Hartfield 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

There had been a change in leadership since the last inspection. his had caused some disruption and adaptation to structure and skill-set. However the provider was aware of this and taking action to promote stability in the governance. Staff wellbeing was prioritised and staff were encouraged to contribute their views within team meetings, although less so in one-to-one meetings which was being improved upon. There was a culture of encouraging equality between staff and people using the service; valuing what people could contribute to the service.

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 were recognised for good performance and representing the service in a way which reflected the culture. An Employee of the Month scheme celebrated staff who were kind and dedicated. Staff meetings and supervision records showed that values were emphasised in order to share a common aim to enrich people’s lives. A service improvement plan provided a reference point for the service to focus on the direction improvements needed to take.

Staff were recognised for good performance and representing the service in a way which reflected the culture. An Employee of the Month scheme celebrated staff who were kind and dedicated. Staff meetings and supervision records showed that values were emphasised in order to share a common aim to enrich people’s lives. A service improvement plan provided a reference point for the service to focus on the direction improvements needed to take.

Staff told us the management team arranged meetings where staff were encouraged to contribute their views. They also told us the leaders were visible and involved in the day-to-day care. One staff member told us, “[Manager] comes and meets the residents. She walks around and talks to them. She talks to us carers also. She asks the residents and the staff if they are OK. It is good when managers talk to people." Staff wellbeing activities were replicated for all staff including night staff. The manager told us, “We treat everyone with respect and fairness.” The manager gave us an example of how staff with protected characteristics were supported sensitively whilst maintaining confidentiality. The leadership team spoke about people who used the service as valued citizens. The regional director told us, “We have ‘tools down’ time to have engaging sessions with people. It’s about creating meaningful relationships.” They added, “It’s a privilege to care for people. There is a wealth of experience and knowledge amongst the people who live here.”

We saw that complaints had been dealt with compassionately and with candour. A staff charter outlined the mutual expectations in relation to compassion, teamwork and respect for staff and management. We saw risk assessments for staff members with associated risks when carrying out their role.

The manager told us they took action to ensure staff felt at ease to communicate. They told us, “It’s about being approachable. [Staff] are not shy in telling me or a team leader if they have concerns. The regional director added, “It’s about positive reinforcement and accountability. Making sure people understand their responsibilities and reinforcing a person-centred approach for staff as well as residents.” Staff told us the new management team had held a number of staff meetings. They said they had been encouraged to speak up and raise any concerns they had at these meetings.

The provider ran listening sessions with staff which invited constructive feedback. There was a suggestion box where staff and people could anonymously communicate with the team. We saw a whistleblowing policy in place which provided information and reassurance to staff that they could raise a concern without fear of reprisal.

The regional director told us that supervision meetings were being revised since the management team had identified staff saw supervision meetings as not necessarily a positive. The structure would include a holistic discussion relating to training needs and development as well as wellbeing. The manager told us that they accommodated, and supported staff needs. There was a mental health first aider for staff and people. We were given an example of when a staff member was struggling emotionally, and the mental health first aid colleague spent time with them to support them and they felt more content in their day. The manager told us, “We have a wonderful array of cultures and ethnicities amongst the staff team.” They told us that plans were in place for staff to share their backgrounds with the people they supported, empowering the residents to understand and learn to support relationships.

Yearly appraisals were detailed and structured but did not prompt for discussions relating to how individual protected characteristics and diversity could be supported or acknowledged in the workplace. Supervision records were less structured and although focussed on developmental needs and performance, did not prompt for discussion about staff workplace adjustments or needs. We saw that staff were encouraged to bond as a team with protected time to get to know one another and promote inclusive working. There were appropriate equality and diversity policies in place.

The manager had joined the team in recent months and was embedding into the role. They told us they completed a lot of the audits currently but hoped to delegate some responsibility to deputies when they were in post to be more time-efficient and thorough. There was an acknowledgement from the leadership team that staff changes had resulted in some disruption with audits but these had been addressed as soon as practically possible once identified. The regional director told us, “The goal for the care homes I oversee, is that we need to be at least good on our worst days.”

The provider had thorough business continuity documentation in place detailing easily accessible contact information and clear delegation. We saw a business continuity plan which accounted for possible disruptions and measures to minimise impact to people. This had been revised and updated recently.

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.

The regional director told us, “The clinical director is part of a lot of forums and sends out information that has changed such as medication and updates in NICE [National Institute for Clinical Excellence] guidance.” The manager told us of plans in place to integrate with the community, saying, “We are doing the garden challenge which is a competition between the homes. We have some great families who are supportive. We are starting a dementia café. We have kids from the local nursery who come and play with the residents.”

We saw that there had been some learning from audits which had resulted in actions being taken to improve care. Care plan audits had identified where people lacked a plan for care at the end of their lives and care notes demonstrated these had since been completed with people. Audits had also been analysed to provide trends such as the location of falls and clinical meetings had actioned a redistribution of staff to respond to the risks. We saw that the business continuity plan included a protocol to debrief and learn lessons from emergency incidents which disrupted business.