Creative Support - Cecil Gardens

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• 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

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.

This is the first assessment for this service. This key question has been rated 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 68 (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 provider had a clear set of values referred to as ‘We Care.’ Each letter stood for a different value which included welcoming, respectful and effective. The provider embedded these values into the running of the organisation. They referred to them within meetings and discussed whether new programmes or initiatives met these values. This helped to ensure staff and people who used the service were aware of these values.

Not all leaders understood the context in which the provider delivered care and support. They did not always embody the culture and values of their workforce and organisation. Leaders had the knowledge, experience and credibility to lead effectively.

Members of the provider’s management team were regularly in the service to oversee and drive improvements. They were knowledgeable about the running of the service and keen to emphasise the changes and positive impact. One staff member said, "We’re really getting on the up in this place." The team worked closely with the local authority to make the necessary improvements.

There had been several changes to the management team in a short space of time. At the time of our assessment, a registered manager was in post. However, another member of staff had been appointed and was being supported to move into this role. As a result of the changes, people who used the service were not clear about who was running the service. People did, however, feel confident in approaching staff members they were comfortable with to share any concerns.

We received mixed feedback from staff about how the service had been led during the changes; with some feeling these had been well-managed whilst others described feeling unsupported. The provider acknowledged there had been a lot of changes and the potential impact of this. They noted the different avenues of support in place for people. These included agreeing to flexible working requests, and routes to escalate concerns outside of the management team.

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

Staff gave us mixed feedback about their confidence to raise concerns. Some staff were confident in the processes and felt they would be listened to whilst another said, “Staff are not being supported by the management team. If staff have a concern, they can’t tell the management team as nothing will be done about it.”

There were several routes for staff to escalate their concerns which included a telephone line where concerns could be raised anonymously and a staff suggestions box, where staff were invited to share their feedback. A representative from the human resources department had attended the service and invited staff to share their feedback about the changes made at the service. A member of the provider team had written to all staff to share their responses to the concerns.

Regular staff meetings were held, and staff contribution to the meetings had recently been added to the agenda to ensure this was captured. One staff member told us, “We have monthly staff meetings where management update us on any new rules they’ve put in place and areas staff have improved. They tell us areas we need to work on to ensure that quality care is being provided for the people we take care of.”

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 took efforts to understand and promote an inclusive culture at the service. Staff completed anti-racism training, and the provider had an equality, diversity and inclusion strategy. This gave clear reporting lines for those who have experienced or witnessed incidents of discrimination. The provider had also created resources for staff and managers to understand different religious festivals to guide them in how they supported people during these times.

The provider did not always have clear responsibilities, roles, or good governance. They did act on best information about performance and outcomes and shared this securely with others when appropriate.

The providers checks had identified and driven improvements in some areas. However, these had not consistently identified the concerns noted during the assessment. For example, time specific medicines had not been administered at the correct time, risk assessments lacked detail or contained inconsistent information, and fluid balances not effectively monitored. This presented a risk people may not receive high quality, safe care. People had not been affected because of these. The provider swiftly implemented corrective measures which were shared with the staff team to improve practice.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners for improvement, including the local authority. The service shared relevant information with the housing provider, and escalated safety concerns. A programme of activities and events was organised and all who lived at the service were encouraged to participate. This aimed to promote a sense of community within the service.

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. There were both weekly and monthly staff team meetings to discuss a wide variety of topics. For example, incidents which had occurred, outcomes of the provider’s audits and key policy updates. This helped to develop staff practice. Consideration was giving to wider organisational learning. The provider held conferences which were an opportunity to revisit the strategic plan, support peers and provide updates from assessments and checks of services. The provider also had assurance groups who considered how their practice could be improved, following best practice, in areas such as medicines and moving and handling.