Last updated: 9 February 2026
"Stable staff retention and positive culture with varied activities, but medication safety gaps and developing governance need attention."
We found there were not protocols in place for all ‘as and when’ needed medication... Charts to show where patches had been placed on people to ensure rotation were not in place... The daily counts for medication were not always taking place.
A recent staff survey results had 100% of staff who had completed it as happy in their work, feeling valued and clear on their roles.
People and families felt there was enough staff. One relative told us, ‘I like the fact that there’s a slow turnover of staff.’
Staff were provided with training to meet people’s needs, which was promoted via the staff newsletter. Staff were encouraged to become champions in areas of care such as dementia and continence.
There was a new governance system which needed embedding and further development to ensure it gave complete oversight and identified all concerns to ensure they were addressed.
There was a varied activity programme within the service including exercise, cooking and celebrations of such days as VE day. There was links with the local church and recently a local playschool visited.
Management oversight isn't reliable enough yet as checks missed problems like medication monitoring and consent records.
These checks and audits had not identified all the issues we identified from this assessment.
Medication safety has gaps like no guides for extra doses, missing patch rotation charts, and spotty daily stock checks.
there were not protocols in place for all ‘as and when’ needed medication to give staff guidance on when and how to give this medication... Charts to show where patches had been placed... daily counts for medication were not always taking place
Only standard training to meet basic needs with no funded specialist qualifications or regular supervision mentioned.
Staff were provided with training to meet people’s needs, which was promoted via the staff newsletter.
AI Generated
Last inspected: August 2025
Management Quality
Well-led: Requires improvement
Direct feedback from current and former employees

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