Turning Point - Hollygrove

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 71 (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 service applied the principles of Right Support, right care, right culture effectively. This was reflected in the way people were supported to make choices, maintain control over their lives and maintain independence. Staff and leaders spoke about the importance of supporting people in a person-centred way making sure they had opportunities to lead fulfilling lives.

The registered manager told us they had completed work on improving the culture at the service. When they had started work the culture was not in line with the provider values and vision. Staff had been provided with guidance and support on how best to work with people with learning disabilities. There were also mentors which were staff from other services managed by the provider. The mentors worked alongside staff to demonstrate the principles of person-centred care.

Staff told us they enjoyed their work and spoke positively about working with people with learning disabilities. Comments from staff included, “It is rewarding”, “I can’t imagine working anywhere else” and “I feel like I belong here.”

There was good communication at the service and information was regularly shared. For example, there were regular newsletters about what was happening at the service shared with everyone.

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.

Since our last inspection there had been a change of registered manager. The current registered manager also managed another local service run by the provider. To make sure there was always management cover there was a clear line management structure. A team manager took day to day responsibility for supporting the registered manager with management tasks. Leaders were also supported with regular oversight visits from the locality manager.

Staff said they felt well supported by the management team and said they were approachable. One member of staff said, “The new manager is really good and on the phone if needed. They are really trying to bring the service back to 100%.” Staff said they felt valued, listened to and able to share ideas for improvements. One member of staff said, “I feel valued, [registered manager] does listen to us if we have any concerns or ideas.”

There were regular staff meetings for staff to share information and learn about any changes and the provider did regular staff surveys.

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

The provider had systems to support staff with speaking up if needed. Staff said they knew how to raise concerns both internally and outside of the service. There had been no notifiable events or incidents under the duty of candour process, though the provider had policies and procedures if needed.

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 had training on equality, diversity and inclusion which was regularly refreshed. The provider had policies and procedures to ensure staff were treated equally and with respect. The registered manager said, “We are a diverse team, we embrace differences. We do different international days where we can bring in different food dishes from different countries.”

There were various equality, diversity and inclusion networks for staff to join if they wished. There were regular meetings to discuss different topics within all of the networks. There was a local and national staff forum where staff could raise concerns or seek support.

Staff said there was no discrimination and all staff were treated fairly. One member of staff said, “I feel we have equal opportunities and our duties are distributed equally.” The registered manager had installed a suggestion box which enabled staff to share ideas and concerns anonymously if needed.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

Governance systems were not always effective in assessing quality and safety across the service. For example, some people’s needs had changed, and care was being provided differently to guidance in people’s care plans. Whilst staff had received communication and information about different ways of working, changes to care plans had not been carried out. Some care plans had conflicting information recorded which could be confusing. Audits of care plans being completed had not identified the shortfalls we found. The registered manager took immediate action following our prompt to update the affected care plans.

Some changes to people’s care and support had been implemented by staff following consultation with healthcare professionals. However, the registered manager was not able to locate 1 record of a consultation. They provided assurance the consultation had taken place and said they would contact the healthcare professional again to ensure good governance.

Other checks and audits were effective in identifying areas for improvement. These had been completed by different staff at the service and by leaders and the provider. Actions were added to a service improvement plan which helped to monitor actions until completed.

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 in partnership with various stakeholders. This included social workers, healthcare professionals and people’s relatives. Feedback from professionals was that staff communicated well and understood people’s health needs. Relatives told us they felt included and were kept up to date with changes.

The registered manager was a member of a local providers network. This enabled them to attend learning events and link up with other registered managers and providers to share learning.

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.

The provider had an innovation fund where services could submit their ideas to enhance and develop services. Leaders had submitted ideas to enhance the garden at the service and provide people with means to grow their own vegetables. The service had learned they had won the grant and were looking forward to putting their ideas into practice.

The registered manager had lots of ideas to develop the service and was keen to develop their own and staff knowledge.