Birling 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. 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 75 (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 clear shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding the challenges and the needs of people living with a neurological condition and their communities.

The provider supported people to be the lead in their care, promoting dignity, respect, compassion and valuing people as individuals. Staff had a clear understanding of these values and an exceptional understanding of the challenges and the needs of people and their communities. One staff member told us, “The values here are about giving people the best quality of life possible.”

The operations manager told us, “I am absolutely passionate about meeting people’s wishes. The families also need support, and the wider support is also important. The ties are not broken when people pass away.”

Managers told us they felt being visible was important to enable them to oversee the culture of the service and provide support to staff. One manager said, “Visibility is important. Knowing how people are being well cared for and treated. We go to handover including with night staff and I do walk arounds.” Staff confirmed this and told us, “There is an open-door policy in the office, you can speak to them about anything, mangers have time for the staff. They see what’s going on.”

Staff were consistently positive about the management of the service. Staff told us managers were accessible, present and there was a very positive culture. Staff said, “I feel 100% supported and valued.” Another member staff told us, “[The managers] are honest and supportive, there is positive reinforcement, and they give us feedback.”

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.

Managers had a good understanding of the Single Assessment Framework and had clearly kept up to date with the changes at CQC. They had reflected on how they demonstrated compliance. The new system of audits in place were more outcome focused which reflected this learning.

There was no registered manager in place at the time of the inspection, however, an appointment had been made to this role, with an imminent start date. Duties were being undertaken by the home manager, deputy manager and operations manager. The home manager felt supported in their role. They told us, “I have a really good team who provide me with support.”

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

The provider had a “Freedom to Speak Up” policy in place, and staff told us they felt confident to voice their views in the knowledge they would be listened to. One staff member told us, “We are encouraged to make suggestions. We can raise things with the activities co-ordinator. We can go speak to the management team; they do listen. If people need new chairs we go to the supervisor. There is always someone to speak to who will listen.”

The management discussed with us how they took the decision to review their whistle-blowing process, after CQC received anonymous concerns about the service. This is still in progress, and the provider is looking to identify who is best to lead this. To ensure staff feel empowered to speak up and raise concerns, the provider is considering whether a staff member may be most appropriate to lead, to encourage maximum openness. The operations manager told us, “We want staff to feel comfortable and listened to.”

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. There was a staff equality and inclusion policy in place. Staff told us they the managers were supportive where they needed support such as reasonable adjustments in their role. If staff had concerns managers were accessible, and they could raise concerns. Staff told us, “The management are supportive, encouraging and always here if you need any help.”

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate. There were systems in place to support managers to identify and address risks to the service and quality concerns. Where there were identified areas for improvement, action was taken to address concerns. The provider was in the process of improving auditing to focus more on outcomes for people. This was supported by a strategy and business plan to drive forward good governance within the service.

The provider understood their duty to collaborate and work in partnership to enable services to work seamlessly for people. They shared information and learning with partners and collaborated for improvement. Staff worked closely with the local GP who visited the service weekly to improve health outcomes for people. The outcome from people’s health appointments was shared with staff as appropriate and staff had a good understanding of people’s healthcare needs. The operations manager told us they worked with organisations such as the Huntington’s Disease Association to “make sure we provide the best care we can for the residents.”

The provider had a focus 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 and operations manager attended events and conferences and shared learning with staff. They were members of local learning networks and were able to demonstrate they had kept up to date with new developments in the sector.