Care and Support Service - Monica Wills 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 good.

At this assessment the rating has changed to 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 93 (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 clear vision that placed older people at the heart of the service. Staff and managers consistently described values of being people-focused, caring, honest, responsive, inspirational and dedicated. These values promoted inclusion, respect, equality and person-centred care and were evident in the way support was delivered across the service.

Staff told us the values were embedded through induction, training, supervision and regular team meetings, creating a consistent culture focused on achieving the best possible outcomes for people. The values were reflected in the wide range of opportunities available, which enabled people to remain active, maintain independence and continue contributing to their community in meaningful ways.

One staff member told us, “Everything we do is about supporting people to live the life they want to live.” People and relatives gave examples that reflected this culture, describing how staff took time to understand individual preferences, aspirations and strengths, and adapted support accordingly. This values-driven approach empowered people to make choices, pursue their interests and achieve outcomes that mattered to them. As a result, people experienced a strong sense of belonging, purpose and wellbeing, demonstrating that the provider's vision was not only understood by staff but consistently translated into positive outcomes for those using the service.

Leaders at all levels were highly visible, inclusive and demonstrated a deep understanding of the people they supported, the workforce and the wider community. They embodied the organisation's values of being people-focused, caring, honest, responsive, inspirational and dedicated, and consistently led by example. Their leadership promoted a culture where people, relatives and staff felt listened to, respected and valued.

Staff, people and relatives described leaders as approachable, compassionate and supportive. Leaders had the skills, knowledge and experience to lead effectively and were committed to fostering an open, learning culture where feedback was welcomed and used to drive improvement. They demonstrated integrity, openness and honesty in their decision-making and actively encouraged people, relatives and staff to share their views and experiences. One person told us, “I find the village manager is very helpful.” They went on to explain that “She holds residents’ meetings in a very professional approach” and “She conducts the meetings very well.” Another person praised the wider team, saying, “The office staff are very helpful, if they can’t help, they will proactively find someone who can.”

Staff spoke positively about the leadership team and the support they received. One staff member said, “They are approachable and always at the other end of our gadgets if you need support.” Another told us, “I feel comfortable in raising issues and concerns to the team leaders.” Leaders were visible within the service, knew people well and used supervision, meetings and day-to-day engagement to support staff development, wellbeing and the delivery of high-quality, person-centred care.

The impact of this leadership was evident throughout the service. Staff described feeling empowered, supported and motivated to provide the best possible care, while people experienced consistent, compassionate support that reflected their individual needs and preferences. High staff retention, strong teamwork and positive feedback from people and relatives demonstrated a stable and values-driven culture. This helped ensure people achieved positive outcomes and remained at the centre of decision-making, reflecting the provider's commitment to continuous improvement and excellence.

The provider promoted an open and positive culture where people and staff felt confident to speak up and knew they would be listened to. Information was provided in accessible formats tailored to people's individual needs.

Staff felt supported to raise concerns and share feedback. One staff member said, “I feel comfortable in raising issues and concerns to the team leaders,” and another said, “They are approachable and always at the other end of our gadgets if you need support.”

People also described the management team as responsive and approachable. One person told us, “You only need to say it, and it is done,” while another said, “They are friendly and approachable. I would tell them if I wasn't happy with something and I am confident it will be fixed.” These comments demonstrated a culture where feedback was welcomed and acted upon.

The provider valued diversity within its workforce and actively promoted an inclusive and equitable culture. Staff spoke positively about working for the organisation and described feeling respected, supported and valued. They told us the provider embraced diversity, offered flexible working opportunities and encouraged staff to bring their whole selves to work. One staff member said, “It doesn't matter who you are or where you come from, everyone is treated with respect and given the same opportunities.” Staff were enthusiastic and passionate about delivering person-centred care, and their comments reflected a positive workplace culture where inclusion, equality and wellbeing were prioritised.

The provider had effective governance systems and accountability arrangements to monitor quality, safety and performance. Staff received appropriate training and regular competency checks to help ensure safe and effective care.

At the time of the assessment, the provider was inducting a new registered manager to oversee the service. Day-to-day management was provided by a senior manager, supported by team leaders and leads responsible for human resources, operations, quality and innovation. Team leaders were the main point of contact for staff and people, providing oversight of care delivery, responding to concerns and maintaining a visible management presence within the service.

