Bethany 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

The service had made improvement. There was now a registered manager in place improving stability of management. They were enthusiastic about the role and were leading improvement at the service. Where staff required clinical supervision, this was now in place to ensure there was effective oversight of staff practice. A range of audits were now undertaken regularly. An action plan was in place to ensure any areas where improvements was needed was acted upon. There were regular meetings for staff. Staff and the registered manager understood their roles. The service worked in partnership with health and social care professionals to improve outcomes for people. Some staff were finding the pace of change challenging as things had improved at the service. However, they understood change was for the right reason.

This service scored 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The registered manager told us they were committed to driving forward improvements at the service and supported the providers vision of providing high quality care and support to people. They told us they explained the vision and value to staff through regular meetings and through leading by example. Staff told us registered manager had made a lot of improvement in the service since they started. However, some staff had struggled with the pace of change. One staff member commented, “We can see the improvements. Fresh blood is always good to bring a place up the only problem is he is doing it too fast.” Some staff were also unhappy with working together with the sister service to increase staff flexibility and there was still work to be done to increase staff understanding regarding the need for this change. The registered manager told us they were planning team building activities such as diversity day to bring the team together and improve working relationships. Despite some staff unhappiness most staff understood the changes were for good reason, one staff told us, “The managers have the best interests of the residents at heart.”

There is a system of regular staff meetings in place. Staff meetings were two way and staff raised concerns and points during the meetings. There were now regular clinical meetings and a system of clinical oversight to ensure staff were being well supported and guided appropriately.

There was now a permanent registered manager in place providing stability at the service. They were supported by a deputy manager and a clinical lead, who were based on site. Staff freely approached the registered manager throughout the day when they had questions or issues to raise. Staff told us they could contact the registered manager at any time for support and he would give them it. One staff said, “I feel very supported by my manager and by the management here.”

The registered manager had a professional background as a registered mental health nurse. They were enthusiastic about the role and told us they were committed to driving forward improvement. They were currently undertaking a recognised qualification in Health and Social Care Management to develop their skills and knowledge. They also participated in training and events to keep up to date on best practice and learning.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Both the management team and staff understood their roles and who to speak to if they needed support and guidance. The registered nurses supported the care staff to provide care and support to people. Both the management team and the care team had daily meeting to discuss people’s needs and the effective running of the service.

There was a system of audits in place to quality check the provision of service. Where improvements were needed these had been included on an action plan and had or were being addressed. For example, the registered manager had focused on supporting staff to improve their knowledge and skills. Training attendance had improved, and overall compliance was 90%. During the assessment we identified that there were areas where care planning still needed to be improved. This had also been identified on the action plan. The registered manager was supporting nursing staff to improve their care planning skills through training, learning and discussion to ensure this was embedded going forward. Each person now had a key worker responsible for ensuring their care plans were updated. This work was ongoing at the time of the assessment.

People were supported to access healthcare services if they were unwell. People were also supported to be involved in the local communities of their choice. For example, one person told us they enjoyed accessing a day centre and meeting up with friends.

The registered manager provided regular updates to health and social care professionals on actions they were taking to make improvements. They told us, “We have a common purpose to improve people’s quality of life. I send them a weekly report about training, incidents and how things are going.”

Concerns had been raised by some health and social care professionals about the service and the support people were receiving. However, the service had been working to make improvements and most of the issues identified had been addressed or were being so at the time of the assessment.

Staff worked with a number of clinical partners to provide people with support. For example, staff worked with the diabetic team to review people’s diabetic medicines and the Home Enteral Nutrition (HEN) team where people used a feeding tube for support with nutrition and hydration. Staff were aware of the guidance shared by health and social care specialists for people’s support.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.