Alban Manor Nursing 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

The provider grew their management team after our previous inspection with the addition of a Quality Manager. This further developed an open culture where staff felt comfortable to raise any concerns. Staff felt they were able to speak up and were confident the management team would hear their ideas, innovations or concerns. Leadership was visible. Processes were well established and operated underpinned by an inclusive and positive culture of continuous learning and improvement. People were cared for well as established links had been made with external professionals.

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 spoke positively about the culture of the home. Staff all said there was effective communication at all levels and strong teamwork which supported them in their daily work. Staff said managers were open and supportive and welcomed discussions about the development of the service and wider culture of the home. One staff member said, "I think we have an open home, we are kept involved by the managers who tell us what is going on. We have the meetings to talk about things and the managers door is always open. When [Provider] is here they always come around talking to the residents and to us, checking we are all ok and doing well and if there is anything we need. I think it is a well managed home. We have won lots of awards lately which we are proud of, and shows we work with other organisations to deliver good care. A second staff member said, "I would describe the visions and values of Alban Manor as absolutely beautiful, caring, warm, welcoming, friendly and a family home." Staff told us they shared a strong sense of teamwork and comradery. Staff said when there was sickness, annual leave or short notice absence they covered this from the existing staff team. Staff and the management team were proud they did not use any agency staff as they felt this helped with consistency and embedding a strong positive culture of support in the service.

The provider, registered manager and senior staff maintained a constant presence throughout Alban Manor and carried out daily walkarounds. These consisted of a variety of visual checks and discussions with people and staff to ensure people’s needs were met. Visiting relatives were welcomed into the home and many told us they felt valued and part of the service. One relative said, "There is a culture of kindness and dedication at the home." A second relative confirmed these actions and told us, "The registered manager often wanders around to see how each resident was doing, she absolutely radiated compassion for people." The views of people, relatives and staff were gathered through surveys. The results of these were analysed and the results then used to develop improvements from that feedback. We discussed with the provider the need to separate people and relative feedback as this was combined and could give a false impression. The provider acknowledged this and would send separate surveys in future, with a focus on additional areas around care, culture and safety. An independent audit around the 6C’s of culture sought feedback from staff about the culture of Alban Manor. This found the service to be caring, compassionate, courageous, committed, competent and communicative. This audit helped to assess the 'Health' of the service and the stability of staff. Staff were provided with regular supervision to review their practice and discuss their personal development. Staff meetings were held where information was shared with the staff team for ideas and suggestions. For example the outcome of audits and external reviews. The provider said they would also share with staff and people the service improvement plan to further embed openness and transparency with staff and encourage staff to feel part of the wider business.

Staff were all very positive and supportive of the registered manager and wider management team about the continual improvements made in the service and the leadership and support they gave. One member of staff said, "I think it is a safe home, it is well managed by [registered manager] who is a really good manager. They are on the floor and gets involved. They know what goes on here." A second staff member said, "I would speak to my manager if I need any support, but I know I can always go to any of the managers who are always happy to guide me." A visiting professional echoed the views of staff about the open and welcoming nature of the registered manager. They said, "Residents and relatives seem happy with the care received at Alban Manor. We are always welcomed and staff are open to discuss difficult issues and work with us to resolve them."

Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty. All those we spoke with were positive about the management team and felt engaged by them in all aspects of the care delivered.The registered manager and provider were both registered health professionals. They used this knowledge and experience to make changes and improvements to reflect these skills whilst developing their practise to ensure peoples social and personal care needs were met safely. Allocated tasks and regular auditing were being completed by the management team regularly to assess progress against the ever evolving service improvement plan. A health professional who has worked with the service for a long time said, "I would say we have a good relationship with Alban Manor and we have been developing a culture of collaboration which I understand historically has not always been present. The [registered manager] is particularly responsive to suggestions."

Staff told us they were able to speak up at work and said they thought their concerns would be taken seriously, listened to and acted upon. One staff member said, "I can speak up and challenge anything within the staff team. If I think it is not right, I will challenge." A second staff member said, "I have no problem going to speak with the managers, I am not always confident so it is good to know that I can." The registered manager told us that it was one of their primary aims to develop and embed a culture in the home that supported speaking up and whistleblowing. They were aware that staff or people may not always be confident to raise concerns and recognised this feedback was an integral part of fostering a culture of openness, transparency and reflection.

Processes were effectively operated to support the open culture within the home. Staff received training in safeguarding adults from harm or abuse, which meant they understood their responsibility to speak up on behalf of people who may be at risk of harm or abuse. Whistleblowing training and support lines meant staff had access to outside agencies to report concerns if they were concerned about staff or managers conduct. Regular meetings gave staff opportunities through daily handovers, team meetings or individual supervisions to raise any concerns, issues or suggestions. The provider regularly completed their own audit which also looked at staff feedback for their experience of working in Alban Manor.

