Horton Cross Nursing Home

The service provides nursing care for up to 47 people, including older adults and people living with dementia. At the time of our visit, the service supported 34 people.

Since the last assessment, the provider and the new registered manager have made significant improvements across all five key questions, embedding a culture of safety, strong leadership, and person-centred care. The registered manager had a clear vision for improvement and was praised by staff and relatives for creating a positive culture. Governance systems were embedded, with regular audits and action plans. Staff felt supported and confident to raise concerns. The provider maintained oversight through quality audits, and there was strong engagement with people and families via meetings, newsletters, and surveys.

The provider remains committed to continuous improvement and sustainability. Clinical governance was robust, with regular audits and strong multidisciplinary working.

Staff training compliance was high, and staff were well supported.

The environment had been extensively refurbished, creating a welcoming and homely atmosphere. Bedrooms and communal areas have been redecorated, new flooring installed, and safety measures such as keypad access and door alarms introduced. Gardens have been revitalised, and communal spaces now include a café-style refreshment area for people and visitors.

Medicines were managed safely, with robust systems for ordering, administration, and monitoring. Medicines requiring additional security were audited weekly, and covert medicine decisions were made in line with best interest principles.

Infection prevention and control measures were effective, and staff had completed relevant training. Individual risk assessments were reviewed regularly, and actions were taken promptly to reduce risks, such as purchasing additional pressure-relieving mattresses and introducing clear guidance for mattress settings. Fire safety arrangements were in place, with practical drills and personal emergency evacuation plans in place.

People’s nutritional needs were met, and improvements to the dining experience were evident between the first and second day of the assessment. Staff supported people to make choices and promoted independence, for example by offering finger foods.

People and relatives consistently praised staff for their kindness and compassion. We observed positive interactions and a culture that promoted dignity and respect. End-of-life care was handled sensitively, with staff forming a guard of honour when a person passed away, a practice valued by families.

Care plans were person-centred and regularly reviewed. The service used a “resident of the day” approach to ensure holistic reviews of their care and environment. Activities were varied and meaningful in the communal area, supported by an activity coordinator and volunteers. Life story work was underway to further personalise care. This would ensure people who stayed in their rooms received personalised social support.

Complaints were managed appropriately, though records could be clearer about how outcomes were communicated.