The Old School 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 outstanding. At this assessment the rating has remained outstanding. This meant service leadership was exceptional and distinctive. Leaders and the culture they created drove and improved high-quality, person-centred care.

This service scored 100 (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 created a strong, values-driven culture where people, relatives, staff and leaders shared a common commitment to delivering outstanding person-centred care. The service's values were not simply understood but consistently demonstrated in everyday practice and contributed directly to exceptional experiences and outcomes for people.

People benefited from a culture where dignity, compassion, independence and meaningful living underpinned every aspect of care. Throughout the assessment, staff consistently spoke about people as individuals and focused on helping them achieve positive outcomes rather than simply meeting care needs. Conversations with staff demonstrated a shared understanding of the provider's vision and a collective commitment to promoting wellbeing, maintaining identity and enhancing quality of life.

Families consistently described the culture as welcoming, inclusive and caring. One relative told us, “I feel like part of an extended family because staff genuinely care about the people and their families.” Another relative explained, “I have confidence in this service. Management and staff listen and involve us in decisions. They [staff] are committed to achieving the best for people.” Feedback from relatives was overwhelmingly positive and reflected a culture where relationships were highly valued.

Staff consistently described a positive and supportive culture. One member of staff told us, "Everyone works together and wants the best for the people living here." Another explained, "We are encouraged to share ideas and improve things. The managers listen and make you feel that your contribution matters." Staff told us they felt valued, respected and empowered to contribute to service development, which helped create a motivated and engaged workforce.

The culture also promoted inclusion, respect and individuality. Leaders encouraged staff to understand people's life histories, preferences and aspirations and to use this knowledge to personalise care. Staff consistently focused on what people could achieve and worked creatively to help people remain connected to relationships, interests and experiences that mattered to them. This strengths-based approach was evident throughout the service and had a positive impact on people's wellbeing and quality of life.

Leaders had successfully embedded a culture of openness, reflection and continuous improvement. Staff felt comfortable discussing concerns, learning from mistakes and challenging practice when necessary. Positive feedback, achievements and examples of good practice were celebrated and shared across the service, creating an environment where people felt proud of their work and motivated to improve outcomes further.

Professionals consistently described the service as compassionate, collaborative and committed to achieving positive outcomes. Healthcare professionals told us staff and leaders worked in ways that reflected a clear person-centred ethos and consistently demonstrated the values they promoted. Feedback from families, staff and professionals aligned closely and provided strong evidence of a genuinely shared direction and culture running throughout the service.

People experienced care and support from a workforce united by common values and a shared commitment to excellence. The provider had created a positive, inclusive and person-centred culture that consistently translated into outstanding experiences and outcomes for people.

Leaders were highly capable, compassionate and inclusive and had created an environment where people, relatives, staff and professionals felt valued, supported and listened to. Leadership was visible, responsive and strongly focused on achieving exceptional outcomes for people.

The registered manager and leadership team demonstrated an excellent understanding of people's needs, service performance and areas requiring development. Leaders maintained a strong presence within the service and knew people, relatives and staff exceptionally well. Families consistently described leaders as approachable, responsive and genuinely interested in people's wellbeing. One relative told us, "I know I can speak to the manager about anything, and it will be sorted." This visibility helped leaders maintain oversight whilst remaining connected to people's experiences of care.

Leaders demonstrated exceptional compassion in their interactions with people, families and staff. Relatives spoke particularly positively about the support they received during periods of deterioration, difficult decision-making and end-of-life care. Relatives described leaders as, “Calm”, “Supportive” and “Reassuring.” Staff also spoke positively about the support they received during challenging situations. They told us, “Management and staff take the time to understand our experiences and wellbeing needs.”

Leaders recognised and developed people's strengths throughout the workforce. Staff consistently told us managers recognised individual skills and interests and encouraged professional development. One member of staff told us, "They see people's strengths here. If you're interested in something, they support you to develop it and share it with others." Another explained, “They [managers] encouraged me to lead projects and contribute to improvements. They recognise people’s strengths and capabilities.” This approach increased confidence, engagement and ownership throughout the team.