Staff spoke positively about the support they received from team leaders. One staff member told us, “The team leaders are always there when you need them. They listen, give advice and help us find solutions quickly.” Another said, “I can always pick up the phone to a team leader if I need guidance. They are very supportive and approachable.”

People also valued the responsiveness of team leaders. One resident told us, “The team leaders are on the ball. If there is a problem, they sort it out straight away.” Another person said, “You see them around regularly and they always make time to check how things are going.”

The management team regularly reviewed service performance, quality and people's experiences. Audits and monitoring processes were used to identify trends, share learning and drive improvements. Electronic systems supported oversight of care delivery, incidents and actions, while care plan review and staff punctuality monitoring helped ensure people received timely, person-centred support.

Regular meetings with people, relatives and staff provided opportunities for feedback and continuous improvement. Managers told us they felt well supported by senior leaders, which helped promote a culture of accountability, learning and effective governance.

Staff worked collaboratively with healthcare professionals, relatives and community organisations to achieve the best outcomes for people. For example, when 1 person's wellbeing was deteriorating, staff proactively coordinated meetings with healthcare professionals and family members to develop a personalised support plan. The joined-up approach resulted in improved emotional wellbeing, greater engagement in meaningful activities and a reduced need for specialist intervention. This demonstrated how compassionate care, combined with effective partnership working, had a significant and lasting impact on people's quality of life.

The provider demonstrated an exceptional commitment to partnership working and community integration, ensuring people remained active, connected and involved in the wider community. People were supported to maintain important links with local churches and faith groups and to access places of interest across Bristol. For example, people enjoyed visits to local landmarks, including Bristol Cathedral, where they met socially and enjoyed activities such as cream teas.

The service had developed strong relationships with local schools, creating meaningful intergenerational opportunities. Children regularly visited the village, and people supported them with reading, shared life experiences and participated in events such as VE Day commemorations, where people spoke about their experiences of wartime. These initiatives promoted social inclusion, reduced isolation and enabled people to make valuable contributions to their community.

The village was also used by local community groups, including the Stroke Society, which held meetings on-site that people were able to attend. This created further opportunities for people to remain engaged with local issues and community life.

The provider worked seamlessly with advocates, healthcare professionals, local authority teams and community organisations to support people's wellbeing and achieve positive outcomes. Information was shared appropriately with partners, and learning was used collaboratively to improve services. This strong culture of partnership working ensured people experienced coordinated support and remained connected to the communities and relationships that were important to them.

People were actively involved in shaping the service and developing innovative approaches to care. One person told us, “I am always involved at the right level and always invited to take part in anything that affects me.” This was evident in the provider's work with people experiencing sight loss, who helped determine the most effective colours and formats for printed materials, ensuring information was accessible and meaningful to those using it.

People were enabled by an innovation leader to contribute to projects in ways that reflected their abilities and interests. For example, a resident-led beer crafting project involved people growing hops, watering plants, selecting can colours and learning about different stages of production. Staff supported people living with dementia to participate in meaningful ways, helping them develop skills, confidence and a sense of purpose. The Innovation Lead said, “We meet each other where we are.” The project brought together people, relatives and staff, strengthening relationships and promoting inclusion.

Innovation was used to improve people's experiences and outcomes. Staff were trained to use a lifting cushion and introduced the equipment for people before it was needed, helping reduce anxiety and increase confidence. Staff told us the equipment had enabled a person to be safely assisted from the floor following a fall when safe to do so, preventing a prolonged period on the floor and reducing discomfort.

The provider was also trialling hydration testing, which involved using a non-invasive monitoring tool to identify early signs of dehydration. This enabled staff to recognise people at risk sooner, take prompt action such as increasing fluid intake and seeking healthcare advice where needed, helping to prevent deterioration and support people's health and wellbeing.

Leaders told us this had helped reduce the risk of hospital admissions during periods of hot weather. Additional innovations included smart sock technology to identify potential health deterioration at an early stage and pain assessment technology to support people who could not easily communicate discomfort. A relative told us, “I am very impressed with how innovative they are. They always seem to have the best technology available to help people live their best life.”

Learning was embedded throughout the service. Incidents, complaints and changes in people's needs were reviewed and used to improve care planning, training and practice. This proactive approach to co-production, learning and innovation helped improve people's independence, wellbeing and quality of life.