Gosberton House Care 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 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 some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

At the last assessment the provider was in breach of the regulation in relation to good governance. At this assessment we found there had been some improvement and the provider was no longer in breach. However, more time was needed to ensure that the improvements became embedded in the care provided.

This service scored 61 (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. However, more time was needed to embed this with staff.

While the provider had a vision, at present it was too early for this to be embedded into the organisation. In the relative’s meeting the provider was keen to ensure that relatives understood the culture they were trying to embed in the home. This included a no blame culture so that issues could be raised and resolved by staff in an open and transparent way.

The provider had an interim manager who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. They had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty. However, the interim manager had a permanent manager role at the provider’s other home and was only working at Gosberton House on a temporary basis. The provider needed to employ a new registered manager for the home to give it stability and to ensure the improvements identified could be driven forwards.

The interim manager was working with staff to improve the quality of the care provided. Staff told us they felt supported by the interim manager through the changes. One member of staff told us, “The manager is supportive. If I am struggling with anything I can go in and see her.” They added that there had been so many positive changes since the interim manager had been around.

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

Staff were confident to raise concerns. They were aware that the provider had a whistle-blowing policy and how they could raise any concerns they had.

Relatives told us about an issue where a member of staff was unpleasant to their loved one. This had been raised by another staff member. The relative was happy with the action taken by the provider and was confident their loved one was safe. They told us, “I am confident that if it happened again, someone [a member of staff] would speak up for [Name].”

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 the provider was supportive of their external responsibilities and worked with them to help them balance their work and home life.

The provider told us how they were able to be flexible in areas to support staff with disabilities. For example, by offering training in a different format that was more accessible for a person.

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 had identified that the home was not being managed well. They brought in a interim manager from their other home while they were looking for a new manager for Gosberton House.

Governance systems were not fully in place and more work was needed. The interim manager had identified a number of the concerns we raised but had not had the time to put systems in place to consistently monitor the quality and safety of care provided. For example, the interim manager had taken action to identify staff training needs and had clear plans in place to support staff to complete all their mandatory training. In addition, extra clinical training was planned for the nurses to ensure their clinical skills remained up to date.

Staff told us that since the interim manager had started working with them there had been positive changes in the home. For example, medicines were now well managed.

The provider and interim manager were aware the care plans were not always reflective of people’s needs. They had taken immediate action to review and update the care plans to keep people safe. In addition, they had put a system in place to ensure that care plans remained relevant and were updated in a timely manner.

The interim manager had put in place a set of audits to monitor the quality of care provided. Audits were in place to monitor care plans, medicines, mattresses, infection control and many other areas of the home. The audits had started to identify all the concerns we found at the assessment and an action plan was in place to identify and monitor all the changes needed. However, more time was needed to ensure these audits remained effective and improvements were sustained.

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 provider was clear that improvements were needed in the home. They had started to focus on continuous learning and improvement across the organisation and local system. However, previous incidents had not been identified or reviewed to identify if care could have been improved. The provider was starting to encourage creative ways of delivering equality of experience, outcome and quality of life for people.

The provider had put resident, relatives and staff meetings in place to listen to concerns and identify areas for improvements. Concerns raised at one residents’ meeting was about the quality of the fish on the menu. The provider has identified a new place to purchase fish to hopefully improve quality. A relative told us the new owner was engaged with the home and arranged quarterly meeting to discuss any changes and the improvements they were making to the home. They told us, “Since the new owner, staff are more relaxed.”

The provider was in the process of surveying health care professionals, staff, residents and relatives to gather their views of the service and where they would like to see improvements being made.

The provider had met with the local GP’s to discuss the needs of people living at the home and how the GP could support people within the home instead of making people attend the local surgery.

The provider was looking to improve the use of technology in the home and to move all the care plans to an electronic system. This would mean staff could access the information more easily and would not need to go to the office to view care plans. The care given could also be recorded in a more timely manner. They were also planning to introduce an electronic medicines management system. This would reduce human errors in monitoring medicines and increase safety.