Yew Tree Nursing 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

The registered manger and provider had made improvements to the management, oversight and governance of the service since the last inspection and were no longer in breach of regulations. Since the last inspection the registered manager had improved the quality monitoring systems and oversight of the service and the service was no longer in breach of regulations. Policies and procedures supported staff to speak up, raise concerns, and keep people safe. Staff told us they felt the service was well led and managers were available and approachable. Systems had been improved to learn from incidents or concerns and implement measures to reduce risk.

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 felt supported by the registered manager and senior leaders within the organisation. Staff said the manager promoted a positive approach to person-centred care. The registered manager told us how there sole focus was on ensuring the very best from staff in providing care and this sometimes meant taking a tough line with staff who didn’t perform. We found the management team to be focused on achieving good results for the people in the service.

There was a clear organisational strategy. The core values of the organisation were embedded into the culture of the home, through team meetings, staff supervisions and observed practice. People’s views about the way the service operated were sought and taken into consideration.

Staff we spoke with were complimentary and supportive of the management team. However, before the assessment some staff had shared they felt the nmanagement tema were strict and didn’t always listen to staff. We did not find any evidence during our visits that this was the case. Staff meetings detailed actions and we could see that these were resolved. The registered manager told us they had clear expectations of staff conduct and had on occasions had reason to raise performance issues with staff.

Policies and procedures supported service improvement. There was a clear organisational structure and staff roles and responsibilities. The manager had oversight and knowledge of the day to day management of the service and there were systems of governance and oversight to ensure the smooth day to day running of the service.

Staff we spoke with felt they could raise concerns with the registered manager and they would be listened to. Staff were aware of the whistle blowing policy. There were supervisions and team meetings to ensure staff were given the opportunity to discuss any concerns.

Policies and procedures provided people, staff, and visitors the opportunity to feedback about their experiences of the service. Processes encouraged communication and there were systems to use feedback in improving the service.

There were no restrictions on people or staff freedom of identities and no discrimination in the policies or from our observations.

Policies and procedures promoted fair and equitable terms in the workplace and there were no restrictions on the rights of staff to freedom of expression.

The registered manager told us how they had taken the findings from the last inspection and applied the necessary policies, procedures and ways of working to improve.

Governance systems had improved from the last inspection and the provider was no longer in breach of regulation. Systems of oversight and management had improved, for example last inspection we had concerns over how falls were managed, this assessment found systems were monitoring risks and actions taken to reduce falls. Where falls had occurred these were identified and actions taken to reduce further risks.

People and relatives told us they were supported to work with other agencies.

Staff told us they worked well with other external agencies and felt that at times they connect with the local community. There are community events through the summer at which efforts are made to involve as many people form the service as possible.

When we sought feedback from external agencies they were complimentary about their contact and input with the service.

The policies and procedures promoted openness and transparency with other services. Where required the registered manager had contacted the local authority and when required notified CQC of any incidents or concerns. There was also a focus in the policies and procedures to involving the service in the community and ensuring people were not unnecessarily isolated in the service.

Staff told us they felt the service was improving. The registered manager told us how they had implemented improved systems to learn from any incidents or concerns and of their commitment to having a service that continually learns and improves.

There had been improvements to the systems, policies and procedures that underpinned effective service learning and improvement. Risks identified during the previous inspection had been addressed and systems of oversight and management had improved.