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 requires improvement. At this assessment the rating has improved to 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.

Since we last inspected the service’s culture had developed and improved. Relatives said they were now more involved in how it was run. A relative told us, “[The service is] very different now, you feel you can ask and be shown things, managers are very open and above board.”

Another relative said they had more input into their family member’s care, and this was positive for them. They told us they had taken part in improving their family member’s room. They commented, “When I go there, I get a good vibe feeling, I don’t feel I can’t or shouldn’t be there. Welcoming, friendly and kind, a nice atmosphere, it’s been a godsend for us knowing [person] is well looked after, really good.”

Staff also praised the improved culture at the service. A staff member said, “The service has done a full U-turn. There are more activities for people and people are central to the service. The managers are approachable.” Another staff member told us, “[Interim manager] is brilliant – they’ve turned the place around. There are more activities now, and more trips out.”

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.

At the time of our inspection the service did not have a registered manager in post. A potential registered manager had been identified and was due to start work at the service. In the meantime, the provider had appointed a competent and experienced interim manager who was running the service effectively supported by one of the provider’s compliance managers.

A relative said the interim manager was, “Very approachable, I could talk to them for hours, they are lovely and welcoming and do the best they can. They communicate well by phone or email.” Another relative told us, “It’s very well managed and if we need to know anything they ring us and get back to us. They get in touch about appointments. We sit down and speak with management, and they listen and understand where we are coming from.”

The interim manager led by example, modelling inclusive behaviours, and open and cooperative relationships. Relatives and staff felt listened to and supported. New systems were in place to ensure any issues about the quality of the service were identified and addressed. Where necessary, the interim manager accessed appropriate support and development in their role from one of the provider’s compliance managers who was assigned to the service.

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

Staff spoke out if they had any concerns about the service. They told us managers were open to feedback and encouraged it. A staff member commented, “They want everyone to be part of improving the service. They ask for our views when they make changes and if we don’t agree with something they listen.”

The provider sought staff feedback through annual staff satisfaction surveys. Outcomes were reviewed and addressed through ‘You said, We did’ initiatives, ensuring staff feedback informed improvements at the service.

The service operated an open-door policy, allowing staff to approach managers and care team leaders at any time to discuss concerns or seek guidance. Staff also shared their views at staff meetings, supervisions, and appraisals.

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 completed annual mandatory training in equality, diversity, and inclusion to ensure awareness, understanding, and application in daily practice. The provider’s equal opportunities policy was accessible and included in the staff handbook.

Managers complied with the Equality Act 2010. They made reasonable adjustments for staff with disabilities, health conditions, or other protected characteristics. Staff said managers were supportive of their personal circumstances and enabled them to work flexibly where necessary.

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.

At our last inspection the provider’s audits had failed to identify shortfalls at the service, namely an institutional practice, and care plans lacked evidence of people’s involvement in planning their care. At this inspection these shortfalls had been addressed. The institutional practice had ended, and staff were using a range of communication methods to ensure people had a say in their care to ensure it reflected their goals and aspirations.

The service’s audit system had improved. Managers and senior staff carried out a series of checks and audits to ensure the service was running safely and effectively. They were supported by the provider’s compliance team who reviewed audit findings and carried out their own regular audits. The information collected was compiled in a provider-level quarterly governance report.

Audits showed the service identified shortfalls and put action plans on place where necessary to address them. Action plans requested by the local authority and CQC were included. This meant managers and the provider had oversight of the service and a clear understanding of what needed to be done to achieve ongoing compliance and fulfil their contractual obligations.

Manager walkarounds and ad hoc observations on shifts had increased ensuing the interim manager understood how the service was performing on a day-to-day basis. The interim manager was knowledgeable about all the people using the service and their support needs, and the strengths and abilities of the staff team.

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.

Together with the NHS Local Partnership Trusts (LPT), the provider had ensured that, where necessary, care staff had the training they needed to carry out delegated care tasks. This resulted in one of the provider’s employees being accredited by the LPT to deliver delegated care task training to care staff. This meant training could be promptly provided in-house when it was required.

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.

Managers shared information and learning with other health and social care organisations to bring about improvement.For example, they worked with the local authority to better understand and address safeguarding issues.

The provider kept up to date with developments in learning disability support. They followed the Justice for Oliver campaign (which came about after the death of Oliver McGowan, an 18-year-old autistic person). Staff completed Oliver McGowan Training on Learning Disability and Autism. This helped to ensure they had the right skills and knowledge to provide safe, compassionate, and informed care to the people they supported.