The Gardens 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

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the service management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care. The service was in breach of legal regulation in relation to the governance of the service.

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.

Although staff generally gave good feedback, they said at times staffing levels impacted on their ability to provide personalised care.

The provider did not ensure people always received the care they wanted. The shortfalls we found impacted on the quality of people’s care. People and relatives also gave mixed feedback about staffing levels not being enough to meet people’s needs in a timely way.

Staff told us there was a question about the effectiveness of the management oversight of part of the home called the Blackwell Suite. A staff member said, “This is a specialist mental health and challenging behaviour unit, however the nurse in charge is an RGN and the manager does not have a mental health background.” The manager confirmed they were unable to provide evidence staff had received specific mental health training, or details of the clinical mental health support for nurses working in the Blackwell Suite.

Management oversight at the home had been inconsistent. The provider was unable to provide reassurances management had the skills, knowledge, experience to manage effectively. This was especially the case for the specialist mental health part of the home. They were also unable to provide evidence staff had the appropriate training skills and support to care for people with specialist mental health needs. However, other staff commented they were well supported in their role.

Staff confirmed they felt supported to speak up. A staff member commented, “I am very happy here. I have no real complaints, sometimes there might be little things, little problems but you just have to mention it and it’s sorted.”

The provider had systems to enable people to speak up and give feedback about the home, such as meetings or speaking with the manager.

Staff gave positive feedback about equality, diversity and inclusion. A staff member commented, “I have been here 2 years, and I really like working here. Staff work really well together. We help each other out and we're like a family.”

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who work for them. The provider had policies and procedures to promote equality, diversity and inclusion.

The provider’s quality lead told us they conducted internal inspections of the home and produced a report and action plan. The manager told us they were working through the action plan to improve the service. Despite this there were still shortfalls in the quality of care when we visited the home.

The provider had a structured approach to quality assurance. This comprised of various audits and checks. Although most had been done consistently, they were not always successful in addressing shortfalls identified, such as addressing overdue training. This had been identified in previous audits but had not been addressed at the time of our assessment. Medicines audits were not taking place on a regular basis, and it was not clear who was responsible for ensuring completion of these audits. We found shortfalls within the home that the provider had not been proactive in identifying and addressing. This included MCA requirements, training compliance, improvements to the environment to ensure it was safe, recruitment records and PEEPs.

People told us the home had links to the local community. A person said, “They sometimes have a singer in, and they have children in from a local school.”

Staff told us there were usually able to support people to access the community. A person asked for support with this, and this was provided straightaway.

We did not receive any feedback from partners.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement. Staff were aware of other professionals involved in people’s care and worked alongside them when needed.

Although staff did not specifically mention learning, the provider’s systems needed improving to ensure they could identify and share learning regularly.

The service did not always focus on continuous learning, innovation and improvement across the organisation and local system. There was very limited evidence to show accidents, incidents, safeguarding concerns and complaints had been reviewed regularly to enable lessons to be learnt so that people were safe.