Hazelgrove Court 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 and identified a regulatory breach in relation to governance and quality assurance systems. At this assessment the rating has remained requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care. The provider was in breach of legal regulation in relation to governance and oversight of medicines management.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There had been a number of management changes over recent months. Some staff commented, “Morale is quite low sometimes” and “staff morale is a nightmare; we have a meeting to try and sort this out.” Staff also told us, “We can't fault the area manager, we feel listened to, and she doesn't make us feel that she is better than us." They added, “[Deputy manager] is firm but fair and listens.” We were also told, “I spoke with [regional manager] about the hairdresser cancelling, so she came in and did it herself, they are a qualified hairdresser. They advertised for a new hairdresser that day!” The regional manager felt improvements to culture and staff morale had already taken place. They commented, “Staff are more relaxed, open to discussion. We’ve introduced more 1 to 1 meetings and staff meetings, promoting open and honest dialogue. We propose to do a survey in around 4 weeks which we hope will demonstrate a more positive viewpoint.”

During the inspection the regional manager and deputy manager were inclusive and visible. One staff member said, “[Deputy manager] is always around and you can go to her with anything.” Another said, “Management are supportive. All staff know their own responsibilities and get on with their own job.” The management team were responsive to feedback during the assessment and, where possible, took immediate action to make improvements.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The provider did not always have robust systems of accountability and good governance. Some shortfalls found during the assessment had not been identified by the provider’s audit processes. This included hygiene concerns, staff deployment, medicines management and associated care records. The regional manager responded to our feedback and took immediate action where they could. A new governance and oversight process was introduced part way through the assessment with the aim that this would provide increased accountability and oversight. The provider was working to embed and review this process, but we could not be sure of its effectiveness at the time of the assessment.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

There was a renewed focus on learning and improvement, driven by the regional manager and newly introduced governance procedures. A home manager had been appointed who was completing their induction, supported by the regional manager and deputy manager. Learning had taken place since the last inspection in relation to IPC procedures, however, oversight systems needed to be embedded and evaluated. Positive initiatives had taken place, with the activities co-ordinator involving people in ‘Blankets for Baby Rhinos,’ knitting blankets for a sanctuary in South Africa and being interviewed about their efforts on a local radio station.