Layden court Care 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

We assessed all quality statements for this key question. At the last inspection we found breaches of regulation because the provider's quality assurance systems and processes were not effective and had not enabled them to assess, monitor and improve the quality and safety of the service. We found enough improvement had been made during this assessment for the provider to have met the requirements of the previous Enforcement Notice. The provider had improved their governance systems to assess, monitor, and improve the quality and safety of the service. Clinical staff demonstrated they were competent to perform their roles. Most records were up to date and accurate and where risks were identified, measures to lessen the risks had been implemented. Systems to record, analyse and investigate accidents and incidents helped to prevent further incidents. However, there remained some areas of care records, medicines management and infection prevention and control which would benefit from further improvement and the provider’s audits had not identified these. This is a continued breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We were confident in the management team to drive and oversee the continued improvement of the service. It was clear the registered manager was keen to provide the best possible service to people, addressing concerns and mistakes in an honest and proactive way. People and staff spoke positively about the registered manager and management team, who promoted a positive, caring culture. There was a clear management structure and systems of accountability had been strengthened. The provider had effective systems and processes to investigate and learn from incidents and concerns. The team worked collaboratively with people using the service, those close to them, and other professionals.

This service scored 71 (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 had a good level of knowledge of people and staff and maintained an ‘open door’ approach to be accessible to people, their visitors and staff. They valued people and promoted a positive culture in the service. When incidents had occurred, they were very responsive, taking action to address all related concerns.

The service had a clear statement of purpose and description of the values, which the team aimed to work in line with. Staff had opportunities to attend meetings and training sessions, which supported communication and consistency of approach in the team. The registered manager made sure staff understood health and social care and health and safety regulations.

Members of the management team were aware there were further improvements to be embedded into practice and felt they were making good progress with this. The registered manager was was committed to continue to improve the service. They had a good understanding of their regulatory responsibilities. They were enthusiastic about their work, and open to feedback and learning. Most staff spoke positively about the leadership of the service, saying there had been some improvements in the way the service was managed. They felt the management team were approachable and competent leaders.

The management team maintained oversight of the culture and practice in the service by means of a range of checks and audits, including unannounced nighttime visits by managers. However, these had not picked up on or addressed the shortfalls we saw at our visit. The relationships we saw between people, their visitors and staff were warm and friendly, and people were actively encouraged to be involved in broader decisions about the running of the home. During or visit, the atmosphere was calm and relaxed. Managers were proactive in promoting a positive, person centred, person led culture.

People felt they could speak up and their voice would be heard. Staff told us they were encouraged to speak up, especially about issues they felt might impact negatively on people using the service. They knew how to raise concerns with the provider or outside organisations and told us they felt comfortable to do so if needed. They also confirmed they attended a range of staff handovers and meetings, and were encouraged to discuss any ideas for improvement. Members of the management team talked openly and honestly about the culture at Layden Court. Everyone told us of the registered manager’s ‘open-door’ policy, which enhanced communication in the team by providing readily available avenues people, staff and relatives to talk about issues.

The management team sought feedback about the service through various means, including surveys, meetings and reviews involving people, those close to them, staff and other professionals. There was clear information for people on how to make a complaint, and for staff on how to raise concerns, including whistleblowing. Guidance and support was available to managers when responding to any concerns that were raised. The management team were working to an improvement plan for all aspects of the service and were making good progress with this.

Staff described being treated fairly and equally in line with best practice guidance and equality law. They were supported to complete equality and diversity training. They told us the management team created an inclusive, respectful culture in the service. Staff told us they felt valued and supported by the provider and enjoyed working at the service.

The provider had clear policies regarding equality, diversity and human rights. This helped to make sure the provider met their legal obligations to staff. It was clear the management team followed these policies so staff with protected characteristics were supported appropriately and protected from discrimination. Staff said the culture of the service was open, fair and inclusive, and they worked together well as a team. Flexible working was in place to support staff, for instance, with their caring responsibilities at home.

Members of the management and staff team were aware of the shortfalls identified at the previous inspection, were aware of the need for improvement and were making good progress with this. They were clear about their roles and responsibilities. Staff told us the registered manager was passionate about improving the service for people, open and fair, and nurtured a positive culture in the service. Staff confirmed they were regularly involved in meetings and had opportunities to discuss their opinions and contribute their ideas to the running and improvement of the service.

Overall, the provider had improved systems in place to oversee and manage the quality and safety of the service. Members of the management and the staff team were involved in carrying out a range of audits and checks covering all aspects of the service. There was good coordination of these audits and checks, and findings were discussed with staff. Staff fed back daily about any changes in people's support needs or issues via meetings and handovers, which were recorded and monitored. We identified some areas for improvement in care planning, in the management of medicines regarding topical creams, and in the cleaning regime. The provider’s systems needed further reviewing and embedding into practice to ensure they were properly effective as the shortfalls found during our visit had not been identified by the provider’s audit processes. Following our visit the provider took prompt and appropriate action to address these areas.

When we asked people and relatives if they felt the service was well led they spoke positively about their experience. Comments included, “It is generally better than before. There have been a lot of changes in managers, also there are new carers”, “[The registered manager] is very good. If you have a problem she will sort it” and “The new [registered manager] is much more approachable and forthcoming”.

The registered manager understood the importance of collaborating and working in partnership. Staff told us they had built positive working relationships with health and social care professionals and worked in partnerships with them to achieve good outcomes for people.

The feedback we received about the service from partner professionals painted a picture of an improved and improving service. Health and social care professionals told us staff worked effectively with them.

Staff were responsive to issues raised and worked together, reviewing and assessing health care to ensure people's needs were met. The service worked with a range of partners and had established links with local services and the local community. This included healthcare and social care services, hospitals and community organisations and places of worship.

Staff spoke positively about the learning, innovation and improvement the registered manager was leading in the home. They said the registered manager was honest, accessible and promoted a positive, person centred culture. The registered manager was keen that staff received the support and training they needed to meet the needs of people who used the service, and to make their work interesting and rewarding. Staff told us they were encouraged and supported to learn and take opportunities for personal progression in the organisation.

The management team were very committed to improving the service. Processes were in place to respond to concerns raised by people and relatives, staff, and the local authority. The registered manager made sure issues were followed up with lessons learnt to ensure equality of experience and good outcomes for people. The registered manager’s response to recent incidents was open and honest and demonstrated a willingness to use lessons learned to avoid similar incidents in the future. The management team understood their duty of candour, to be open when things went wrong.