'Mollies' Hebe Healthcare Kings Norton

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• 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.

This is the first assessment for this service. This key question has been rated 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 registered manager and deputy manager shared their vision for the service. The registered manager told us, “Our key values are respect, dignity and empathy; making sure everything is person-centred. We tell staff you should never influence and give your opinion; you should value people’s beliefs and preferences.” Staff we spoke with told us they were onboard with these values. One member of staff told us, “This is a good company to work for, everyone is friendly and supports the residents which is the main factor. If it was bad I would tell you. They are just so supportive, not just with staff but with residents. I have nothing bad to say about ‘Hebe’.”

A relative spoke highly of the service and the support both they and their loved one received from the management team and care staff. They told us, “I cannot emphasise enough how much [person] is looked after there. It is such a godsend and the staff there are so nice and look after [person] so well."

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.

The registered manager split their time between the different units they were responsible for. They were supported by the deputy manager who did the same. Both held a comprehensive knowledge of the people supported by the service. There was a team leader who was in charge when the deputy and/or the registered managerwere not on site. The registered manager was supporting the deputy manager to develop their own learning and was supporting them to achieve their management qualification. They told us, “I had a very good manager previously and she pushed me to do Level 5. I have encouraged the deputy to do the same.” The deputy manager added they felt very supported by the registered manager and encouraged to develop their learning.

The registered manager prided themselves on having an ‘open door’ policy when it came to ensuring they were accessible to people using the service, their loved ones and staff. In turn, all parties confirmed they had no problems accessing a member of the management team and found them to be approachable and accessible.

An on-call system was in place to ensure staff had access to a member of the management team at all times.

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

Staff told us they felt listened to. They were aware of the provider’s whistle blowing policy and told us they had no concerns about using it, if necessary. With the registered manager recently taking on the additional role of becoming the nominated individual, a meeting was arranged to discuss the management changes with staff and assure them if they did have any concerns or complaints, systems were in place to address these. Staff were told that whilst the registered manager held both posts, staff had the opportunity to raise any concerns they may have directly with the provider themselves or the deputy. A member of staff told us, “If I did have concerns about the registered manager, I would go directly to the provider or to CQC.”

Another member of staff said, “If I have any problems, I can go to my manager at any time and they will sort it out. I’ll go to the deputy first and then the registered manager. Honestly, I have found them both supportive and approachable every time.”

Staff told us regular staff meetings took place as well as tenants meetings and we saw evidence of this.

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.

Staff reported they felt they were treated fairly by management and felt the service was a good place to work. Staff were provided with the opportunity to develop in their roles and were encouraged and supported to develop their skills. One member of staff told us, “This is my first role in care, I feel very well trained.” They described the autism training they had received as helpful and explained how it had positively informed their support for people using the service.

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.

Systems were in place to ensure effective oversight of the service. Care staff were clear about their roles and responsibilities and those of their colleagues and the management team in general. Staff were provided with training and support to enable them to carry out their role effectively and meet the needs of the people supported by the service.

The registered manager and the deputy manager were a visible presence at the service and accessible to people using the service, staff and visitors. A number of audits were in place which fed into an action plan, providing the management team with oversight of the service. Where accidents and incidents took place, staff were aware of their roles in reporting and acting on these events.

The registered manager had recently become the nominated individual and the deputy manager was being supported to develop their learning and career potential.

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 was supported by a variety of professionals including healthcare professionals. The management team were open and transparent throughout the assessment.

The deputy manager commented, “We pride ourselves on our relationships with professionals” and went on to describe the positive impact these relationships had for a number of individuals living at the service. A professional spoken with confirmed this.

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.

Systems were in place to ensure lessons were learnt from any accidents and incidents. Reviews took place of people’s care on a regular basis, and people’s views were regularly sought to ensure the service met their needs. An action plan was in place and used to keep on top of the service and identify any actions that needed to be taken.

It was clear from our conversations with management and staff that the culture of the service was not based on assuming everything was fine. Instead, staff regularly checked in with people and asked for their views. Staff did not presume that just because a person liked something now, that it would always be that way.

Staff confirmed they were encouraged to speak up with any ideas they may have for the service or individuals and told us they felt listened to.