Abney Low 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

We assessed all quality statements in the well-led key question and found areas of good practice. The assessment of this key question found improved practice since the last inspection, our rating for this key question has improved to good. The service promoted a culture of learning and improvement, to help further improve standards in the safety and quality of the care being provided. Leaders were capable, transparent and compassionate and were well thought of by people and staff alike. Clear responsibilities and governance processes were in place to help identify current areas of risk and drive-up improvements. Policies and practices were in place to ensure the voices of staff were heard, helping to ensure input from staff was valued and acted on. The service worked in collaboration with external health care providers to share learning and help improve the quality of people’s experiences. The service was aware of potential impact of their activities on the environment and were making a positive contribution to help reduce it. There had been a significant reduction in the use of paper by the introduction of electronic records.

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.

Feedback from staff and leaders confirmed staff understood a shared vision and strategy which had been developed through a structured planning process in collaboration with people who use the service, staff and external partners. The area manager explained how since the last inspection, staff had begun working in line with the strategy leading to positive changes within the service.

Processes were in place to help staff and leaders demonstrate a positive, compassionate, listening culture, focused on learning and improvement. These included the use of de-brief meetings to discuss any shortfalls in the safety and quality of the service, to help further enhance the positive experience of care and support people received. Policies were in place to help ensure equality and diversity were promoted. We saw how people’s protected characteristics did not act as a barrier to accessing care and support and how overseas staff were supported in way which embraced their diversity and culture.

Feedback from staff confirmed leaders had the experience, capacity, capability and integrity to ensure the organisational vision was delivered, and risks were well managed. Staff told us leaders were visible and led by example. Staff told us they found the new manager approachable and supportive and that they had made many positive changes since they were appointed. Comments from staff included, “[Manager’s Name] is brilliant, they have done so much to improve things here,” “They are very approachable and always listen to our point of view” and “[Manager’s Name] cares a lot about the residents and staff.”

Processes were in place to recognise and reward positive staff practices, which evidenced leaders were compassionate and inclusive. Staff fed back what incentives they would like and these were included in an annual awards and recognition evening. A ‘Team member of the month’ scheme was in operation, staff were able to nominate their colleagues for a £100 recognition reward which was shared with professionals, families and friends. Processes also demonstrated high-quality leadership was sustained through safe, effective and inclusive recruitment and succession planning. For example, a 'Buddy System' helped enhance the induction process to enable staff to feel empowered. New staff were provided with a nominated person for their induction period and the 'buddy' was awarded if the employee successfully completed their 6-month probationary period. There was also a bonus scheme which provided staff with a possible rise in their wages and was based on good attendance and training completion.

Feedback from staff confirmed leaders acted with openness, honesty and transparency. Staff told us they felt encouraged to raise concerns and that the manager operated an open-door policy and always welcomed their ideas and feedback. Staff told us they had no concerns about speaking with the manager about any aspect of their job or any concerns they had. Their comments included, “[Manager] is so easy to talk to” and “I have no concerns about asking for support or advice.” Managers promoted a culture of speaking up in the home. There was a culture of speaking up in the home, staff were able to feed back their views in various formats such as written surveys and face to face meetings.

Processes were in place to help ensure when concerns were raised, leaders investigated and lessons were shared and acted on. The service operated a duty of candour, when something went wrong, people received a timely apology, and actions were taken to prevent the same happening again.

Feedback from leaders confirmed action was taken to help prevent any disparities in the experience of staff with protected equality characteristics. The area manager explained how staff who had been recruited from overseas were provided with support to help them settle into both their working and domestic life in the UK.

Processes were in place which helped to protect the rights of staff under the Equality Act. For example, staff were supported to raise ‘how they work best’ in order to ascertain the best of their ability and to promote ‘Great Care’. Risk assessments and any reasonable adjustments measures were located in staff’s personnel folders. This helped to create a more equitable and inclusive organisation.

Feedback from leaders confirmed information was used effectively to monitor and improve the quality of care and that mandatory quality frameworks, recognised standards and best practice guidance were used to help improve equity in experience and outcomes for people. The area manager explained that since the last inspection, governance processes had changed in direct response to the shortfalls in practice which had been identified. New tiers of governance promoted effective oversight of the manager’s own audits and checks, reducing the risk of any shortfalls being left unactioned.

Processes were in place to help ensure effective governance, management and accountability. Policies and procedures helped staff understand their role and responsibilities. Managers were able to account for the actions, behaviours and performance of staff. For example, by using supervision, appraisal and competency checks. Systems to manage current and future performance and risks to the quality of the service, allowed a proportionate approach to managing risk. Audits and governance processes such as the analysis of accidents and incidents, helped ensure the service had an accurate picture of risk to the safety and quality of the service at any one time. Knowledge was shared across the staff teams. An open door policy provided open and transparent communication, enabling staff to raise any issues or suggestions for improved practices.

People’s experiences confirmed they felt staff enabled them to access communities to enable better outcomes. People told us they received support from other health and social care professionals. Relatives told us how they also helped to support their family member, which was important to them. One relative told us, “I do [Name’s] fingernails, toenails and cut their hair.”

Feedback from staff and leaders confirmed they were open and transparent, and collaborated with relevant external stakeholders and agencies. The area manager explained how the management team of The Anchorage and the provider’s other homes, would get together once per month to shared learning and to aid the exchange of best practice guidance. This helped the service continually improve and helped lead to better outcomes for people.

The service worked with partners to ensure people received better outcomes. For example, we saw how the service engaged with the nurse practitioner at the local GP to help access the right care to meet people’s needs.

Processes were in place to help people receive the best possible outcome with regards to their care and support. People’s recorded care evidenced how staff worked with external partners to help ensure people received the right care and support to meet their needs in a holistic way. For example, we saw how for one person who was under the care of the TVN (Tissue Viability Nurse), the advice given by that professional had been adopted into the care plan for staff to follow.

Feedback from staff and leaders confirmed they had a good understanding of how to make improvement happen. The approach used was consistent and includes measuring outcomes and impact. For example, the area manager explained how learning and sharing of best practice amongst staff was discussed in detail and that the embedding of good practice was an ongoing process.

Processes were in place to help to ensure that learning happened when things went wrong, and from examples of good practice. For example, flash meetings and supervision processes. Staff were supported to develop their skills around improvement and innovation, and could request additional training for topics they had an interest in. Leaders encouraged staff to speak up with ideas for improvement and innovation. The service had strong external relationships to help support improvement and innovation. For example, the service had invested in completing the ‘Six Steps Programme’ to help enhance the provision of end-of-life care and supporting staff to further develop their roles around end-of-life care.