Clawing the way out of special measures
In just two years a Sussex care home has been transformed from being rated inadequate, and in special measures, to a good service. Here, registered manager ALISON BARNES looks back at the way change has been embraced since she joined Temple Grove at Herons Ghyll in East Sussex.
What is the key to achieving a good rating for a care home? – understanding and embracing regulations. What is the most challenging element of improving an inadequate service? – embedding new practices throughout nursing and care. What is the most valuable resource beyond your team? – support from family and friends when, for example, you leave home at midnight to help on a night shift at short notice, or when you step in to help cover maternity leave.
This is what I have found in a two-year journey with my team in a Sussex care home which has been transformed since it was rated ‘inadequate’ by the Care Quality Commission.
The home is now officially ‘good’ and in the latest CQC report is described as ‘excellent’ in the provision of complex care.
Local health commissioners told inspectors that no other provider in the area could look after complex cases and as such, people were being left in hospital. Their care manager said: “Temple Grove have the skills to look after complex clients and, despite tight budgetary pressures, we have managed to significantly increase the fees we pay to reflect the level of care provided here.
We increased the fees because no other nursing home would touch the people we refer here and they were just staying in hospital.
In my mission to rebuild CQC’s confidence in the home I have focussed on five things:
- – Getting the staffing levels right
- – that means achieving 0% agency input.
- – Listening and watching
- – even noticing the impact on residents of the choice of words used by nurses and carers.
- – Equipment – ensuring team members have the right equipment to do their job.
- – Monitoring call bell response times – delayed response times show the team is under pressure.
- – Looking after the team, listening to their needs, noting their interests, providing training to further those interests.
Underlying everything has to be a genuine kindness among nurses and carers, and this is something I will not compromise on when recruiting. People can be taught a lot, but kindness must be inherent.
I believe in the ‘Mum Test’ often talked about by the CQC and encourage every member of my team to work as if with the aim of enhancing the life of their own mother in the care home.
And my ethos has worked. I joined Temple Grove, between Uckfield and Crowborough in East Sussex in February 2015 when it was rated inadequate. By November 2015 the home was judged ‘good’ in three out of five categories. Now it has been rated ‘good’ in all five categories and our next target is to achieve ‘outstanding’.
We are all proud of our achievements, mostly because of the effect on Temple Grove residents. One relative told CQC inspectors: “This home is just fantastic. I used to teach health and social care and I dug my heels in and insisted my husband was brought here. It’s like a home from home.
“The staff are excellent, always smiling, compassionate, and happy to talk to me or my husband.” Inspectors said: “When we asked what made this service stand out we were told: ‘They liaise very well with the specialist Parkinson nurse and consult me over any changes to medicines. They work well with occupational therapists and provide equipment and assessment when we need them. The staff spend so much time talking to my husband and asking him what he wants.
The local reputation of this place is fantastic and well-deserved, that’s why I was prepared to wait weeks in a hospice to place my husband here.’”
The inspectors’ report says staff treat people as individuals with dignity and respect. They are knowledgeable about people’s likes, dislikes, preferences and care needs and skilled to approach people in different ways to suit the person and communicate in a calm, friendly manner which people responded to positively. People’s health was monitored and they were referred to health services in an appropriate and timely manner. Any recommendations made by health care professionals were acted upon and incorporated into people’s care plans. People with complex care needs were given excellent care and the service is used as a first point of call for local health commissioners.”
I hope other homes will benefit, and take heart, from our experience here at undergone at the nursing home and talks here at Temple Grove.