Cascade (Hurst House)

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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

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

This is the first assessment for this service. This key question has been rated good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 82 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a shared vision, strategy, and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The manager told us about their experiences of managing the service and being promoted from within. Internal opportunities for promotions included roles such as team leader or lead roles: key worker or championrole.

The manager told us there was an emphasis on reflective practice and shared learning and a clear shared ethos which included improving health and well-being and social inclusion, engagement, and participation.

There was a very strongemphasis on learning and development which was demonstrated by an inclusive culture where all staff recognised, they had a role to play in its success. Staff we spoke with knew the importance of listening and involving people and their role in identifying and challenging poor practice.

Detailed reviews helped to strengthen and promote a positive culture and each month different themes were promoted from service priorities which had been identified because of feedback and service audits.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience, and credibility to lead effectively. They did so with integrity, openness, and honesty.

Staff were complimentary about their leaders. One staff member told us, “The manager was highly thought of, had good people skills and was supportive, passionate, and looked to promote from within. She is a good teacher, very patience and will share ideas and challenge poor practice.” Another staff member told us, “I feel greatly supported with the quality of service and care being shown by my managers as they really embody an open policy system at work.”

Night staff told us they felt connected to the wider team and received support through early morning visits for training and supervision, and night audits were completed in a fair and supportive way by the manager. Night staff told us, “You never know when they are going to pop up.” Another said, “Staff work in a consistent way with good inclusivity and staff go above and beyond, to support and develop the residents.”

We observed a collaboration between different agencies and various meeting minutes we reviewed demonstrated regular communication between staff, staff and leaders and leaders and more senior management all undertaken in a professional way looking at different themes and areas for development.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Staff told us that they felt treated, and that they were confident that where they raised concerns, these would be dealt with by the provider.

Staffs’ knowledge of safeguarding and whistleblowing were firmly embedded. A previous allegation of abuse had resulted in some cultural changes and changes to practice. Oversight was strengthened to ensure greater accountability.

Staff were routinely asked for their feedback and robust policies and procedures were in place, and these were fully accessible and staff were aware of them.

Family members felt informed. One told us, “There has historically been some problem with medication but there is good accountability, and I am always told if something goes wrong, this helps to build trust, concerns are passed on by email and phone with good communication”, they referred to the deputy manager as, “Very switched on with in depth knowledge.”

The provider strongly valued diversity in their workforce. They had an inclusive and fair culture which had improved equality and equity for people who worked for them.

Staff received training on the Equality Act 2010. There was a fair recruitment and staff selection in place, and all staff told us about opportunities and encouragement for self-advancement.

Good governance policies helped to ensure staff were supported appropriately in line with the regulated activities they were delivering including recruitment training and supervision. Staff told us they were well supported, given their shifts in advance and reasonable adjustments made around their needs. Staff surveys showed staff were supported when dealing with difficult circumstances both in and out of work and had confidence in the manager and access to human resources.

The organisation monitored the ethnicity of its staff and had an ethnically diverse group of staff, both male, female from different backgrounds, religions, and level of experience. For all staff there were two tiers of training to be completed as part of induction and thereafter, and further advanced training in health and social care including the care certificate for anyone new to care.

The provider embraced and valued staff differences, and promoted people’s understanding of diverse cultures, beliefs, and religions. The skills development team did a lot of work around supporting people to understand the world we live in, which included exploring the universe and space and how people are different. This included looking at different sexual orientation and helping people to understand it. The organisation had representation across its workforce to support diversity and inclusion with a LGBTQ and equality policy with staff representation.

People attended community events including at the local high school and events such as local pride events and supporting and involving people using the service in the celebrations of different religious festival and events and recognising the value of a diverse work force to support staffs and people's well-being.

Celebrations were held to recognise people’s successes and life events such as birthdays.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver high-quality, sustainable care, treatment, and support. They always acted on the best information about risk, performance, and outcomes, and shared this securely with others when appropriate.

