The Laurels and The Limes 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 requires improvement. At this assessment the rating has remained 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.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service did not have a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. We received mixed feedback from staff regarding the culture amongst the team. Most staff told us staff worked well together; however, most staff told us they were unsure about the changes taking place in regards to the management team. A staff member said, “I enjoy working at the home and they (staff) care from the heart. People are cared for, and staff work well together to achieve this. I feel the management team are supportive to a point, but a new manager is starting.” Another staff said, “There is so many management changes, I am not sure who is managing at the minute, things are up in the air, I think we have a new manager starting.” Daily handovers were in place to enable staff to share information.

Not all leaders understood the context in which the service delivered care, treatment and support. They did not always embody the culture and values of their workforce and organisation. At the time of our assessment the registered manager was due to leave the service. The provider had recruited a new manager who was in the process of completing their induction. We received mixed feedback from people and staff regarding the leadership and management of the service. A relative said, “I would go straight to the manager if I needed anything.” Whilst another relative said, “Staff don’t know the care plan, they washed [name’s] hair a way they don’t like and it has put them off having a shower. They lost [name’s] glasses, and it took over 2 months to get new ones.” The management team completed walk rounds and night checks, to ensure the service was operating effectively, however these had not always recognised concerns we found during our assessment. The provider had recently recruited a quality manager, to monitor the quality of the care and support people received.

People did not always feel they could speak up and that their voice would be heard. There were clear whistleblowing procedures in place and staff understood their responsibilities to whistle blow on poor practice. However, not all staff felt comfortable to raise concerns. Most staff told us they felt supported in their roles. Comments included, “Managers are supportive,” and “The team get on, I would go to the managers if needed.” Complaints were handled effectively. Where concerns had been raised, these were recorded and investigated.

The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them. All staff were supported with their professional development. No staff told us they had been subject to discrimination. Whilst some staff meetings had taken place, this mostly involved senior staff, meaning not all staff were involved in regular meetings. However, staff had received regular supervisions and appraisals. One staff member said, “Almost everyone is happy, and we have good team work, communication is good, every day we have a handover and everyone knows what is happening on a daily basis.”

The service did not always have clear responsibilities, roles, systems of accountability or good governance. Quality and governance program’s were in place which covered a range of audits such as health and safety, medicines management, IPC, managers daily walk round, resident of the day, mattress audit, and nutrition audit. Members of the management team also complete observations of meal-time, call bells, staff deployment, medicine round, safe moving, handover, hand washing, care interactions, personal care and activities. However, these had not always effectively identified concerns we found during our assessment, such as IPC, meal time experience and managing risks concerns. The regional manager completed a monthly oversight report for the provider.

We received mixed feedback from people, relatives and partners about their care and support. Most people told us improvements could be made to community engagement, activities and staffing. One person said, “The staff have been nice, I choose to sit in my room, it is too noisy downstairs.” A relative said, “[Name] would like to go out and about, but I can’t always take them. He used to love going out.” Newsletters were sent to relatives on a monthly basis, which included any changes and celebrations taking place.

The service did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not always actively contribute to safe, effective practice and research. The service had recently received a quality monitoring visits from commissioners and the LA. Some improvements were noted; however, this visit was overall positive. The provider was implementing a new system to further improve the monitoring of accidents and incidents. Refurbishment plans were in place, however several areas of the service required redecoration at the time of our assessment. Meetings had taken place with people and their relatives; however, this had not been done for some time and did not involve a range of people. Feedback had been sought from people and relatives and was due to be completed again. People and relatives would benefit from feedback surveys at this time due to the changes taking place at the service.