Healthcare professionals consistently praised leadership responsiveness, communication and partnership working. Professionals described leaders as, “Knowledgeable”, “Proactive” and “Committed to achieving positive outcomes.” One health professional told us, “I have confidence in the staff and managements' ability to coordinate care, respond to concerns and maintain high standards.” Relationships with external agencies were characterised by openness, collaboration and mutual respect.

Staff consistently described leaders as fair, supportive and inclusive. One member of staff said, "The managers genuinely care about both the residents and the staff." Staff reported feeling, “Listened to”, “Respected” and “Encouraged to contribute ideas.” Leaders created a psychologically safe environment where staff felt valued and empowered to improve practice. This culture of inclusion and support contributed directly to workforce stability, wellbeing and quality of care.

Overall people experienced care within a service led by capable, compassionate and inclusive leaders who consistently modelled the values they expected of others. Leadership was highly effective, strongly person-centred and directly contributed to the outstanding experiences and outcomes achieved throughout the service.

The provider was exceptional at fostering a positive culture where people knew they could speak up and their voice would be heard.

The service had an exceptionally open, honest and transparent culture where people, relatives and staff felt empowered to raise concerns, share ideas and provide feedback. Leaders actively encouraged speaking up and consistently demonstrated that concerns, feedback and learning opportunities were welcomed, valued and acted upon. This created a psychologically safe environment where continuous improvement was driven by openness, trust and accountability.

Staff consistently described a culture where they felt comfortable speaking openly with managers and leaders. They told us they would have no hesitation raising concerns about people's care, safety, wellbeing or staff practice and were confident leaders would listen and act appropriately. Staff explained they were encouraged to challenge poor practice, contribute ideas and participate in discussions about service improvements. This openness created a culture where staff felt respected, empowered and able to influence positive change.

Leaders actively promoted transparency and openness throughout the service. Staff spoke positively about the registered manager's approachable leadership style and described an environment where discussing mistakes, concerns and learning opportunities was normal practice. Rather than focusing on blame, leaders encouraged reflection, learning and improvement. Staff told us they felt supported when raising concerns and were confident their views would be taken seriously.

The service demonstrated a strong commitment to learning from feedback, incidents and concerns. Following significant events, leaders facilitated structured debriefs which provided staff with opportunities to reflect, discuss experiences and contribute directly to future improvements. Staff described these sessions as supportive and constructive and explained they helped ensure lessons learned were embedded into practice. Evidence showed learning from incidents resulted in tangible improvements to care delivery, communication processes and support arrangements.

People and families also experienced a culture where their voices were heard and respected. Relatives consistently described leaders as approachable and responsive when concerns were raised. Feedback was actively encouraged through regular communication, reviews and engagement opportunities. Families told us they felt comfortable discussing concerns and were confident they would be listened to. Records demonstrated concerns and complaints were investigated openly and thoroughly, with outcomes communicated clearly and changes implemented where necessary.

Leaders demonstrated openness and honesty during difficult situations. Families described being kept informed following incidents, healthcare changes and reviews and reported that leaders communicated sensitively and transparently. Evidence also showed leaders applied the principles of Duty of Candour appropriately, ensuring families received information, explanations and apologies when things had gone wrong.

The service had developed systems that encouraged staff participation and involvement in service improvement. Staff surveys, quality improvement initiatives, consultation opportunities and reflective discussions enabled staff to share concerns, suggest ideas and influence decision-making. Staff consistently reported that leaders listened to suggestions and regularly implemented ideas originating from the workforce. This reinforced confidence that speaking up led to meaningful outcomes.

Professionals also recognised the service's transparent and collaborative approach. Healthcare professionals described leaders as open, responsive and willing to discuss challenges honestly. Relationships with external agencies were characterised by trust, openness and a shared commitment to achieving positive outcomes for people.

As a result, the service had developed a culture where speaking up was actively encouraged and valued. Staff, relatives and professionals felt respected, listened to and confident their concerns would be addressed. This openness strengthened learning, promoted accountability and contributed directly to improvements in care quality, safety and people's experiences.

