Ventura

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 requires improvement. At this assessment the rating has remained requires improvement. This meant governance was inconsistent and not always effective to monitor the quality and safety of the service. The provider was previously in breach of the legal regulation in relation to good governance. At this assessment we did not identify sufficient improvement, and the provider remained in breach of this regulation.

This service scored 62 (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 aims and objectives of the service were outlined in the provider’s statement of purpose. These included treating each person as an individual and fostering a warm, friendly atmosphere. We observed staff consistently reflected these aims in their day-to-day practice. The provider respected people’s human rights and embraced diversity across the organisation. Staff worked well together and told us morale within the team was positive. A staff member said, “It’s a lovely place to work.”

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. Leaders demonstrated the knowledge and skills needed to manage the service effectively. The service had an established leadership team, including 2 registered managers, 1 of whom also acted as the nominated individual. However, feedback highlighted staff were not always clear about which manager to report to on specific points. We raised this with the management team, and during the assessment, they provided us with an overview of management roles and responsibilities in relation to governance. Leaders maintained a visible presence at the service; they engaged and actively contributed to the assessment process. The provider was open and transparent about recent challenges and shared their plans for the development of the service. People, relatives and staff spoke positively of the leadership team. A relative said, “[registered manager] and her team have become part of our family, they have been supporting [person] for many years, and we have really seen an improvement in both mental and physical health. They are aware of my complex disabilities too and reassure [person].” While governance systems were not always effective, the provider was responsive to our feedback and took action to address concerns.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. The provider had procedures to support staff in raising concerns and contacting external agencies when necessary. There were processes for staff to speak up such as supervision and daily handover meetings. Staff told us they felt supported. They described the management team as approachable and said they would feel comfortable raising any concerns. A staff member said, “I absolutely would.”

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 ensured policies and procedures promoted equality, diversity, and human rights, to guide staff on best practice. Staff had access to equality training to improve understanding of protected characteristics and awareness of bullying and harassment. Staff told us the registered managers were supportive, inclusive and fair to all staff, they felt confident action would be taken if any concerns were raised. A staff member said, “There’s good communication, they’re really supportive and with my personal life. They wouldn’t tolerate it.”

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. The service was completing a range of service level audits to monitor the quality and safety of the service; however, they did not identify, and address shortfalls found during this assessment. For example, audits were not effective at resolving issues identified with high water temperatures, staff recruitment and incident records. The nominated individual was present and involved in the day to day running of the service, however, they were not conducting formal provider audits, which may have identified the issues we found. Governance processes had led to some improvements since the last inspection, for example in relation to people’s risk assessments, infection prevention and control and policies and procedures. The management team responded positively during the assessment, providing evidence of actions taken to address the shortfalls identified.

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. The service worked effectively with other professionals and maintained positive working relationships. A professional who regularly works with the service said, “From my interactions with the home, I feel the residents are safe and well looked after. I have good communication with the manager.” The registered manager told us the service worked in partnership with professionals, including the GP and community mental health team, to ensure people’s individual needs were met. They described how they had established links with other providers and regularly participated in forums to share ideas and promote best practice.

The provider had not always focused on continuous learning, innovation and improvement in the service. At our last inspection, we identified shortfalls in relation to the management of people’s risks and environmental risks. At this assessment, some improvements had been made; however, some areas required further improvement, such as staff recruitment. Additional shortfalls were also identified, for example, relating to incident recording and documenting lessons learned. Further work was needed to establish a consistent culture of learning, innovation and improvement. Feedback was sought from people and relatives through questionnaires and monthly meetings with key workers. Staff had completed a recent questionnaire; the results were summarised and actions identified. Staff reported good communication with managers, regular meetings took place, however these were not always well recorded. The management team explained they actively participated in provider forums and maintained a relationship with the local authority to support ongoing service developments.