The Hurst Residential 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 with a breach of regulation 17 in respect of good governance. At this assessment the rating has remained requires improvement. However, improvements were seen and the breach of regulation 17 met.

This meant the management and leadership was sometimes inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The provider had a range of policies and procedures that guided staff on how to support and care for people in an effective, caring and responsive way. Which also promoted an open and positive culture that allowed the service to consistently learn and improve outcomes for people. This however was not reflected within peoples’ documentation.

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.

The provider had a shared vision and culture, but improvement was required to ensure it was embedded throughout the service and understood by staff. The provider was passionate about ensuring that people received support based on equality and human rights, and diversity and inclusion. However, staff needed support in understanding some peoples’ behaviours in order to have a better understanding of their role in promoting person centred care. A recent incident in the home had impacted on a staff member which had altered their approach to their role. We discussed this with the registered manager who would arrange counselling for the staff member.

The registered manager and staff understood and supported people’s cultural and spiritual needs. People were treated equally and their individual needs were met in line with their preferences. The management team knew people well and worked alongside staff to support and promote good practice.

Leaders did not always have the skills, knowledge, experience and credibility to lead effectively.

Staff leaders were kind and respectful, however on cross referencing the training programme against the staff rotas, not all staff had received the appropriate training or refresher to take the lead in the home in the registered managers absence. For example, refresher training in managing epilepsy and diabetes. The registered manager was committed to improvement and was open and transparent regarding the improvements made and those that were on going. We were told that the focus of the service was to ensure people were safe and supported with understanding.

There were systems and processes in place to support staff development and progression within their roles. They talked of how they were supported to attend training, gain qualifications and extend their role, for example becoming a medicine giver. Regular supervisions, and competencies took place.

The registered manager was committed to improvement and was open and transparent regarding the improvements made and those that were on going. We were told that the focus of the service was to ensure people were safe and supported with understanding from staff.

There were systems and processes in place to support staff development and progression within their roles. They talked of how they were supported to attend training, gain qualifications and extend their role, for example becoming a medicine giver. Regular supervisions, and competencies took place.

The service fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff told us they were confident to speak up about concerns and they had numerous opportunities to speak up if needed, at handovers, team meetings and supervision. One staff member said, “I would go straight to the manager.” Staff were aware of the whistle blowing policy and felt that they could raise concerns and be listened to. The provider had up-to-date whistleblowing policies and procedures which were in line with current guidance.

The provider/registered manager understood their responsibilities under the duty of candour. The Duty of Candour is to be open and honest when untoward events occur. We have received notifications as required. During our assessment we found that the management team were open and transparent. They admitted when things had gone wrong and demonstrated how they were using these to make improvements.

People confirmed they knew how to complain, and a copy of the complaints policy was available in the home. A record of complaints was held in the service, but they did not always contain the outcome and action taken to resolve the issue. However there had been no recent complaints recorded and this had been discussed at a previous assessment and improvements in the system could not be tested.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

All staff said they enjoyed working at The Hurst Residential Home. Staff felt they were treated as individuals and their needs were taken into consideration, such as shift times being arranged to fit in with studying and family commitments.

There was a strong ethos at the service of treating people as individuals, this extended to the workforce as well. There were robust measures in place to monitor, maintain and promote good mental well-being across the staff group. Staff were encouraged to undertake training in equality and diversity.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance.

Although the provider had made improvements to the systems they used to assess and monitor their service, more time was needed to embed and drive forward these improvements. The registered manager had used data and information from records to continually plan improvement in the quality of care. These had been shared with CQC and the local authority during 2024.

The quality assurance systems demonstrated there were still improvements to be made in respect of the collection of data to ensure that shortfalls were acted on in an effective way with an action plan. For example, the need to expediate necessary improvements to the environment. Such as removing malicious graffiti, essential repairs to the communal bathrooms and showers and the overall upgrade of the service.

Whilst care plans and risk assessments had been improved to be person centred, daily notes lacked the information that ensured people were receiving the support and social needs they wanted or required. Events and incidents had not been fully analysed for patterns and trends to ensure lessons were learned and shared with staff. It was acknowledged that some audits and overviews were not up to date, for example, the accident and incident audit had not been completed for six months, this was updated during the assessment process. The training programme overview was not up to date and therefore not assuring the provider that staff had completed the necessary training to undertake safe care and support. This was updated and provided during the assessment process.

The service followed robust arrangements for the confidentiality of data, records and data management systems.

The registered manager monitored and managed staff performance, and acted quickly to improve skills or conduct. The staff were positive about the management team and could see improvements in the home.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

The registered manager and staff worked closely with external professionals and told us they would be confident to contact someone directly without hesitation if they needed to.

Health professionals told us that they have a good relationship with the service and staff work with them in a professional and knowledgeable way. One told us, “They do work alongside us and the outcomes here are mostly positive, they support some very complex people and do it well.”

The registered manager had close links with the local authority and utilised any additional training opportunities when they were offered and felt very supported.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system.

The registered manager spoke passionately about the need for continuous learning to drive improvements for the service. They shared their plans to continue improving the service. However, their systems and processes were not always operated effectively to support these plans. For example, when we discussed incidents and accidents and lessons learnt, we found the learning was not as robust as it could have been and lessons learnt were not taken forward effectively. Whilst we did identify shortfalls during this assessment, the provider was responsive and took action to address key areas of improvement.