The provider strongly valued diversity in their workforce. They had an inclusive and fair culture which had improved equality and equity for people who worked for them.

Leaders had created an inclusive and equitable culture where staff from all backgrounds felt valued, respected and able to contribute fully to the success of the service. Equality, diversity and inclusion were embedded throughout the organisation's culture and leadership approach, ensuring staff were treated fairly, supported to succeed and empowered to influence the development of the service.

The service demonstrated a strong commitment to creating an environment where every member of staff felt included and respected. Staff consistently described leaders as supportive, approachable and interested in their wellbeing, regardless of role, background or personal circumstances. They told us managers took time to understand individual needs and worked collaboratively with them to ensure appropriate support arrangements were in place. This created a culture where staff felt comfortable being themselves and confident that their contribution was valued.

Leaders actively promoted inclusivity through their management practices and workforce development approaches. Staff reported they were treated fairly, had equal access to training and development opportunities and were encouraged to progress within the organisation. Opportunities for learning, supervision, mentoring and career development were available across the workforce, and leaders demonstrated a commitment to helping staff achieve their professional goals. Staff told us progression was based on individual strengths, aspirations and abilities rather than role or length of service.

The provider recognised that supporting staff well was essential to delivering outstanding care. Leaders worked flexibly to support individuals experiencing personal challenges, health needs or caring responsibilities. Evidence showed reasonable adjustments were considered and implemented where required and that leaders took a compassionate approach when responding to staff wellbeing concerns. Staff consistently reported feeling listened to and supported during difficult periods, which promoted trust and loyalty across the workforce.

The service encouraged staff from all roles and backgrounds to contribute ideas and participate in improvement activity. Leaders actively sought workforce feedback through surveys, supervision, meetings and improvement projects and demonstrated that suggestions led to meaningful change. Staff told us they felt their opinions mattered and described a culture where ideas were welcomed regardless of seniority or job title. This ensured diverse perspectives contributed to service development and improvement.

Leaders fostered a culture where discrimination, bullying and poor behaviour would not be tolerated. Staff consistently stated they would feel confident reporting concerns and believed managers would respond appropriately. The positive and respectful culture was reflected in staff feedback, which consistently highlighted teamwork, mutual respect and strong working relationships. Staff described colleagues as supportive and explained that differences in background, experience and perspective were viewed positively and contributed to learning and growth.

The organisation's commitment to equality and inclusion was also evident in the way it recognised and celebrated staff achievements. Leaders acknowledged individual contributions, supported progression and encouraged staff to develop areas of expertise. Staff described feeling valued for their skills and unique contributions rather than being viewed solely through their role. This contributed to high levels of engagement, motivation and workforce stability.

People benefitted directly from this inclusive workforce culture. Staff who felt respected, supported and able to contribute positively were more confident, engaged and motivated to provide high-quality care. The strong culture of inclusion enabled leaders to retain experienced staff, develop talent and maintain a workforce committed to delivering person-centred support. The service had created an environment where equality, diversity and inclusion were not treated as standalone initiatives but formed part of everyday practice. Staff felt valued, respected and empowered, creating a stable and compassionate workforce that consistently delivered positive outcomes for people.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver high-quality, sustainable care, treatment and support. They always acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

The service was exceptionally well governed and managed. Leaders had developed highly effective governance systems which provided robust oversight of safety, quality, performance and outcomes in respect of people’s care, whilst maintaining a clear focus on continuous improvement and sustainability. Governance arrangements were not only effective at identifying issues but consistently drove improvements that resulted in better experiences and outcomes for people.

Leaders demonstrated a comprehensive understanding of the service and maintained effective oversight through a range of interconnected quality assurance systems. A structured programme of audits, compliance monitoring, quality assurance visits, performance dashboards and action plans enabled leaders to identify risks, monitor trends and respond proactively to emerging concerns. Governance systems were aligned to the CQC Assessment Framework and provided leaders with detailed information regarding care quality, staffing, training, incidents, safeguarding, medicines, infection prevention and control and people's outcomes.

