Bradbury House

On this page

• 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.

At our last assessment we rated this key question Good. At this assessment the rating has remained 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 71 (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.

A positive, person‑centred culture was evident throughout the service. People using the service, their relatives, and staff consistently reported feeling respected and valued, and they described the service as well managed.

Staff feedback reflected a supportive staff culture; “I enjoy working with the team. The most challenging part can sometimes be when the shift is very busy, but teamwork and good management helps manage this…I’m proud to be part of the team”.

Staff contributed to a values framework and team building exercise which further promoted a shared direction and culture.

Staff also feedback to us that any concerns, progression and training needs that they identified for themselves were listened to and actioned by the provider; “They are supportive and give me the opportunity to discuss my progress, any concerns, and additional training needs”. The provider also told us they offered a coaching and mentoring programme to support staff development.

The provider was transparent and advised us recent staff meetings had needed to be postponed due to unforeseen circumstances. However, these were now expected to take place each quarter with set standing items to be discussed. For example, safeguarding, updates on residents, staff updates, training, incidents, complaints and compliments. Previous meeting minutes evidenced updates regarding the service, as well as comments and suggestions made by staff.
 

The provider had exceptionally 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 always did so with integrity, openness and honesty.

Leaders demonstrated high levels of capability, compassion and inclusivity. People, relatives, staff and external professionals consistently praised the management in the service. Staff told us, “The registered manager is very supportive and always available to [have] a meeting to help me with any challenge or issue l have at work”. A person told us “I am very impressed with the management here- every little thing they look at and try to improve- I have complimented them often. I always ask them how do they manage to keep the staff morale so high”. A relative told us that leaders were “Very pleasant, responsive and good communicators.”

Professionals told us that leaders “invest highly in their teams and support them in many ways that others would not even think about or invest in”. Some of the ways they created an open culture of support for staff was to provide coaching for career progression, sessions from a visiting physiotherapist as well as the option for counselling sessions if staff required this.

The provider evidenced the development of a staff “values charter” was implemented with staff input and agreement. The four key values chosen were “caring”, “all together”, “respect” and “empathy”. This was then rolled out in the service and fed into recruitment processes and induction programme for new staff. This has then been built on by introducing the “Values Awards” where staff are nominated by fellow staff, visitors, residents and relatives for demonstrating and going beyond the core four values of the charter.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

The provider had an open and supportive culture where staff felt able to raise concerns and contribute to improvements. Staff consistently described managers as accessible and responsive showing confidence that issues would be addressed. Staff told us they were able to attend handovers and staff meetings where concerns or learning could be discussed, and changes occurred as a result, for example, “We discuss residents updates, critical health changes, medications, moods or challenges [in] behaviours, daily living and activities, nutrition and incidents. Handover helps to ensure a good continuity of care”.

Staff had a good understanding of the whistleblowing policy and felt confident in raising concerns if needed about the quality or safety of care. The provider also evidenced staff surveys whereby staff were able to provide feedback anonymously. This helped promote an open and transparent culture where staff felt able to speak up without fear of negative consequences.
 

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The provider had implemented several measures to ensure staff were treated fairly, supported appropriately, and able to work in an inclusive environment. Staff were offered a culturally appropriate meal provision when at work and has access to coaching from the management team, as well as external counselling services.

Leaders had a strong focus on diversity and inclusion and promoted a culture of acceptance and respect for different cultural beliefs among both staff and people using the service. Protected characteristics were recognised and respected, and there was a clear zero-tolerance approach to discrimination. Staff had received training and understood how to identify and respond to discrimination within the workforce.

The service ensured people’s religious and cultural needs are met by inviting leaders from different faiths to meet with people. The registered manager advised they are adaptable to the needs of people and staff, should they require this. The service’s flexible working arrangements for staff have enabled staff to adjust their working to support their cultural needs.
 

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

Senior managers had processes in place to oversee and manage the service. Regular audits were undertaken and covered areas such as medicines, health and safety, accidents and incidents, infection control and care plans. However, we observed some of these audits could be improved, as they hadn’t identified some of the concerns noted during the visit. The service demonstrated they were proactive in driving improvements in these areas and after the visit, they had evidenced implementing action plans for doing so.

They were proactive in seeking external audits for the service and acting on feedback. The trustees were also involved in undertaking audits and driving improvements in governance.

Regular safety checks and audits were also carried out for the environment and equipment. We saw that actions were identified because of the audits and reviews were carried out to make sure the required actions were implemented and embedded.
 

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.

People’s care plans demonstrated people were referred to appropriate healthcare professionals when needed. Information and guidance from external healthcare professionals was shared with care staff to help ensure consistency in providing care and support.

The provider encouraged partnership working. Staff supported people to attend health appointments and supported them with reviews of their care.

The registered manager promoted visitors coming to the service without prior arrangement. The activity centre also provided support to the local community in reducing isolation and providing a valuable resource for people to engage in meaningful activities, as well as provide an insight into what support could be provided to them in the service. This also supported the provider in obtaining respite stays from people who were already attending the activity centre from the wider community.

The registered manager also attended external forums to ensure that the provider was aware of local and national initiatives, guidance, training and best practice. These included the local Skills for Care Registered Managers Network, the Local Authorities’ Safeguarding Summit (which worked with key stakeholders, such as NHS, Social Care, Police and Fire agencies) and the Buckinghamshire Social Care Academy. The provider was Gold Standards Framework Accredited and were active in sharing their learning from this programme and encouraging other services to become accredited.

This meant the provider was active in the wider community, participated in discussions and learning which will enable them to drive further improvements and innovation.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

The provider had effective systems and processes in place to ensure lessons were learned when things went wrong. Where issues were identified, appropriate action was taken to drive improvements and ensure these were sustained.

The management team supported staff development by providing opportunities for learning, training and progression. Comments from staff included “I feel valued and listened to…the management team regularly acknowledge how well I am performing and I do receive positive feedback from other colleagues”

Staff told us that when incidents or concerns occurred, information was shared through handovers, care records, incident reports, supervision sessions and team meetings. This allowed staff to reflect on practice and identify learning to improve future care.

The registered manager also confirmed that learning from incidents and feedback was routinely shared through team meetings and supervision sessions to ensure continuous improvement across the service. This meant the service had a strong learning culture.