The Grange

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 inspection we rated this key question requires improvement. At this inspection the rating has changed 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 service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion. The service focussed on staff engagement with people and their communities gaining an understanding of their needs. The registered manager told us that recent inspection had supported learning and driven improvement within the service. The registered manager told us, “I have learnt a lot from the recent inspection, and we have changed a lot of our processes to ensure they are more robust, and we now have effective and efficient systems in place.” The management had clear values and had developed a listening culture where staff felt they were available for them to talk to.

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. The registered manager was clear about their roles and had the skills, knowledge and experience to perform their job. The registered manager felt supported by the provider who also completed regular audits and monitoring.
The registered manager told us, “We have worked through the action plan to ensure we have met all previous actions.” The registered manager had clear values and had developed a listening culture where staff felt they were available for them to talk to.
There was a clear staffing structure in place with 2 senior leads supporting the registered manager with the day to day running of the service.
 

The service fostered a positive culture where people felt they could speak up and their voice would be heard. The registered manager had a policy and processes for staff to follow on ‘whistle blowing.’ We reviewed staff meeting minutes and saw they included information about the service as well as reminders about training, staff rota’s, safeguarding, incidents and PPE. There was detailed action plans completed to evidence how issues raised were to be addressed, dates to be achieved and if actions had been resolved or remained outstanding. The registered manager also held regular discussions with people to share their thoughts about how the service was ran and to discuss the support they received and if any improvements could be made. A member of staff told us, “We have regular meetings and supervisions with the manager which is a good opportunity for us to discuss anything with them.”

The service valued diversity in their workforce. The provider worked towards an inclusive and fair culture by improving equality and equity for people who worked for them. There was a policy in place to protect staff from harassment and bullying and a focus on protected characteristics under the Equality Act. The registered manager had developed an inclusive workforce and recognised the value of diversity amongst the team.

The service 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. Improvements had been made since our last inspection, and the service was no longer in breach of regulations. The management team had established audits which provided them with a good oversight of the service. The registered manager had given staff a clear direction of their vision for the service. Staff understood their role and contribution in sustaining improvements.
The registered manager and provider had good oversight of the service. The registered manager monitored the service through audits they had in place, to evidence quality assurance processes. These audits helped to shape the service with actions plans for continual improvement and oversight.
The registered manager understood their responsibility under duty of candour to be open and honest when things went wrong and investigate these. Notifications were raised promptly to the appropriate authorities when required these included the CQC and local authority safeguarding team.
 

The service 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 registered manager had developed good links and worked closely with health professionals. This included GPs, district nurses, occupational therapists and social workers.

The service focused on continuous learning, innovation and improvement across the organisation and wider system. They encouraged creative approaches to promote equality of experience, outcomes and quality of life for people. The service had learned lessons from the previous inspection and taken action to drive improvements and enhance outcomes.
The registered manager worked closely alongside the provider to review governance processes, strengthen quality assurance systems and drive further improvements in the service.