East Bristol Reablement Service

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 requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care. The service was in breach of legal regulation in relation to good governance.

This service scored 62 (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 values of the organisation were on display at the service. Staff reviewed the values as part of their induction and ongoing training. The service aims were clear in the service’s statement of purpose and service user guide. Staff told us they worked together as a team to achieve the service’s aims and objectives in supporting people with reablement.

People spoke positively about the culture of the service and the support they had received. A person said, “They are very good at treating me with the utmost dignity.” A staff member said, “Our service is brilliant and we promote independence, people enjoy us going there, people feel safe, we work brilliantly as a team.”

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. The service had a clear staffing structure with designated roles and responsibilities. Staff told us they were supported in their roles. A staff member said, “I can go to the registered manager for anything.” Leaders had access to training relevant to their roles from within the organisation to support their learning and development.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Systems were in place for staff to speak up including supervisions, staff meetings and surveys. A staff member said, “I would have no hesitation in speaking about a concern.” Staff could input into a wider organisational workplace survey. Staff told us they could raise things. However, some feedback was that changes did not always then occur. A staff member said, “It easy to raise things, not sure if we’re always heard.” This related mainly to staff travel time and organisation of visits.

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.

The provider had an equality and diversity policy which underpinned equitable treatment of service users and staff. The service had a diverse staff team which brought a range of skills and knowledge. Staff told us they worked well together and were supported by their colleagues. Equality and diversity were discussed regularly in team meetings. Events and national observations were highlighted, for example religious festivals, awareness days and significant remembrances. This ensured staff would be aware of these in relation to the people they supported.

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

Governance systems failed to consistently identify regulatory shortfalls or drive service improvements. Although leaders conducted regular audits, these checks lacked the depth required to recognise specific gaps in medicines management, person-centred care planning, goal monitoring and individualised risk assessments. Three safeguarding notifications had not been submitted to CQC as required. Management audits of safeguarding concerns raised had not identified these had not been submitted. Notification of other reportable incidents had been sent to CQC as required.

Staff received training in data management and confidentiality. Leaders were vigilant about confidentiality of information. The provider’s CQC assessment rating was displayed at the service and on the provider’s website as required.

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 had positive working relationships with other departments and relatives. Staff directed people to information and services within their local community which could benefit them in their reablement journey.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not always actively contribute to safe, effective practice and research.

Whilst improvements in the service were made, these were not formally demonstrated to show the progress made. For example, changes had been made in the recruitment process to improve the interview questions. Governance systems did not link to a service improvement plan.