The Raikes Residential Home

People, professionals and staff consistently provided consistent positive feedback regarding the service. We observed highly compassionate, kind and gentle interactions with people and staff. Leaders demonstrated a high-level of compassion in their roles and capability by ensuring the service had robust governance systems in place to support safe and effective care. The service demonstrated a high level of commitment to learning and improvement. There were some minor improvements and recommendations made which the service was very responsive to, and took any immediate actions required to make improvements.

There was a positive approach to safety within the service. Staff were supported by a highly positive learning culture where regular team meetings took place, and any incidents were thoroughly documented with actions or lessons learnt. The service established safe transitions and pathways in the service, having a high standard of working with other partners and agencies. There were robust safeguarding training and processes were in place. There were good examples of multi-agency working with other professionals to manage risk, and professionals provided positive feedback for the service. There was a high level of safety in the service whereby thorough, appropriate maintenance checks were completed. The service had safe staffing, with robust recruitment processes and relevant training. The service had appropriate procedures in place to ensure safe infection prevention and control (IPC). There was robust medicines management in place including for those people who used covert or “as and when required” (PRN) medications.

There were effective assessment processes in place for those being admitted to the service. People were provided with client guides with information on the service’s values and care support, however, some of the information was outdated. This was immediately rectified by the service. Staff teams worked well together in the service; this was supported by staff and professionals who provided consistent positive feedback. People’s care was effectively monitored to improve people’s outcomes and appropriate consent documentation was in place. Most people were supported to live healthier lives, for example, by appropriate nutritional and dietary information, or supported to complete exercises through activities. However, there was a lack of meaningful activity for those cared for in bed. The service has advised us how they will make improvements in this area.

There was an exceptional culture of kindness, compassion and respect throughout the service. People, relatives and professionals we spoke with repeatedly told us the care was outstanding. People were treated as individuals, and this was evidenced in care plans. People were mostly supported to maximise their independence, choice and control, however, there was some minor restrictions to accessing outside areas, where people could not access outside without asking staff. This was immediately rectified by the service. People’s immediate needs were responded to including call bells being answered in a timely manner. We also observed people’s immediate needs met, for example, when people presented with distressed behaviours. Staff in the service told us they were well supported in the service with their wellbeing and enablement.

Care plans were person centred and care provision was well integrated with local relevant services. People were provided with relevant information including safeguarding and complaints which was displayed throughout the service. We advised there could be improved signage in the building to support with orientation, especially for people living with dementia. The service told us how they will make improvements in this area. People told us they felt listened to however, there was a lack of evidence people were involved in care plan reviews. There were also limitations in how people could give feedback in other ways, for example, a lack of resident’s surveys and inconsistent resident meetings. The service has told us how they will make improvements in this area. People who may be at risk of inequality were supported to have equal access, outcomes and experiences. There were appropriate processes in place to support people to plan for the future, including end of life care.

The service did not have a registered manager in place due to exceptional circumstances. However, leadership in the service was a strength. A new manager had been appointed and was due to start imminently in their role. There was a clear shared value base in the service. Leaders demonstrated an exceptional level of compassion, inclusivity and capability in their roles, as well as a person-centred approach to leadership. People, staff and professionals displayed a high level of confidence in leaders. People and staff were able to speak up in the service and felt highly assured any concerns would be dealt with swiftly and appropriately, and there was a strong level of openness and transparency in the service. There was a high level of commitment to whistleblowing and speaking up, with appropriate speaking up policies in place and whistleblowing information visible throughout the service. There was a diverse workforce in place. There were robust systems and processes in place to support good governance in the service, for example, regular audits which were completed by leaders. There were robust partnership working with other services, and professionals provided consistent positive feedback. There were highly robust processes in place to support learning and innovation including an incident, falls tracker and lessons identified and there were regular team meetings. The service also supported other services with relevant learning improvements.