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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

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 outstanding. At this assessment the rating has remained 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 96 (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 very clear shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the challenges and the needs of people and their communities.

The service demonstrated a strong, relationship-led culture that was open, inclusive, and centred on shared learning. The registered manager had established clear values which were fully embedded into everyday practice, and staff were consistently supported to understand and live these values in their work. This created a positive and cohesive environment where people, relatives, and staff felt valued and respected.

Feedback highlighted the strength of relationships developed between staff, people using the service, and their families. One relative told us, “They’re like family to [person]. They support everyone, all the family, not just [person].” This reflected a culture that went beyond task-focused care, instead promoting compassion, trust, and holistic support.

Staff worked in small, consistent teams, which strengthened relationships and enabled a shared understanding of people’s needs, preferences, and aspirations. This continuity supported a culture of accountability and pride in delivering high-quality care. Staff demonstrated a genuine commitment to learning from each other and from people’s experiences, using this to continuously improve how care was delivered.

There was a clear emphasis on openness, where feedback was welcomed and used constructively. The service actively encouraged honest communication with people, relatives, and staff, fostering a culture where concerns could be raised and addressed quickly. This strong, values-driven culture ensured that everyone involved with the service was working towards a shared goal of providing high-quality, person-centred care, resulting in consistently positive experiences for people and their families.

Leaders within the service were highly regarded by staff, people, and relatives, with feedback consistently highlighting their compassion, visibility, and effectiveness. There was a strong sense that leaders were approachable, supportive, and genuinely committed to the wellbeing of both people using the service and their staff team.

Staff described a positive and empowering leadership approach. One staff member said, “I feel the management are supportive of our wellbeing and ensure there is a structure in the office to provide efficient assistance to staff where needed.” Another shared, “I believe the management team are dedicated, approachable and genuinely supportive. For me the service is such a great place to work, and I think that reflects strong leadership.” This demonstrated leaders had created an environment where staff felt valued, supported, and able to deliver high-quality care.

Leaders were also committed to continuous learning and improvement. The registered manager was in the process of completing two professional qualifications and had actively engaged in CQC roadshows to keep up to date with changes in regulation. They told us, “We realised it was very important for us to keep up to date. We keep on the look out for external trainings. We make that concerted effort to seek out [information and training opportunities].” This proactive approach ensured the service remained forward-thinking and responsive to best practice guidance. They told us they shared learning with staff in a variety of ways. The registered manager said, “We’ve done some workshops with staff in addition to their normal training. Last summer we had a run of medicine issues. We got staff to share with each other, support each other and come up with best practice. We also share learning through quarterly meetings, feedback directly to care teams involved with individuals and in weekly huddles. We work really hard to make sure we have a learning culture. In every meeting with staff we talk about major learning that we have and it is shaped by the staff. There was a significant drop in medicine errors after this.”

Relatives also spoke highly of the leadership team, highlighting the consistency and professionalism of the management structure. One relative commented, “[The service] is so personable at all levels. The management structure is stable in the office and they’ve got it sussed.”

This strong, values-driven leadership fostered a culture of inclusivity, learning, and high-quality care, ensuring positive experiences and outcomes for people and creating a motivated and supported workforce.

Leaders were further strengthened by the active involvement of the nominated individual, who played a visible and hands-on role in the day-to-day running of the service. Their presence and engagement provided additional oversight, guidance, and reassurance to both the management team and staff. Management described feeling well supported by the nominated individual, as well as by colleagues at head office, which contributed to consistent decision-making and a shared sense of direction. This support enabled leaders to maintain high standards, respond effectively to challenges, and continue driving improvement across the service.

The provider was exceptional at fostering a positive culture where people knew they could speak up and their voice would be heard.

The service had developed a highly open and transparent culture where staff felt confident, supported, and empowered to raise concerns or challenge practice without fear. All staff we spoke with demonstrated a clear understanding of how to speak up, including the option to do so anonymously if needed, and consistently told us they would feel comfortable doing so.

