager ensured all staff were trained and were following best practice guidance and instilled a positive and inclusive culture within the service. Meetings, supervisions and casual conversations promoted a shared vision for the staff and people using the service. People were encouraged to give feedback formally and informally. Easy read and pictorial questionnaires were distributed to people to give feedback and make suggestions. People were also able to speak with the staff whenever they wished or the registered manager, we observed people frequently visiting the office and chatting with the registered manager throughout our assessment.

The service was led by a capable and compassionate registered manager who was supported by the provider’s head office management team and the senior team within the service. Staff provided positive feedback about the support they received from the registered manager. Comments included, “I have training and can ask for any I might need. I do have supervision meetings with [registered manager] and see a lot of [operations manager] as well. We have staff and house meetings and I can say anything I need to.” The registered manager explained their leadership style and told us, “I am very hands on and try and lead by example, I am not just office based. I show them (staff) how I want things done and how I expect it to be done.”

Leaders now demonstrated they had the knowledge and skills and experience to ensure people received safe and effective care. The registered manager and many of their staff had worked for the provider for many years and had continued to build knowledge and keep up to date with changes and best practice. The service was regularly visited by staff from the provider’s head office, including the CEO, the senior leaders also knew people well and people enjoyed their visits.

Staff said they would be comfortable to speak up and gave examples when they may need to. Staff were able to speak with the registered manager whenever they wished, this included evenings and weekends. A staff member said, “I have no issue in raising things. We discuss things all the time but if I needed to raise something important or more serious. [registered manager] or the deputy would listen.”

Policies and procedures were in place to ensure everyone had the freedom to speak up. The service has an open culture and there was a whistleblowing policy should staff wish to refer to it. Speaking up was a regular point on the staff meeting agendas. We saw staff meetings were held to discuss safeguarding and whistleblowing; staff were encouraged to raise concerns when needed.

The workforce at 19 Stone Lane was diverse; staff had a wide range of backgrounds and experiences. The registered manager ensured staff’s protected characteristics and lifestyles were considered when planning the rota. For example, a staff member’s working pattern was designed around their family life. Where some staff had cultural and religious beliefs, these were respected. A staff member shared the same beliefs as a person living at the service; their working week included days where they could both attend church services together. A staff member told us, “I feel valued, supported and respected.”

The management team ensured everyone was treated fairly and were not discriminated against and considered any protected characteristics. The registered manager told us about where a risk assessment had been completed and reasonable adjustments had previously been made to support a staff member. The services equality and diversity policy was followed by staff and management.

The registered manager told us how they undertook quality assurance processes to ensure staff were delivering high quality service to people. The registered manager attended meetings with managers from the provider’s other services. This was to share ideas and provide mutual support. They gave an example and said, “A manager was having a problem with a resident and we gave support.” They told us about other topics discussed at meetings and said, “We discuss CQC and changes, we discuss [quality assurance system] how it’s going and expectations.”

Quality assurance processes were now embedded and effective. This resulted in improvements to the quality of the service. The provider had recently changed the way quality assurance were conducted and had a new system which was used alongside the previous system this ensured all areas of the services were audited and nothing was missed. The registered manager told us the new system was working well as outcomes had to be evidenced, for example, when completing a kitchen audit, photographs had to be uploaded to show what had been audited. Staff knowledge was included in audits to confirm their understanding. Checks and audits were in place, which covered all aspects of the service, such as, medicines, care records, safeguarding and accidents and incidents. Learning from audit outcomes were shared with staff to discuss where improvements could be made and minimise the chance of recurrence.

People went out frequently at a time that suited them. They attended health appointments and went out socially. People had 4 week planners so they knew what to expect for the day, but staff were available outside of the planned events if people wished to go out on an ad hoc basis. A person told us about the activities they enjoyed and said, “I like music and pub beer.” And, “I like Butlins on holiday.” There were open visiting times although most people went out to visit friends and family. A relative told us about a birthday party held for their loved one, people from the provider’s other services also attended the party. The relative said, “[Registered manager] put on a lovely big spread for [person’s] party.”

The registered manager ensured people were able to make choices and went out when they wished. They did this by planning staff availability at times where people preferred to go out. The registered manager and their team built positive links with health and social care professionals to ensure people received timely and appropriate support. The registered manager told us about some of the community links which have been made and said, “A lot (of people) go to buddy’s café run through Mencap. A lot of the staff working there have a learning disability too, it’s very welcoming. They (people) like to go there as if they get upset there they are not judged.” They also told us that people from the provider’s other services group together for parties and had made friendships across the services. They said, “We have Christmas parties, everyone knows everyone, they all consider each other as friends, [person] said they wanted to invite others from the other homes to their birthday party.”

Health and social care professionals provided positive feedback about the registered manager and their team. Their comments included, “From my first contact with [registered manager], I felt they were open, honest and transparent in providing me with information related to the person I was reviewing and the organisations as a whole. [Registered manager] answered all of my email enquiries in a really speedy and professional manner and provided any and all information I requested. [Registered manager] helped me with the person in a caring, responsible and professional manner causing as little disruption or distress as possible.” Another said, “I have found the manager to be responsive to my suggestions and keen to work with [my organisation], in order to improve the care provided to the residents. The manager has always come to me quickly with any concerns and to seek advice. I have observed the manager communicating with the residents in a positive, respectful manner.”

People’s care records were kept updated with advice and input from health and social care professionals so staff could access the information. People’s 4 weekly planners were audited to confirm they were completed with the person and to ensure they met and reflected their preferences, people were included in these audits. Some people had social stories in place, these were created to help people if there was a change to their preferred routine. The social stories were pictorial to aid understanding and included photographs so they knew what was due to happen, where and with whom. This helped relieve people’s anxieties about upcoming events.

The provider had learned from the concerns found at our last inspection. They had ensured staff followed the principles of the MCA and removed unnecessary restrictions to people. Risk assessments were completed with people to ensure they were receiving support that suits them in a safe and effective way. The registered manager identified where improvements were needed and worked through action plans as needed. They told us, “When I first came here, they didn’t have any planners in place, it felt like it wasn’t person-centred. Staff would take them (people) all out for a walk together which just ticked boxes. I have put the planners in place to make sure they (people) are involved and live a full life. Making sure everything is their choice, making sure we do what is fulfilling for them.” Actions from incidents, safeguarding and audit findings were shared to embed a culture of learning and being open. Staff were able to increase their skills and knowledge and were supported with promotions within the service. A staff member commented, “I have been given the opportunity to become a shift leader. I've really enjoyed playing a big part in plans for the day and how we support people.”

There were processes in place to enable learning and improvement. The registered manager had established a schedule of planned meetings amongst their teams and ad hoc meetings when needed. Meeting minutes evidenced staff were able to give suggestions and were kept informed of changes to good practice guidance or events within the service. The meetings provided an opportunity for learning and improvement points to be shared with staff. People and their relatives provided feedback to the service, questionnaires were designed so people could fully understand and answer questions which were meaningful to them. We saw feedback was taken seriously, for example, a relative provided feedback about their loved one’s choices and health. The registered manager responded to the relative with assurances and explanations, reaffirming the person was able to make decisions which were respected by staff.