Cressington Court 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 service 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 the same. Although we were assured the provider had worked hard to achieve more consistent leadership to help promote a culture which supported the delivery of high-quality, person-centred care, further time was required to evidence sustainability and embed improved practices. We assessed 8 quality statements in the well-led key question. The service had made improvements since the last assessment and was no longer in breach of regulations. The management team had worked hard to prioritise and address the shortfalls in the safety and quality of care found at the last assessment. The manager had reviewed governance processes since the last assessment to help identify areas of risk and drive-up improvements. Although there was not a registered manager in post, the manager had made an application to CQC to become registered. The manager was visible in the home and had an open-door policy. They promoted a culture of staff feeling valued and comfortable to speak up and make suggestions. We received positive feedback about the manager from staff. Processes were in place to ensure any concerns were listened to and acted on appropriately. The manager promoted a culture of learning and improvement, which was understood and practices by staff to help further improve standards in the safety and quality of the care being provided. The service worked in collaboration with external health care providers to help improve the quality of people’s experiences.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Feedback from staff and leaders confirmed staff understood a shared vision and strategy which had been developed through a structured planning process in collaboration with people who use the service, staff and external partners. The manager explained how since the last assessment, they had worked hard to ensure staff understood the strategy to make the necessary improvements and had worked alongside the manager to help implement the required changes. The manager told us, “I try to promote a sharing culture and a changing mantra and attitude about staff supervisions. We talk about CQC visits and what we have done afterwards. It’s a learning culture and I want openness and want staff to verbalise when they have made a mistake, so we learn from it.”

Processes were in place to help staff and leaders demonstrate a positive, compassionate, listening culture, focused on learning and improvement. These included the use of regular meetings to discuss any shortfalls in the safety and quality of the service, to help further enhance the positive experience of care and support people received. The new manager had worked hard since the last inspection to help develop a culture where staff were valued and high-quality care for people was promoted. Members of staff told us how they felt supported by the manager and had seen improvements since the last inspection. One member of staff confirmed, “There’s a much better atmosphere and better team working.” Policies were in place to help ensure people’s protected characteristics were valued and did not act as a barrier to the accessing care and support they needed

Feedback from staff and leaders confirmed leaders had the experience and integrity to ensure the organisational vision was delivered, and risks were well managed. The manager explained how a lessons learnt approach was always adopted and how discussions took place with staff daily. The manager also told us how they shared any identified shortfalls in practice with staff to include staff as much as possible in the running of the home. Feedback from staff confirmed they thought highly of the manager. Comments from staff included, “[Manager Name] is the best manager I have ever had”, “[Manager Name] is visible and supportive, fair and approachable” and “I feel the management has improved and is more consistent.”

Processes were in place to recognise and reward positive staff practices, which evidenced leaders were compassionate and inclusive. The manager was visible throughout the service and available to staff. This helped instil a positive culture which was adopted and practised by staff. However, further time was needed for renewed processes to become fully embedded and effective.

Feedback from staff and leaders confirmed they encouraged staff to raise any concerns and how they operated an open-door policy and always welcomed their ideas and feedback. There was a culture of speaking up in the home, staff were able to feed back their views in various formats such as written surveys and face to face meetings. This was promoted in the home with various information posters providing staff with the information they needed to voice their views. Comments from staff included, “We have meetings and 1-1’s and I feel confident to speak up” and “I feel able to contribute and share ideas.”

Processes were in place to help ensure concerns could be raised by people and staff and that leaders investigated appropriately. Processes and practices had been reviewed and improved since the last assessment. However, further time was needed for renewed processes to become fully embedded and effective.

Feedback from leaders confirmed action was taken to help prevent any disparities in the experience of staff with protected equality characteristics. The manager explained how staff who had been recruited from overseas were provided with support to help them settle into both their working and domestic life in the UK.

Processes were in place which helped to protect the rights of staff under the Equality Act. Risk assessments and any reasonable adjustments measures were utilised if required. This helped to create a more equitable and inclusive organisation. The provider employed staff from overseas and made adjustments to help them adjust to a new culture and workplace.

Feedback from leaders confirmed information was used effectively to monitor and improve the quality of care and that mandatory quality frameworks, recognised standards and best practice guidance were used to help improve outcomes for people. The manager explained that since the last inspection, governance processes had been reviewed to help address the shortfalls in practice which had been identified. The manager told us how the provider and the in-house clinical governance team also had oversight of the manager’s own audits and checks, to help ensure any shortfalls in practice were appropriately identified.

Processes were in place to help ensure effective governance, management and accountability. Policies and procedures helped staff understand their role and responsibilities. Managers were able to account for the actions, behaviours and performance of staff. For example, by using supervision, appraisal and competency checks. Systems to manage current and future performance and risks to the quality of the service, allowed a proportionate approach to managing risk. Although audits and governance processes were effective at identifying any shortfalls in the safety and quality of the service, where actions had been identified it wasn’t clear who was responsible and by which date they would be complete. This meant it was sometimes difficult to track what actions had been completed from one audit to the next.

People’s experiences confirmed they felt staff enabled them to access communities to enable better outcomes. People told us they received support from other health and social care professionals.

Feedback from leaders confirmed they were open and transparent, and collaborated with relevant external stakeholders and agencies. The manager explained how they had worked closely with the local authority since the last inspection to help ensure people were admitted into the service safely, whilst they had worked to address the shortfalls found at the last inspection.

Feedback from partners confirmed there were no concerns with how the service worked in partnership with external services.

Processes were in place to help people receive good outcomes with regards to their care and support. People’s care and support records evidenced how staff worked with external partners to help ensure people received the right care and support to meet their needs in a holistic way.

Feedback from leaders confirmed they had a good understanding of how to make improvement happen. The manager told us that although they had focused on addressing the findings at the last inspection, the embedding of good practice was an ongoing process towards improving the safety and quality of care for people. Feedback from staff confirmed their suggestions were listened to and acted on to help improve the standard of care. One member of staff told us, “We provide regular updates to managers throughout the day and they are receptive of our findings and act promptly to make improvements.”

Processes were in place to help to ensure learning happened when things went wrong. The management team had worked hard since the last assessment to focus on continuous learning and making the necessary improvements to address the shortfalls found at the last assessment. For example, the manager had devised a risk assessment tool to help ensure people at risk of malnutrition and/or dehydration were appropriately monitored and managed. Regular staff meetings and handovers were used to communicate important information about people and to discuss and reflect any recent incidents and safeguarding events.