46 Bath Road

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 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 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 provider demonstrated how they followed the principles of Right Support, Right Care, Right Culture. People were supported in a homely environment that promoted independence, dignity, and involvement in the local community. People were encouraged and supported to live ordinary lives, supported to access local services and participate in community activities of their choosing.

The culture within the service was open, respectful, and focused on supporting people to live the life they wanted. A member of staff told us, “I respect individual choice and encourage independence, and always listen and involve the person in their care.”

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.

There was a registered manager responsible for 46 Bath Road. They were responsible for 2 other services operated by Milestones Trust, which were in close proximity. The registered manager told us they visited the service at least once a week and were in regular contact with the service coordinator who had day to day oversight of the service. The service coordinator confirmed they were supported in their role and had regular contact with the registered manager and the operations manager.

The registered manager and the service coordinator knew the service, people and staff well. They led with openness and honesty. They were hands on and supported people when needed. On day 2 of the assessment the service coordinator was supporting 1 person to the local pub.

Staff were clear about their roles and responsibilities as well as the organisational structure and who they would go to for support if needed. Comments from staff included, “Both managers are positive and supportive which makes the service a happy place to work in, "and “My managers are very approachable and helpful. They helped and supported me in settling in.” Another member of staff told us, “(names of managers) are an excellent management team, they have always got the time to explain things if I am unsure of anything and are always encouraging and share positive feedback.”

The provider’s quality team visited the service to meet with people, staff and complete checks on the home ensuring ongoing compliance. The operations manager was a frequent visitor to the service supporting the registered manager and the staff team alongside their responsibility to complete checks on compliance to the action plans that were in place.

The registered manager attended monthly management meetings where learning and risks were discussed across the whole organisation.

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

There were policies and procedures for staff to follow should they wish to speak with external agencies alongside a speak up policy within the organisation. Staff were aware they could raise concerns to the senior management team and if not satisfied they could contact the local authority, Care Quality Commission (CQC) or the police in respect of concerns or allegations of abuse. A member of staff told us, “The needs and safety of the people we support is the responsibility of every staff member so whenever I say anything or any situation that appears rather uncomfortable, it is my duty to escalate and report it to the appropriate authorities.”

Staff told us they felt confident to speak up and were assured that their views were valued and acted upon. This created an open and inclusive culture where communication was encouraged at all levels.

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.

People were supported by a staff team who felt valued and supported in their roles. They received appropriate training, enabling them to feel confident and skilled in supporting people, and their views were sought through team meetings and supervisions.

Policies were in place to promote and protect the rights of both people using the service and staff. Staff had completed equality and diversity training.

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.

The registered manager and service coordinator carried out regular, structured checks of the home and of people’s experiences of the care provided. These covered key aspects of the service, including care and support, medicines management, cleanliness and hygiene, the environment, health and safety, staffing arrangements, recruitment processes, and staff training and support. Where shortfalls were identified, clear action plans were developed and implemented. This helped to drive continuous improvement and ensured that people received safe, consistent and care that was effective and responsive to their individual needs.

The organisation’s quality team also completed comprehensive quarterly audits aligned to the key questions of whether the service was safe, effective, caring, responsive and well-led. Findings were shared with the operations manager, who maintained oversight and followed up on areas for improvement during subsequent visits. The service coordinator was able to demonstrate that audits were consistently completed, and actions were monitored through to completion. This provided effective governance and accountability, supporting sustained improvements and positive outcomes for people using the service.

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 were encouraged and supported to maintain relationships with those who were important to them and to take part in activities that were meaningful and enhanced their quality of life. This promoted social inclusion and reduced the risk of isolation. People told us they were regularly supported to access their local community, which helped them maintain independence and wellbeing.

The service worked in close partnership with relatives, ensuring they were fully involved in people’s care. Relatives spoke positively about the service and confirmed they were actively involved and regularly asked for their views. There were no restrictions on visiting, which enabled people to maintain strong relationships with those important to them. This open and inclusive approach helped people feel supported, valued, and connected to their families.

The registered manager and staff team worked proactively and collaboratively with a range of healthcare professionals to ensure people’s health needs were well understood, met, and regularly reviewed. People were supported to attend healthcare appointments and reviews when required, promoting timely access to treatment and continuity of care. This coordinated approach contributed to positive health outcomes and supported people to maintain their overall wellbeing.

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.

We observed strong and visible leadership within the home, which promoted a positive culture and a focus on continuous improvement. Action plans were effectively used to drive service improvements. There were clear processes in place to ensure learning was embedded when things went wrong. Lessons learned and associated actions were consistently shared with staff through team meetings, daily handovers and one to one supervision. This promoted a culture of openness and accountability, helping to reduce the risk of repeated incidents and improve outcomes for people.

The service coordinator identified concerns raised by people and staff regarding laundry being incorrectly distributed, when non-permanent staff were on duty. In response, the service introduced a clear and practical system whereby a photograph of the person is displayed on the washing machine alongside their laundry. This action demonstrated a responsive and person-centred approach to feedback. As a result, the risk of errors was reduced, people’s belongings were returned correctly, and concerns were effectively addressed. This showed the service was willing to listen, learn and implement improvements that had a positive impact on people’s day-to-day experiences.

The provider was committed to staff development and actively supported staff to enhance their skills and progress their careers. This investment in staff development helped to build a more skilled, confident workforce enabling them to support people in a safe and person-centred way.