Prestbury House Care 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

We assessed 7 quality statements under the well-led key question, identifying both areas of good practice and areas of improvement. The overall rating for this key question is good. The provider had introduced a home development plan through audits and checks that were in place and the manager was making the necessary improvements in those areas however, they did not identify areas of improvement found during our assessment such as actions relating to fire risk assessment and events not reported to CQC. The management team immediately took actions to address all feedback given during the assessment. People, relatives and staff described the manager as approachable and accessible to discuss queries or concerns. The provider worked with other agencies, to monitor the health of people and ensure people’s care needs were met. This was supported from feedback we received from external agencies. Relatives and staff told us there were regular opportunities to provide feedback on the service and the management. At the time of the assessment the manager had recently been appointed, an application had been submitted to register with CQC.

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.

Staff described a positive culture and told us they recognised work being done by the manager and provider to make improvements in this area. Managers had been focused on making changes to create a more open culture. They told us staff were now more open and would approach them to give feedback. A staff member told us, “Everyone works as a team. They (managers) pass on information if any emergency or updates.”

The provider’s ‘Statement of Purpose’ set out it’s philosophy of care with their aims and objectives. They were embedding processes to support managers and staff to have a shared vision and culture. Part of the provider’s home audit was to explore where there may be any hidden cultures within the home, this was to help identify if they were any concerns and act if necessary.

Staff described the manager as approachable. They told us they were treated fairly, and senior managers were supportive. Comments included, “The manager is approachable and fair; she is my mentor. She is a kind and empathetic person” and “(The manager) supported me very well.”

The manager was recently in post and had applied to register with the CQC. We observed a focus on embedding good communication and various meetings and updates were held with staff. The provider had various initiatives to support and reward staff. The manager had introduced a staff appreciation event and people could nominate staff for an employee of the month award.

Staff felt confident they were able to speak up. They told us, “(The manager) she will come and say if you’ve got any opinion come to my office, we’ll see if it works. We always see her every morning maybe twice per day.” The manager told us they focused on the culture of the home and encouraging an open door policy of speak up. They were visible throughout the home and knew people and staff well. Feedback suggested the atmosphere in the service had improved, as well as staff morale. Managers shared positive feedback with staff about things that had gone well and compliments.

The provider had a whistleblowing policy in place. This policy referred to an external number who staff could contact for independent and confidential advice. A provider’s recent home audit found staff were not fully aware of access to this independent resource and had taken steps to raise awareness with the staff team. There were regular staff meetings and individual staff meetings. The manager spent time with staff and people and encouraged people to feedback any issues or ideas they may have.

Staff were positive and felt valued. Staff told us, “The atmosphere is getting better; we are working as a team” and “I feel I am treated fairly.” Staff told us managers had supported them with reasonable adjustments and considered their needs.

The provider valued a diverse workforce. Policies were in place to ensure people were treated fairly and people’s diverse needs were respected. Staff undertook equality and diversity training. The manager had undertaken a staff survey to seek views and had taken time to discuss their experiences and was promoting an inclusive culture.

People, visitors and professionals were complimentary about the current management and recent improvements to the running of the home. The manager demonstrated understanding of the areas which were a priority for ongoing improvement. The feedback indicated the manager was supportive and approachable. A staff member said, “It’s a very good place to work. I have seen many care homes and not like this, this one is very nice. They are very friendly.” Staff reported some barriers to recording the care provided to people in a timely way, this related to the lack of availability of electronic devices at times. The manager said they were already aware and currently addressing this.

Overall, effective systems were in place to monitor the quality of the service. The provider had a schedule of audits and other checks which staff undertook. Staff held various meetings to review reports and consider if there were any themes or trends. The manager regularly walked around the home to observe practice and speak with people. There was a home development plan which was created following the various provider audits. The manager had already identified most of the areas we highlighted, and actions were in place to address them. We highlighted an area for further consideration in relation to ensuring people were always supported with their oral care. The provider had not ensured actions required in relation to the fire doors had been addressed in a timely way. The provider had not ensured CQC were notified about all incidents as legally required. Several safeguarding enquiries had been undertaken with the local authority and appropriate action taken to deal with these issues. However, we found not all safeguarding enquires had been submitted to CQC. The regional manager confirmed after the site visit, notifications had now been submitted retrospectively.

People and their relatives told us staff worked in partnership with them and with other health and social care professionals. One person commented, “The home organised a podiatrist to visit me and if I’m unwell they would ring the GP.”

The manager told us they were building links with the local community. There were regular visitors to the home including students and a local nursery.

We received positive feedback from partners, who said the manager and staff worked in collaboration with them. One person said the current manager was “dynamic” and had “Made a difference.” The provider had responded to a quality review undertaken by local authority commissioners and were progressing on a small action plan that had been identified to make improvements.

Staff worked in partnership with numerous health and social care professionals. The GP visited the service on a weekly basis to review people’s health needs. During our site visits, we saw people being visited by an audiologist, district nurses, physios and a best interest assessor. Resident and relative meetings were arranged to support feedback to the service. Activities and events were also promoted through the provider’s website. Relatives said they were made to feel welcome, and the bistro area was a lovely place to spend time with their loved ones.

The manager encouraged ongoing learning and improvement. Staff told us, “I feel supported because if we raise issues and concerns, sometimes when something is missing, they attend to the issues very fast” and “We have monthly meetings, and you can speak up. They ask for updates from staff.”

Processes were in place to focus on continuous improvement. People had been re-issued with information about how to provide feedback or raise a complaint. Surveys were undertaken to seek feedback from people and staff and help guide improvements. We saw information displayed about actions that that had been taken in response to feedback. Electronic recording systems were in place, which supported the oversight of the home, as they enabled various reports, and analysis to be undertaken and consider areas of improvement. The provider held managers’ meetings to share good practice.