The service demonstrated an exceptional commitment to using governance information to improve practice. Audits were not completed as a compliance exercise; findings were analysed, actions allocated and progress monitored until improvements were sustained. Leaders maintained comprehensive action trackers and evidence demonstrated a consistent cycle of audit, action, review and improvement. Where issues were identified, prompt action was taken and learning was embedded into future practice. This ensured governance systems had a direct and measurable impact on the quality-of-care people received.

Leaders maintained strong oversight of risks across the service. Real-time quality monitoring systems enabled trends to be identified and addressed before they impacted negatively on people. Falls, incidents, accidents, complaints, safeguarding concerns, healthcare needs and staffing requirements were reviewed regularly through governance structures. Staff and leaders worked collaboratively to identify areas requiring attention and implement improvements. This proactive approach supported safe, responsive and well-managed care.

The service demonstrated sector-leading approaches to quality improvement. Leaders had implemented formal quality improvement methodologies, including Plan-Do-Study-Act (PDSA) cycles, to evaluate practice and drive sustainable improvement. Quality improvement projects included the redesign of handover arrangements, strengthening communication systems and enhancing risk identification processes. These projects were monitored through governance structures and evidence demonstrated positive impact on communication, safety and care outcomes.

Governance systems supported sustainability by investing in workforce development, succession planning and workforce stability. Staff received regular supervision, competency assessments, training and development opportunities. Leaders maintained oversight of workforce performance and wellbeing and responded proactively to gaps in knowledge or skills. This helped ensure a stable, capable workforce able to meet people's needs both now and in the future.

Records demonstrated that legal obligations and regulatory requirements were consistently met. Notifications were submitted appropriately, safeguarding concerns were managed effectively and records were maintained accurately. Leaders demonstrated a detailed understanding of regulatory expectations and ensured governance processes remained responsive to changing guidance, best practice and service needs.

The service also fostered strong accountability and ownership at all levels. Staff were actively involved in audits, quality assurance activities and improvement work and understood how their contribution influenced outcomes for people. Leaders promoted transparency and openness and ensured governance information was shared and discussed across teams. This created a culture where quality and safety were everyone's responsibility.

Healthcare professionals, families and staff consistently described the service as well organised, responsive and professionally managed. Evidence demonstrated governance systems were highly effective at maintaining standards, supporting continuous learning and achieving positive outcomes for people. As a result, people experienced care within a service that was sustainable, improvement-focused and consistently well led.

The provider clearly understood and carried out their duty to collaborate and worked in partnership, and services worked seamlessly for people. They always shared information and learning with partners and collaborated for improvement.

The service had developed exceptional partnerships with healthcare professionals, community organisations, families and external stakeholders to improve people's experiences, outcomes and quality of life. Leaders actively sought opportunities to work collaboratively beyond the service and used these relationships to ensure people received coordinated, responsive and innovative support. Partnerships were purposeful, influential and delivered measurable benefits for people.

Leaders had established strong and effective relationships with a wide range of health and social care professionals, including the Primary Care Network (PCN), GPs, Community Psychiatric Nurses (CPNs), District Nurses, Speech and Language Therapists, Occupational Therapists, pharmacists, Mental Health Services, social workers and commissioners. Professionals consistently described staff as responsive, knowledgeable and proactive in seeking advice. The service was recognised as a valued partner which communicated effectively, acted on recommendations and worked collaboratively to achieve the best outcomes for people.

The provider demonstrated particular strength in supporting people with complex needs through multi-agency partnership working. Leaders worked closely with commissioners, healthcare professionals and families to successfully support people who had previously experienced instability in care arrangements. These partnerships enabled people to remain closer to their families, avoid unnecessary moves and access support tailored to their individual circumstances. Professionals commended the service's willingness to work positively with complexity and find solutions where other placements had struggled.

Partnership working extended beyond healthcare and was used to enrich people's lives and strengthen community connections. Staff developed relationships with local organisations, activity providers, community groups and businesses to create meaningful opportunities for people. People were supported to maintain connections with their local communities and participate in experiences linked to their interests, histories and identities. Staff actively sought opportunities for inclusion and worked creatively with external partners to help people remain connected to ordinary community life.

