The Swallows Residential 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

The provider's oversight and monitoring systems had improved with some refurbishment and use of equipment to keep people safe. However, processes were not always in place which consistently and independently identified improvements, across the service, linked to innovation and best practice. Governance and oversight processes did not always manage risks to people. This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

This service scored 46 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff told us of a positive culture at The Swallows Residential Care Home. They felt part of an established team, who were supported by the Deputy Manager, provider and consultants. They told us they were focussed on improving the service so they could welcome more people to be cared for. Staff we asked did not know about the overall strategic vision for the service but had access to values expected and service user guides in the main entrance.

The provider supplied the Commission with an action plan following the last inspection. No other updates were provided demonstrating how the service was sustaining change, embedding learning or sharing any other areas of service development/position in the local care economy until we requested it as part of this assessment. A system for demonstrating to any external stakeholders including commissioners of care was not in place during this assessment, despite, for example, more refurbishments being completed and in house training being developed. Governance and oversight processes did not demonstrate how improvements impacted on the quality of the service and how they were learned from, embedded and sustained.

Staff we spoke with said they felt supported by the provider (registered manager) and deputy manager. One of the registered providers had not been present at the service for a significant period. Consultants had been engaged to support staff to improve. Minimal information was shared with the Commission about improvement milestones, project planning or updates outside of the last inspection action plan. It was not clear how internal learning, audits and review contributed to the improvement of the service.

The registered manager and staff were clearly committed to the service. However, shortfalls in governance and oversight, meant they were unable to consistently demonstrate the service was providing the best quality of care and support. Further support was needed to demonstrate outcomes for people through best practice and innovation. The provider held resident and relative meetings, but people were not involved in setting the agenda and minutes did not reflect improvements to be made to the service.

Staff told us they felt able to escalate concerns to the leadership team. However, the minutes of staff meetings did not consistently demonstrate that a positive and professional response was encouraged with external bodies reviewing the service. This had the potential to create a closed culture at the service and did not promote partnership working in the best interests of people using the service.

There were processes for staff to speak up and engage with internal leaders. The service was independent and there was no evidence of learning from similar types of services.

The service was not running at capacity but had recruited and followed basic recruitment criteria to ensure fairness and matters of equality.

Processes were in place to ensure workforce equality, diversity but improvements were needed to staff recruitment practices.

The provider and their consultant representative told us there had been improvements made since our last inspection and we found progress had been made in a number of areas and some of the previous breaches of the regulations had now been met. We found, however, that there was further work to do and that the service was still in breach of Regulation 17 Good Governance.

Whilst we recognised the provider had taken steps to put additional management in place due to unforeseen circumstances, the registered manager did not maintain a frequent presence at the service. The provider and registered manager have legal responsibility for the safe and effective running of the service. The provider had employed consultants to support the service however they have no legal accountability should something go wrong. Whilst some areas had improved (linked to action plans after the last inspection in 2023, wider improvements had not been shared or monitored to demonstrate the impact it had. A decision to reinstate a ‘key worker’ link for each person was taken after feedback from commissioners. It was not clear there was any consultation or consideration of the impact of this stopping had been fully considered before the decision was made. This also impacted on the short falls of systems to review care plans and care records in general. People's records were not always updated in a timely manner to ensure they were accurate, personalised, reflective of people's individual needs and risks. The service responded to concerns being highlighted to them but failed to identify these themselves and act on them.

The service is in a rural area. The provider/registered manager had made attempts to have a program of social activities including visitors however this did not constantly happen and was not always person centred. Staff were committed to support people inside and outside of their working hours.

Staff told us they worked well as a team and had a shared sense of responsibility for those living at the service. For example, one staff member baked a birthday cake for person at the service. However, there was a need to develop wider networks of partnership and community which could further improve the experience of living in the service.

We contacted healthcare stakeholders to seek feedback about the support people received. We were aware of a number of actions raised through recent external quality audits which had yet to be resolved as evidenced in our assessment. Whilst we received no negative feedback however there was no detail about how the service demonstrated this aspect of the service

There was no strategy in place to demonstrate how the service would engage with partnerships and communities, other than those linked to ongoing health and social care needs.

Staff and the provider told us that there had been improvements made at the service since the last inspection. They highlighted the environmental changes for example. We found, however, that whilst there had been changes further work was needed to ensure the service was fully identifying the improvements needed.

'Improvements had been made in all areas identified as needing attention at the last inspection. However, the provider/registered manager had not looked wider than this to develop and ongoing detailed development plan for the service. There had been some unforeseen circumstances which impacted on this, but the service had a deputy manager and consultants in place to support the registered manager.'