No 36

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 outstanding. At this assessment the rating has remained outstanding.

This meant service leadership was exceptional and distinctive. Leaders and the culture they created drove and improved high-quality, person-centred care.

This service scored 93 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There was an exceptionally person-centred culture which was central to everyday practice and decision making. Staff believed in the company values and felt passionate about these. People using the service, staff and relatives referred to LD Care Limited as a ‘family’. There was a genuine sense of community where everyone was treated equally and valued.

Comments from relatives included, “I think there is excellent support”, “It’s a really nice home” and “We are extremely appreciative of the expertise, care and organisation by the team at the service.”

Staff spoke with pride and love about their work. Their comments included, “I can see people we support really are the centre of the service”, “Our own families are part of the service. It makes me feel that I am not just coming to work, but I am part of something special” and “I really love the atmosphere between staff and people. The staff I work with are humble, caring and passionate.”

These sentiments were reflected in everyday practice, and personalised care was central to decision making. Staff repeatedly told us that the provider was willing to put in place any requests from people living at the service to improve their wellbeing or the environment.

There was strong, collaborative teamwork across all the provider’s services. People using the service, staff and managers from the different services knew each other well. Managers from other services visited to offer support and guidance. This enabled staff to learn from the experiences in the other homes. The impact of this was that people had a good quality of life, felt safe, loved and understood. People trusted managers and staff and had opportunities to develop their skills and independence.

There was compassionate, inclusive and highly effective leadership at all levels. The registered managers from all the provider’s services worked closely together. They provided hands-on care and worked directly with staff to ensure they had a deep understanding of people’s needs to ensure a consistent approach. Managers were role models to other staff and made sure they were involved in all aspects of the service. Staff told us they valued this and learnt by example.

All the managers at the service had been promoted from other roles within and the provider was committed to developing staff and supporting them into their roles. The registered manager and other managers had qualifications in care management and undertook a range of other specialist training. They shared learning together. Managers all spoke about the value of their roles as support workers and senior staff before becoming managers. They explained this helped them to understand the role and know people well. People had good relationships with the management team and felt comfortable with them.

Staff told us managers were highly effective. Their comments included, “Managers are brilliant, reliable and visible”, “Managers are supportive and approachable” and “Managers do not just tell us what to do. They are involved. They listen to us and support us.”

Staff also commented on the support from the director of the company. A staff member told us, “The owner of the company knows us. [They have] time to speak with people, staff and visit the homes.”

Managers understood about best practice and how to develop the service in line with this, ensuring people received very good quality care.

There were systems to enable staff and others to speak up when they felt something was wrong. Staff told us they knew what to do if they had concerns. They explained they felt confident speaking up. Managers were open, honest and transparent. When something went wrong, managers apologised to people and explained the actions they were taking to prevent this happening again. Comments from staff included, “If we feel something needs to change or improve, we can raise it with managers” and “We are encouraged to give ideas.”

Staff received holistic support that valued their mental and emotional wellbeing. Staff described being included and supported to feel like part of the whole organisation. They explained their personal needs were respected and met. For example, a staff member described how their own family situation and needs sometimes had an impact on their ability to work. They commented, “My managers understand this and support me. This means a lot to me.” Another staff member described how they had difficulties with a personal issue when they started working at the service. They told us, “LD care supported me and my family. I will always remember that because they didn’t just see me as an employee. They cared about what was happening in my life.”

Staff told us how managers adapted their roles to ensure their individual needs were met. For example, a staff member explained that they did not speak English as a first language and lacked confidence when speaking. They told us that their line manager knew they liked to sing. They encouraged them to sing English songs with people using the service. They explained, “This helped my English, but more importantly it became something enjoyable I could share with people.” They went on to say how this had become a regular activity, and they enjoyed seeing people joining in with the songs and feeling happy because of this.

The provider valued and celebrated the diversity of the workforce, supporting staff to share their traditions, cultures and beliefs with each other and people living at the service. A staff member told us, “We are encouraged to share our own culture with people. I enjoy seeing how interested and happy they are to join our celebrations. This helps to make the home feel like a community.”

The provider’s governance systems were highly effective and involved all staff within the service. Staff were empowered to review care practices and make suggestions for change. Staff at all levels were involved in audits and had opportunities to share feedback. Managers regularly carried out additional checks of staff knowledge and competencies through formal and informal discussions. The provider invited external partners to carry out audits. The registered manager told us, “Governance is about being able to identify when something could be done better and then doing something about it.”

People using the service, relatives and staff were asked for feedback about their experiences.

The service was embedded in the local community, creating opportunities for people living there to feel valued and be respected by others. For example, people volunteered at a local place of worship, were litter pickers and involved in planting trees. People also took part in a London wide horticultural project to help create green spaces. A staff member explained, “We want the people to feel part of the local community not just someone receiving care. Seeing people participate and interact with others helps them feel recognised and this makes us proud.”

Staff worked in partnership with external professionals to make sure people received personalised care and support. The service had scored exceptionally well in all quality monitoring surveys the provider had received from external professionals with professionals commenting on the positive way staff worked with people, their approach and professionalism.

There was an embedded approach to quality improvement involving people using the service, their relatives and staff. The provider had achieved advanced accreditation with the National Autistic Society. This award demonstrated the provider’s continuous commitment to reflective practice to improve the outcomes for people using the service. Managers ensured all staff had an in-depth understanding of how to support autistic people. They established best practice through staff development providing a wide range of training and encouraging staff contributions to learning and development. All members of staff were committed to providing person-centred, high-quality care. They found innovative ways to remove barriers, supporting people to try new things. The registered manager told us, “When we look back at where people started, we realise how significant the achievements are for them.”

The provider actively encouraged staff professional development. Staff undertook professional qualifications and a wide range of training. Managers regularly discussed policies and procedures with staff describing why these mattered and how staff could follow them in everyday practice. Staff confirmed this and understood how these procedures were central to the work they undertook. Some staff and managers had undertaken specialist training to provide expertise in a specific area.

There was a culture where staff felt able to speak openly. There were regular meetings and managers worked alongside staff. Staff told us they were encouraged to question practice and make suggestions so the whole team could learn together.