Families were viewed as key partners in people's care. Leaders had developed strong relationships with relatives and consistently involved them in care planning, service development and decision-making. Regular Family and Carer Listening Events created opportunities for dialogue and partnership, whilst ongoing communication ensured families remained informed and involved. Families described feeling respected, listened to and treated as equal partners throughout their involvement with the service.

Professionals consistently praised the service's partnership approach. Feedback described staff and leaders as approachable, collaborative and willing to work constructively to solve problems. One professional highlighted the service's ability to bring together multiple agencies around a person and maintain focus on achieving positive outcomes. Others described communication as effective and responsive and told us recommendations were consistently implemented.

Partnerships also strengthened learning and development opportunities for staff. Leaders actively engaged with external networks, healthcare teams and professional forums to ensure staff remained aware of best practice and emerging developments. Learning was shared within the service and used to improve care delivery, strengthen governance and develop staff skills and confidence. People experienced coordinated, well-connected and highly responsive support that benefited from the expertise and involvement of a broad range of partners. Leaders had created a culture in which collaboration was valued, relationships were nurtured and community connections were seen as an essential part of achieving outstanding outcomes for people.

The provider had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

Leaders had created a culture where reflection, creativity and learning were embedded into everyday practice and where staff, people, families and external partners were actively involved in improving the quality of care. Improvements were not only identified and implemented but were evaluated to ensure they achieved meaningful and sustainable benefits for people.

Leaders consistently demonstrated that learning was valued and translated into action. The service had developed robust systems to learn from incidents, feedback, complaints, compliments, audits and quality assurance activity. Staff were encouraged to reflect on practice, contribute ideas and participate in improvement projects. This created a culture where learning was viewed positively and used as an opportunity to enhance outcomes for people rather than apportion blame.

Staff were actively involved in evaluating the effectiveness of improvements through surveys, feedback and reflective discussions. As a result, communication improved, accountability increased and staff felt better equipped to identify risks and respond proactively.

The service consistently demonstrated an ability to turn learning into practical improvements. Evidence showed learning from incidents had informed changes to care planning, communication processes, staff guidance and risk management. These changes helped improve outcomes for people and increased staff confidence in responding to complex situations.

Innovation extended beyond governance systems and included sector-recognised improvements in people's experiences. The development of End-of-Life Comfort Boxes provided practical, emotional and comfort-focused resources for people and families during the final stages of life. This initiative was recognised positively by healthcare professionals and external partners and demonstrated leaders' willingness to develop creative solutions in response to identified needs. The service also introduced Purple Heart initiatives and personalised bereavement support arrangements to improve experiences for families before and after bereavement.

Staff were actively involved in developing and implementing improvements. Leaders consistently sought frontline feedback, recognising that staff often had the best understanding of where changes could improve care. Staff described feeling empowered to suggest ideas and reported that leaders frequently acted on suggestions. This included involvement in handover redesign, dignity initiatives, audit processes and quality improvement work. Staff consistently told us they felt part of the service's development rather than simply expected to follow changes introduced by others.

The service also demonstrated a commitment to learning beyond its own organisation. Leaders actively engaged with healthcare partners, commissioners and professional networks to identify best practice and share learning. Staff benefitted from specialist training opportunities, quality improvement projects and innovations developed through partnership working. External professionals described the service as forward-thinking and receptive to new ideas, recognising leaders' commitment to continually improving care and support.

Families and people also contributed to improvement activity. Feedback gathered through Family and Carer Listening Events, reviews, surveys and ongoing communication influenced service development and quality improvement initiatives. Leaders ensured improvements were communicated back to families, creating confidence that feedback was valued and used constructively.

As a result, people experienced care within a service that continuously evolved, learned and improved. Innovation was purposeful, improvements were measurable and leaders demonstrated a clear commitment to achieving the best possible outcomes for people through reflection, collaboration and creativity.