St Thomas

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

Leadership was visible within the service, management and office staff had defined roles and responsibilities. Links had been made with external professionals and relationships resulted in positive outcomes for people. Staff were supported in their role and worked well as a team to support and care for people well. People, their relatives and staff had confidence in the management of the service. Policies and procedures were in place to ensure the service operated safely.

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 spoke highly of the acting manager. One staff member said, “[Name] is very supportive, and empowers us to make our own decisions. He will ask staff what they think first. Last week we had a discussion about changing the carpet in the lounge and we were all asked for our opinion.” Another staff member said, “[Clinical lead] is great. I wish [acting manager] could stay here forever.” However, staff gave mixed feedback on the culture at the service. Some staff described an open culture, where they felt supported and able to speak up. Positive comments from staff included, “It’s a nice place to work. All the staff are nice, and they all help each other, it’s a good relationship between carers and nurses whenever we need help they are always there” and, “The relationship between nurses and carers is quite good they’re always communicating.” Other staff comments included, “I have noticed a few staff that get a bit stressed or panicking." And, “Recently it’s happening where some staff are picking on the care staff. We did have a meeting with the manager about it.” One staff member said they felt the culture was changing. They said, “In the staff meeting [manager] really listened and explained things to us, and he’s promised to change things.” Our inspectors discussed this feedback with the management of the service who reassured us they will continue to offer support to staff following the change of leadership.

The provider and staff sought the views of people and their families through surveys, individual conversations and reviews.

Staff told us about daily “care huddles” where information was shared with staff. Staff told us they found these meetings useful for getting updates on how people were. Staff told us, “I can go to [acting manager] about anything, and he will act straight away” and, “I think the manager is OK. I can’t give much of an opinion as they haven’t been here long but what he has done in a short while seems to be OK. The manager and deputy both listen, they sit and take their time with you, if action needs to be taken then they will do this.” The acting manager said, “I have a people-oriented approach, I like to identify people’s strengths, and give people opportunities to explore their strengths. I expect morale is quite low at the moment, but it is going upwards and in the right direction.”

Staff felt supported, attended regular meetings, and were kept fully updated with all aspects within the service. Communication systems were robust. There were daily heads of departments meeting, where information was shared amongst the teams for dissemination. The service ran regular relative meetings, those who had attended spoke positively of these.

The management team told us they encouraged staff to speak up if they had concerns about poor care. The provider had a freedom to speak up champion. Staff knew who this was. Staff comments included, “I haven’t had to raise anything to them that’s pressing. Even a small thing I wouldn’t have a problem going to anyone about it” and, “We have a speak up champion. If I thought care standards were slipping, I would go to [manager] and I am confident he would act on it. The safety of residents affects me, so I would report higher if I needed to.” All the staff we spoke with said they felt confident to speak up and raise any concerns. The acting manager said, “I always encourage people to speak up. If people don’t speak up, how can we put it right? We discuss whistleblowing at meetings to keep reminding staff.

The service had policies in place that supported staff in speaking up. Policies included the topics of safeguarding and whistleblowing. The service displayed posters in staff only areas informing staff of the process to follow. The service engaged with an external independent helpline for staff to ring if they felt concerned but unable to raise those concerns internally.

The service was made up of a diverse workforce. Some staff had moved from overseas to start their employment and told us they had been supported to settle in and made to feel welcome. Overseas staff we spoke with said they felt included and part of the team. One staff member said, “We have a multi-cultural workforce here. We had a cultural day for residents where staff brought in food for other staff to try. We had music and clothes etc; people liked to see us in different clothes from our own cultures.” Another member of staff said, “We are a diverse team. If we get new care staff and they don’t speak very good English, another staff member will help them because maybe they speak the same language.”

Policies and procedures supported diversity and inclusion within the service.

Staff told us the management team were visible and present within the service. One staff member said, “He [manager] is always walking around, I hear his voice all the time.” The management team told us they did regular walk arounds to monitor the service first hand.

During our assessment, issues we raised were addressed immediately or investigated and the manager informed us of actions taken. We saw the management team had a good oversight of the service and were visible. Statutory notifications were made to CQC in line with regulations. Staff were aware of the need store people’s records securely.

People’s relatives told us they were invited to attend regular meetings at the service. One person’s relative said, “There are relative’s meetings; they are open and honest.”

The manager told us the service had good links with the local church. There was a chapel on site which was used for services for the people who lived at the service.

The service had a good relationship with the local GP team. Weekly meetings took place where people’s health needs and medicines were reviewed. A health and social care professional provided feedback that said, " The soft intelligence I have been receiving is positive with the interim manager in post."

People’s care and support records confirmed the service made appropriate contact with a range of health and social care professionals when required and in a timely way. The service was planning to engage with local schools in the future so children could visit and engage with people. The service had recently had an open day to inform the local community about dementia and the support available. This had been advertised on local radio and through posters in shops.

One staff member said, “We have a lessons learned file. Staff can read that and we get told at huddles and daily meetings. We are always looking to improve.”

There was a range of provider led quality assurance audits in place. We reviewed the minutes of the most recent governance meetings which showed oversight and analysis of people’s weight and any weight loss, wounds and falls for example. These records showed how the service sought advice from other professionals when needed, such as the older people’s mental health team and Speech and Language Therapy Team. Regular clinical meetings took place to ensure all clinical staff were kept up to date with people’s health needs. Regular medicines audits took place. When issues were identified, action plans were implemented. We saw actions relating to monitoring the date of opening of topical creams and lotions had been completed. There was a service improvement plan in place. Complaints were recorded and investigated.