Buckingham House

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

There had been clear improvements in the care provision for people, and the staff group were supported and trained to carry out their roles. However, time was needed for these systems and processes to become established and sustained. Although the home had been without a registered manager since October 2023, a new manager was now in post, but is yet to register with CQC. Time was needed to stabilise and establish the management team. The provider’s governance systems were effective, and the provider had worked through an action plan to address the concerns we found at our last inspection. The leaders of the service were visible, and staff told us they felt supported. We received positive feedback from professionals that leaders of the service built good relationships with professionals and people who used the service. Whilst there had been significant work undertaken to improve the service, there were some aspects that still required attention. The systems that were now in place had a positive impact for people and the staff group. However, further time was needed to embed and sustain these systems.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff spoke positively about the new management structure and felt staff morale had improved. Staff stated they would like to see further teamwork embedded to ensure the service continues to move in a more positive direction. Staff said they feel more involved in the service and changes being made.

The provider carried out engagement work with people, their relatives and staff to include everyone in the shared vision. This included carrying out surveys and reviews to highlight areas that needed work and then sharing the outcomes with everyone.

Staff told us they were well supported in their role by the provider and new management team, and they had opportunities for development. We received positive feedback from professionals that leaders communicated well. Staff told us they felt leaders were available and would take action to address any concerns they had.

The provider had taken action to ensure the service was more inclusive. The new manager shared examples of their daily walk around to check people’s care, infection control practices and staffing. The provider has a person of the day check, where staff focus in on one person each day and ensure their care records are up to date and any changes people wish to make to their care.

Staff told us they had more confidence in the management team and the provider, that they would now take action on any concerns staff raised. Staff told us they were aware of the whistle-blowing policy and who they could contact if they felt their concerns were not been addressed internally.

Staff told us they now felt appreciated in their role. Staff shared examples certificates of appreciation thanking staff for their commitment, dedication and hard work. Most of the staff team had worked for the service for a number of years and staff told us they felt the culture had improved and staff were treated equally. Staff were positive about the improvements that have been made and they have benefitted from further training. Staff spoke positively about the new management structure and felt staff morale had improved. Staff stated they would like to see further team working embedded.

Staff understood their roles and responsibilities within the team and how these contributed to ensuring the safety and quality of the service. There was a clear management and staffing structure and staff were aware of their roles and responsibilities, were motivated, and had confidence in the management team. The staff team assessed the quality and safety of the service through audits. This provided effective oversight of what was happening in the service. This meant concerns were responded to in a timely way and allowed reviews of care to be completed promptly. While there had been a period of time where the leadership of the service had not been consistent; at the time of our assessment a new manager was in post, and was rebuilding communication with people, their relatives and external professionals. They were aware of their responsibility to maintain standards of governance and oversight of the service. We could see that meetings were being held to provide people and relatives the opportunity to raise any queries or concerns they had, so these could be addressed. Where meetings had already taken place, actions were in place to address improvements required. Feedback from external professionals was positive.

Leaders told us they felt that the systems and processes in place were adequate but the management team were working towards embedding these processes to ensure the improvements made could be maintained long term. Tasks were delegated between the leadership team and each had lead responsibilities they undertook responsibility for oversight of.

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.

Staff spoken with were positive about changes made since our last inspection. This included management changes, team working, improved morale and how they had benefited from training. Staff told us the operations manager was very supportive, approachable and they felt confident they could raise any concerns and they would address them. Staff spoken with told us they feel supported, respected and were more involved in the changes being made at the service. The management team told us since the last inspection they had focussed on recruitment and ensuring staff were trained. The provider confirmed they had appointed a new clinical lead who was supernumerary. They had been leading and overseeing the clinical improvements needed. Staff told us all care plans had been rewritten, and risks reviewed with involvement of people and their relatives. The team leader completed supernumerary shifts to enable them to review staff competencies, check recording in care records and monitor staff training levels. Staff told us they received supervisions to enable them to review their performance and share concerns in a confidential space. Staff told us they had welcomed additional training from the provider and now felt more confident in their roles.

There were effective quality assurance and auditing systems in place designed to drive improvements in performance. Records showed action had been taken and changes made to procedures as a result of learning identified via these audits. The service’s digital care planning system made alerts when planned care tasks were delayed. This information was monitored in real time, and changes to staff allocations made to ensure people’s needs were met. The service valued it’s staff team and encouraged their development. Staff were supported to access further education and to gain additional skills. The service actively participated in the local community.