Salt Hill Care Centre

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 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 governance at the service.

This service scored 62 (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, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities. Staff supervisions and appraisals were completed as required, in line with the provider’s policy. Staff felt supported. They told us the registered manager operated an open door policy and they felt comfortable to discuss any concerns and suggestions with them. Staff told us they worked together as a team to provide high quality care for people.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support. However, they did not always embody the culture and values of their workforce and organisation. Leaders did have the skills, knowledge, experience and credibility to lead effectively, however, they did not always do so with integrity, openness and honesty. Staff and people told us how supportive both the registered manager and deputy manager were and how they felt listened to if they expressed any concerns, "I think that I am treated well at work. If we have a concern it is acknowledged straight away and I feel heard. I am very happy. It is easy to go to the manager’s office if you have any concerns. They [Registered manager and deputy manager] are both happy to support me. However, we were told by some staff the nominated individual at the time of the inspection was not always approachable and supportive. Staff did not always feel listened to by them and were worried to raise a concern to them.

The provider fostered a positive culture where people living at the service felt they could speak up and their voice would be heard. People told us when they raised a concern, staff listened to them. People told us the registered manager was approachable and regularly visible throughout the day.

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. Staff told us they were fairly treated and had never witnessed discrimination or inequality within the service by the registered manager and the deputy manager. Staff described a diverse team who respected and supported each other.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate. The provider’s monitoring processes had not always been effective as they had failed to identify the concerns we found during our inspection. This included records not always demonstrating people received the right levels of care and safe practices were followed. For example medicines administration records which were not always correctly understood or accurately completed to show people had received their medicines as required.Improvements were required to ensure IPC audits identified concerns we found during our inspection. A regular walk around audit of the home completed by either the registered manager or deputy manager in order to review the infection prevention control of the service including in people’s rooms had not identified the poor quality of some furnishings and staining on some floors.

Daily handover meetings were in place. These encouraged effective communication between the staff team and included detailed information about people’s changing needs and any new admissions. Continuity plans were in place and detailed what action should be taken in the event of an emergency. The registered manager submitted data and/or notifications to external organisations as required. There was an improved emphasis on continuously improving the service and meaningful learning was applied across the whole staff team. Daily audits had been introduced to the service and reviewed concerns in relation to pressure sores, falls and infections.

The manager understood their duty to collaborate and work in partnership with different stakeholders, so the service worked seamlessly for people. The manager shared information and learning with partners and collaborated for improvements. The registered manager told us how they worked with people, their families and professionals to help ensure people received the care and treatment they needed. Staff agreed things were going well and they were more open and transparent. Staff stated they collaborated with all relevant external stakeholders and agencies.

Professionals were overwhelmingly positive about the services work so far to make many improvements and to ensure people continued receiving the care and support they needed. Professionals said, “The new manager and deputy manager have been very proactive in referring residents promptly and seeking advice when necessary. They have implemented most of the recommendations we provided upon our therapy lounge visit and have been very receptive to our support”. And, “I would like to highlight that the falls data from Slough Borough has shown a decrease due to implementation of knowledge gained from our support and possibly early detection and onward referral of residents” and, “The staff are competent and responsive, ensuring that the residents' needs are always met.” Staff and the registered manager encouraged partnership working with key organisations to support care provision, service development and joined-up care, as well as, keeping up with any updates in the health and care sector.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research. The registered manager told us how they monitored the service and focused on continuous learning and improvement. They and the staff had a good understanding of people’s needs, health and wellbeing, and they were able to identify where improvements were needed. The registered manager was positive about the reviews completed by different teams which also contributed to the oversight of the service.

The registered manager and provider sought feedback from people and those important to them and the staff, and used the feedback to improve and develop the service. They also kept in touch with external stakeholders to ensure information sharing was effective and useful to make any changes. Staff had staff team meetings to ensure any items arising from the day to day running of the service and others’ feedback were shared with the staff team to ensure smooth running of the service. The manager had an open-door policy and would welcome any feedback of how to maintain a good service.

Where necessary, external health and social care professionals had been consulted or kept up to date with developments. The registered manager proactively worked with the staff team, families and professionals to ensure people were able to achieve their goals and outcomes that had positive effects on people. The service had good links with the local community and the provider worked in partnership with other agencies to improve people's wellbeing.