Staff said they felt supported at work professionally and personally. They did not raise with us any concerns around not being treated or supported as an equal to others and did not raise any observations or experiences of discrimination. Staff gave examples of where people's religious heritage and background was equally celebrated. They gave examples of recent Diwali celebrations, church services within the home and a recent cultural day which saw staff come to work in traditional clothing for their culture with food made by the chef and supported by a diverse group of staff members for all to enjoy.

Processes were effectively operated to support equality and diversity and promote inclusion. In addition to the development of an open culture within the service, staff received training in equality, diversity and human rights along with dignity and respect. New staff completed a health questionnaire so any reasonable adjustments to support their wellbeing at work could be explored. The management team celebrated national awareness days such as mental health or dementia awareness to further promote understanding among the staff team.

Staff felt the home was well managed and they told us the management team were very approachable and supportive. A visiting professional said, "The managers are open and approachable, they always seem to be very hands on to me. I think people are safe and cared for." Staff were regularly involved in staff meetings and told us they had opportunities to discuss their ideas, opinions and contribute to the management of the service.

There was a clear management structure in place with defined roles and responsibilities. The registered manager demonstrated a good understanding of their responsibilities and has clearly demonstrated how they maintained oversight of people’s care. The registered manager was supported by a quality manager who over the past three years had embedded an audit structure to ensure key areas of risk were swiftly identified and actions taken to improve those areas. Those processes in place to monitor the quality of the service included incidents and accidents analysis to identify patterns and trends. For example, if there were high levels of falls, they would look at things like the time of day, staffing levels, etc to gain a possible insight to cause these falls. Other audits included wounds, care plans, weight, skin integrity, nutrition, medicines, infection control and a variety of health and safety checks among others were carried out regularly. The actions arising from these checks and audits formed the basis of the service improvement plan, which was regularly monitored by the provider.

People were positive about how the service was run and said management where open, available and approachable. People and relatives views were sought about matters relating to the care provision and social engagement in the home. People and relatives felt there was a good range of engagement in the home through activities and a variety of visitors. One relative told us about the range of talks they have in the dementia café to help develop their understanding and how best to support their loved one. People and their relatives told us being at Alban Manor was like being part of a community where people felt comfortable with others and in their surroundings. One relative said, "[Person] on arriving was immediately embraced as part of their family." A second relative confirmed this sense of community telling us, "Alban Manor became a daily refuge for my daughter and I in what might have been a very distressful time."

Staff told us they worked in partnership with people and with relevant health professionals to support people's changing health needs. Staff gave examples of working with professionals such as the nutritional teams to gain accreditation for this area and to better support people's variable diets. Staff were also keen to point out the community group partnerships they work with to benefit people's social engagement. For example, staff told us about recent visits by a bird of prey centre, day trips to the cathedral, trips to pubs, restaurants, garden centres and a visiting musician. Staff said all these activities supported people's wellbeing and helped people feel more connected to one another. One staff member said, "I think we are a good care home, we have won lots of awards lately which we are proud of, so it shows we work with other organisations to deliver good care."

We were told by professionals that the provider and management team worked with a number of partners and stakeholders to support the provision of care. Multi disciplinary meetings [MDT] were held with a range of professionals, such as GPs, nurse practitioners, mental health consultants and specialist nurses, local pharmacist and occupational therapists among others. These meetings reviewed people's needs and sought solutions to find appropriate support to manage those needs. We have reported where this partnership has improved the quality of care people receive and also improved understanding between System Partners. A health professional told us they have noticed a clear improvement from Alban Manor staff in the management of peoples needs over time which had reduced the numbers of emergency admissions and prescriptions of antipsychotics and anxiolytic drugs for residents. These are medicines commonly used to manage psychosis and anxiety in people.

Managers held regular meetings with a variety of stakeholders to review and plan people’s care. This included healthcare professionals from the Integrated Care Board [ICB], social workers, advanced practitioners and commissioning bodies. The local authority did not report any concerns about the location to us.

Staff told us the culture in Alban Manor was one which was open and transparent which supported continuous improvement. Staff said the training and support provided to them enabled them to continually develop and improve their practise. Staff spoke positively about people and how they supported them to achieve positive outcomes in the daily life. A visiting professional told us that staff were keen to learn and develop their knowledge. They said, "Partnership working with the home and management works well. They are open and communicate well with me in a timely way. We discuss what needs to be done and they get on with it. I find that the staff are always wanting to learn which only benefits the residents in the long term."

We have reported where we observed innovative practice during our on-site visit and through our discussions with staff and relatives. These actions arose from partnership working across the staff team and with stakeholders to continually improve quality. For example with a reduction in hospital admissions. The provider had a service improvement plan which was used to monitor actions taken to address issues noted at the previous CQC inspection, ongoing monitoring by the local authority or through their own internal audits. The provider had recently joined a community group whose primary purpose was to share and celebrate best practice in social care. This group supports the management team to continually review and embed innovation and identify and establish best practices across the service. The provider had systems in place to seek and act on feedback from people, families and staff and systems in place to monitor and improve the service. The registered manager had good oversight of the service and was open to suggestions on improvement. Where we identified areas that required attention these were actioned immediately.