Florence Nursing Home

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• 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

Managers and staff were clear about their roles. Managers understood quality performance, risks and regulatory requirements.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

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

The provider had a registered manager in post. The current registered manager told us they had appointed a new home manager to take over from them. The new home manager had applied to CQC to become the registered manager for the home. The current registered manager told us they would oversee the day to day running of the home until the home manager was registered with the CQC. There was an organisational structure in place and staff understood their roles, responsibilities and contributions to the service. Staff were positive about how the home was run and about the support they received from the registered manager, the home manager and nursing staff. One staff member told us, “I get good support from the managers. If I have any concerns, I can share theses with them, and they will help me if I need help. I think they listen to staff.” Another staff member told us, “Teamwork is very good. I attend regular team meetings. The managers are interested in how we feel about our work. It’s a nice place to work.” A third staff member commented, “The managers try to create a conducive environment for the residents and staff.”

The home was involved in the St Christophers Extension for Community Healthcare Outcomes project (ECHO). The aim of the project was to empower and support care home staff to provide individualised, skilled and effective end of life care for their residents. Management support was available for staff when they needed it. There was a 24 hour on-call number where staff can contact managers if they need any advice or support.

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 registered manager told us a satisfaction survey had recently been sent out to people using the service, relatives, professionals and staff. They were waiting for responses prior to assessing the feedback and drawing up an action plan. We saw the results from the last satisfaction survey. This indicated that people using the service, and their relatives were happy with the service they were receiving. There were regular staff meetings in place to support and guide staff with best practice. Staff told us they were able to express their views at these meetings and they felt they were listened to.

We saw a report from a compliance audit (mock inspection) completed in July 2024. This was carried out by an external professional. The report covered the CQC key questions of safe, effective, caring, responsive and well led. The report identified areas for improvement and an action plan. The action plan indicated that the areas for improvement had been addressed. For example, we saw that Mental Capacity Assessments and Best Interest records were in place for people using the service and the fire alarm was tested weekly. We saw records from the local authority commissioning team’s quality assurance visits to the home. This included actions for improvement. The registered manager showed us an action plan confirming the home had taken action to make those improvements, for example a safeguarding log was put in place and the activity coordinator now attends activity forums arranged by the local authority. The home manager showed us records from unannounced spot checks carried out at the home. They told us these were carried out to make sure people were being well care for, the home was clean, and staff were following the shift plan. Audits and checks were in place to oversee good service delivery and ensure people’s safety. Environmental and maintenance monthly audits conducted covered areas such as, infection control, bed rail and bumpers, air mattresses, pressure cushions, hand hygiene, hoists and slings, personal protective equipment, health and safety, safe management of care equipment and call bells. Monthly audits were also completed for service user records including care plans and risk assessments, people’s mealtime experience, medicines management, resident infections, accidents and incidents, and dignity.

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.

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