Hylton 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 remained requires improvement. This meant management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

This service scored 61 (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. New staff received support and training which helped them to demonstrate the provider’s values in their daily work with people. A staff member commented, “I find the work very rewarding, the provider provides care in line with their values. Staff support people to be as independent as they can be.” People and professionals said the service encouraged people to regain or maintain their independence and extend their abilities.

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. Staff members’ comments included, “The manager is very supportive, you can go to talk about concerns, they listen and sort things out” and “The manager is very approachable.”

We received mixed feedback about the effectiveness of communication from some professionals and relatives. A professional commented, “I always find staff friendly, approachable and attempt to be helpful when I visit my client. However, I (and the independently instructed multi-disciplinary team) have had numerous issues with communication.” Some relatives also commented they were not always updated about their loved one’s care.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.The provider had a clear whistle blowing policy. Staff could raise concerns, and written information was available of how to do this. Staff meetings took place, and staff had the opportunity to share comments and give feedback. People were informed of the complaints procedure when they started to use the service and at meetings.

The provider valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them. Staff told us they were able to ask for reasonable adjustments to be made to their working patterns for specific needs, for example to incorporate family commitments.

Improvements were needed to governance to ensure the governance was effective and robust, including the monitoring of the quality-of-service provision. Staff and leaders knew their responsibilities around quality and safety monitoring and governance. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate. Regular audits and checks were carried out in the main areas of the service, such as, around care records, health and safety and staff practice. The manager and senior staff could explain governance systems in the service and their individual responsibilities. However, audits were not always effective as improvements were needed to medicines management to ensure people's safe care and to care records and communication. Systems were not all robust to ensure where improvements were made they were embedded and sustained as identified with medicines management.

Staff at 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. A range of care professionals described the very positive working relationships the staff had promoted for the benefit of people who used the service. A professional commented, “We have delivered bespoke training regarding my client’s needs and all staff attending seemed invested, motivated and willing to learn.” The management team were positive about their links with local partners and health and social care teams. Management attended local provider forums to share good practice.

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. There was evidence of changes that had been made to the service to make improvements and to address checks and audits outcomes and in response to people and staff feedback. However, we identified further improvements were needed in areas as described in sections of the above report.