Homeleigh

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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 identified 1 breach of regulation in relation to the systems in place for governance. There had been a failure, since the last inspection, to improve the shortfalls identified in medicines management. New issues were also identified during this assessment. The shortfalls were corrected post inspection. We also had concerns about the premises. The provider had failed to maintain them to the required standard. The premises were in significant need of improvement throughout. It was acknowledged the management team have made some positive improvements. However, the home has been owned by the provider for many years. During this time there has been significant deterioration in the property which had not been addressed sufficiently. There were clear governance arrangements in place with consistent and regular support by the provider. The regional, registered and deputy managers led by example and had instilled a culture focused on meeting people’s needs. They have worked well together to improve the care provided. Staff told us the management team were open and honest. They felt able to speak up or to whistle blow if required. There was an open-door culture where staff felt able to access support when they needed it.

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.

Staff morale had improved since the inspection last year. They told us the management team were very supportive and the care had also improved as a result. There were some concerns expressed about some existing staff members still being resistant to change. We discussed this with the registered manager and support was in place from the provider to resolve these issues. Staff told us, ‘The management have been really supportive. The standard of care has improved. The registered manager pushes for staff to do more with the residents. This includes new skills and participating in daily living skills as well as accessing the activities. This is lots better’ and ‘Staff morale is much better than it was. There is more of a team but further improvement is needed. There are still some poor staff.’

Staff had regular 1 to 1 supervision, team meetings and training to provide them with the support they required. The registered manager, deputy manager and the regional manager were visible in the service and were involved in day-to-day care.

Staff told us the management team had integrity, were trustworthy and led by example.

There had been a stable management team in place since the inspection last year. They had been more able to access additional support and resources from the provider to help drive the improvement required at the home.

Staff told us there was a culture where staff could speak up about any concerns they had and when concerns were raised, managers investigated sensitively and confidentially, and lessons were shared and acted on.

In an annual staff survey completed by 14 out of 37 staff 93% said they, 'feel able to speak freely, offer feedback and raise concerns.'

Staff told us they were treated fairly.

There were a range of appropriate policies in place to support staff.

Managers demonstrated there were clear governance, management and accountability arrangements in place. The application of these systems had improved since the last inspection. However, the medication audits had not been effective. We still had concerns about shortfalls in the administration of medicines as recorded in the safe domain above. The provider audits and action plans had failed to identify these concerns. There were also ongoing concerns about the suitability of the premises. Some improvements had been made and a positive decision had been reached to move to new premises. However, the existing environment was very poor and in significant need of improvement throughout. This was the responsibility of the provider to ensure action was taken before the building reached the condition it was in.

Medicines audits and provider audits had not been effective at identifying the shortfalls identified during the assessment.

People accessed their local communities as they chose. They told us professionals involved in their care worked well together.

Staff were open and transparent. They collaborated with all relevant external stakeholders.

The Local Authority was working closely with the home since the inspection last year.

The service worked alongside a variety of agencies. These processes worked well.

Staff told us they could speak up and their ideas for improvement would be considered.

People using the service, their families and carers were involved through regular updates, monthly reviews and annual surveys.