Turning Point - Stanfield House

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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

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 as Good.

This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

Leaders had the skills, knowledge and experience to perform their roles. Staff knew and understood the provider’s vision and values and how they applied to the work of their team. Staff felt respected, supported and valued. Performance and risk were managed well. Teams had access to the information they needed to provide safe and effective care. Staff collected analysed data about outcomes and performance. They used this to identify improvements.

However, governance processes did not always operate effectively. When we highlighted concerns to the management team, they took action to ensure that governance arrangements suitably identified and followed up on risks, ensuring mitigations were put in place in a timely manner.

We have not awarded this service a score for Well-led.

Find out about when we will not publish a key question score and what we look at when we assess Well-led.

We scored the service as 3. The evidence showed a good standard. The service 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.

Staff members we spoke with could clearly tell us the provider’s vision and values and felt that this was reflected in the care provided in the service. Managers and the organisation encouraged staff to participate in annual staff surveys and quarterly all staff calls to contribute to the discussions about the strategy. Staff we spoke with felt proud to work for the service.

Constructive criticism was exchanged honestly between managers and staff, and support was always available through manager on-call services, acting as a sounding board and reassurance. Staff described management as “accessible” and fostered a feeling of trust in staff.

We scored the service as 3. The evidence showed a good standard. The service 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.

Supervisors and managers had the skills, knowledge and experience to perform their roles and were supported through the organisation’s management training programmes. The Registered Manager and Regional Manager had a strong understanding of the service and clearly articulated how they worked with local and national teams to provide high-quality care.

All members of the management team were visible in the service and clients were familiar with them, approaching them for casual discussions and requests for assistance throughout our inspection.

We scored the service as 3. The evidence showed a good standard. The service fostered a positive culture where people felt they could speak up and their voice would be heard.

Clients had opportunities to give feedback on the service through a variety of routes. The service had an anonymous feedback box located in the lounge, and during daily meetings, clients were asked for feedback about the service, including their care, activities, and environment, as a standing agenda item. Clients were invited to share feedback during one-to-one meetings with staff, and where a client did not complete their treatment, they were contacted afterwards for feedback. Feedback could also be shared directly with Turning Point, and posters in communal areas highlighted the different routes to share views.

Regional managers had a good working relationship with the clients and took part in daily meetings and activities, offering further opportunities for clients to share their thoughts directly with a senior leader.

Staff members were also encouraged to share their thoughts on the care being delivered and suggest ideas for improvements. Staff could utilise the anonymous feedback box and were asked about the care provided during supervision meetings with their manager. Staff could also utilise the routes through Turning Point directly and told us they felt listened to by their leaders. Staff members shared they were comfortable raising concerns about any disrespectful, discriminatory, or abusive behaviour towards clients. They were confident that they could raise any issues without fear of detriment or consequences.

Managers regularly reviewed the feedback received and considered how improvements could be made. The service had a ‘You said, we did’ display detailing action taken upon receipt of suggestions. For example, clients had requested desks in smaller rooms. Staff sourced and provided fold-away desks. Clients also asked for remote control lightbulbs to be fitted. Staff installed the lightbulbs, with remote controls kept in the admin office.

We scored the service as 3. The evidence showed a good standard. The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

Turning Point had Equity and Diversity Champions available to offer support to staff from marginalised groups.

Where appropriate, managers supported staff with reasonable adjustments, ensuring they were appropriately assisted to fulfil their duties. A member of staff shared praise for the support they had received from managers in relation to caring duties.

We scored the service as 2. The service had clear responsibilities, roles, and systems of accountability. They used these to manage and deliver good quality, sustainable care, treatment and support. However, the service did not always have effective governance arrangements in place to identify, mitigate, and act upon environmental risks in a timely way.

The service had a clear framework for discussions at team and individual level, and ensured comprehensive handovers and learning were shared and discussed. Staff took part in care plan and handover audits, ensuring documentation remained appropriate and completed to a high standard. The audits were sufficient to provide assurance and staff acted on the results when needed.

Plans were in place for emergencies, with a business continuity plan available to all staff members when required.

Staff had access to equipment and devices they needed to fulfil their duties. Staff told us the IT systems worked well and helped support delivery of care.

Management were able to access information supporting them with oversight of the service, including dashboards and reports, enabling them to monitor performance, staffing, and overall client care.

However, during our inspection we observed several issues relating to the environment which we did not see recorded in daily or monthly environmental audits. Management were aware of these issues, and when highlighted by us during our inspection, they took timely action to ensure environmental risks were appropriately recorded, mitigated, and escalated in future.

We scored the service as 3. The evidence showed a good standard. The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

Management engaged with commissioning bodies and described strong working relationships with local services. Where required, the service supported clients to access a wide range of external providers.

Clients and staff were familiar with regional leadership, who visited at least once a month, offering the opportunity to give feedback directly.

We scored the service as 3. The evidence showed a good standard. The service 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 contribute to safe, effective practice and research.

Staff described a process of identifying learning from incidents or feedback, and enacting opportunities for improvement. Management promoted a culture of continuous learning and held discussions around innovation and quality improvement during team meetings and appraisals.