There was a strong and proactive learning culture which was inclusive of leaders, staff, people using the service and stakeholders. Service improvements were sustained over time and reflected a mature, learning‑driven culture rather than short‑term fixes.

One of the most resounding successes of this service was the account from family members of how their relatives had settled and family members were much more comfortable in their relationships and being able to take their relative out without incident. We reviewed the data analysis report for incidents 2022- 2025. This gave a clear indication of incidents, incident type, and other data such as the time, where it occurred, who was involved and any cause and or intervention. There had been a significant reduction in recorded incidents from 223 incidents in 2022 were recorded, 2024, 140 incidents occurred and in 2025 there were just 37 recorded incidents. Staff incidents had reduced dramatically so had staff sickness levels and the use of physical interventions, (safe-holds) had also dramatically decreased. We asked staff and management about the reduction in incidents, and they said a major step had been creating routines and boundaries. Matching people’s needs with staff and considering different personalities. Both staff and people had profiles, and shared interests were identified. Strong leadership, improved staff retention, and oversight as well as an improved and strong emphasis on training and culture.

Case studies showed tangible results in enhancing people’s lives. They showed a strong emphasis on collaborative working to clearly demonstrate a holistic approach to supporting peoples physical, emotional and social well-being. The service had a business continuity plan in place in the event of any adverse incidents and a service improvement plan, which set out its plans to drive further improvement. This was reviewed in an ongoing way. The quality management team completed extensive audits and reviews which were in line with care home regulations and required timely actions and were revisited by the provider within a week. Whilst all the providers services were a blueprint of each other enabling staff and management to provide shared support across houses, all had developed their different personalities and strengths and the care and environment, we observed was flawless.

The provider and its representatives worked with health and social partnerships to stay ahead of good practice and required regulation and to continue to be a leading light in their field.

There was a clear emphasis on how the service enhanced people’s lives and considered current best practice guidance right support, right care, right culture by providing flexible accommodation and supporting and empowering people to live good, healthy, lives.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

Partnership working was key with a collaboration between health, well-being, education, and social care teams. People experienced being supported by a core group of staff who were able to understand their needs and coordinate access to services to enhance people’s physical health and well-being in an integrated approach to meeting their needs. By significantly reducing behaviours, staff were more confident in introducing new experiences and removing previous barriers to learning. Staff had a good awareness of STOMP and negative lifestyles. People experienced healthy lifestyles as staff promoted their well=being and actively encouraged them to participate in their community and the extended community with links to other care services owned by the provider.

A health care professional told us that the service was very well organised. They said: “In my weekly calls they always have prepared notes, and they know what they are talking about, they without fail know what they are doing, with clear lines of direction and leadership. They manage people’s needs very well.”

They told us, “Residents are comfortable and happy, a good team, outstanding.”

We were able to confirm that people were engaged and well supported looking well and healthy and management demonstrated a sharp focus on improving people’s life chances and experiences through meaningful engagement.

The provider focused on continuous learning, innovation, and improvement across the organisation and local system.

Creative solutions were sought to ensure the service was delivering equity of experience, outcome, and quality of life for people. There was good knowledge of underpinning research, regulation, and best practice with a close working relationship with the local authority and with other health and social care professionals. The organisation had other services, which were closely linked. Learning across the organisation was evident with strong managerial links and peer support for managers.

Relevant role specific training was provided for staff and the training matrix showed excellent compliance. There were clear employment benefits for staff who were rewarded for their experience and additional responsibilities, for example key worker duties, shift leads and, or championroles.

The provider had a digital system for care planning and medication administration which staff were trained to use. Lessons learnt from incidents and accidents were shared with staff, and actions were monitored and reviewed accordingly.

The provider had a clear environmental plan with set objectives about sustainability and the allocation of roles and responsibilities for areas of focus such as waste management and travel which reduced the impact on our natural environment.