Staff described a positive and approachable management style that encouraged honesty and open dialogue. One staff member said, “[The service] has an open-door policy. If I’ve got something to say I would be happy and confident to speak up.” Another told us, “I feel management encourage openness and genuinely listen to staff feedback and concerns.” This reflected a culture where staff voices were valued and acted upon.

Survey results further supported this strong culture of openness. In a staff satisfaction survey with a response rate of over 80%, 82% of respondents agreed with the statement, “It is safe to speak up and challenge the way things are done, or to raise a concern.”

Leaders actively promoted psychological safety and continuous improvement by encouraging staff to share ideas, feedback, and concerns. This inclusive approach ensured issues could be identified and addressed early, contributing to high-quality care and a positive working environment.

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 service promoted an inclusive working environment where staff felt respected, valued, and supported in their roles. Feedback from staff reflected a positive culture in which individuality was recognised and contributions were appreciated. One staff member told us, “I feel respected, supported and valued within my role.”

Leaders fostered a culture of fairness and inclusion, ensuring staff were treated equally and had access to the support they needed to carry out their roles effectively. Open communication and supportive management helped to create an environment where staff felt able to be themselves and contribute to the ongoing development of the service.

The service’s emphasis on teamwork and strong working relationships further supported inclusion, enabling staff from different backgrounds and experiences to work together effectively. This helped to ensure a stable and motivated workforce, which in turn contributed to positive outcomes for people using the service.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver high-quality, sustainable care, treatment and support. They always acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

The service had highly effective governance systems in place to monitor, assess, and continually improve the quality and sustainability of care. A comprehensive programme of audits was used to provide robust oversight, including regular internal checks, quarterly audits completed by the nominated individual, which is above and beyond the recommended annual check, and wider organisational (national) audits. These multiple layers of review ensured any issues were identified promptly and addressed effectively.

The service also provided in person quality assurance visits and spot checks during care visits. This provided further opportunities for people to share any issues they had with their support and for the registered manager to observe the relationships between staff and people receiving the care. This approach placed people central to the quality monitoring of their care and ensured the leaders of the service were visible and easily contactable. This collaborative approach led to better outcomes for people as they were able to be involved in the every day decisions about their care package such as whether an additional carer needed to be added to their care team.

There was strong oversight and accountability at all levels of the organisation. The active involvement of the nominated individual in quality assurance processes supported consistent standards and demonstrated a clear commitment to maintaining high-quality care. Findings from audits were used constructively to drive improvement and sustain positive outcomes for people. The nominated individual told us that when the current registered manager joined the service there were improvements that needed to be made. They told us, “We had a couple of poor audits from national office and the nominated individual paid for additional support to come in. The staff team have blossomed.” We saw that audits of the service had identified where information had been missing from plans and a clear action plan was drawn up to address these.

The service also demonstrated good regulatory compliance. All statutory notifications were submitted promptly, reflecting a transparent and well-managed approach to meeting regulatory requirements.

Leaders had established a culture of continuous improvement and learning, supported by effective monitoring systems and strong organisational support. This ensured the service remained sustainable, responsive, and consistently delivered high-quality, person-centred care.

The provider clearly understood and carried out their duty to collaborate and worked in partnership, and services worked seamlessly for people. They always shared information and learning with partners and collaborated for improvement.

We found extensive evidence that the service actively engaged with, and was well embedded in, the local community. The service engaged in a wide range of regular community activities, including those organised by the service directly as well as events arranged by external organisations. This demonstrated a strong commitment to inclusion, wellbeing and community connection.

The service had established and maintained positive, ongoing partnerships with other organisations. This included a continuing partnership with a local health organisation, which supported people’s health and wellbeing outcomes. The service was also working closely with a local day care provider in a dementia champion capacity, sharing knowledge and good practice to improve dementia awareness and support across services.

The service was also proactive; they organised community-focused events that reflected people’s needs and wider health priorities. These included menopause awareness and support sessions, as well as both group and one-to-one dementia awareness support. These initiatives showed the service was responsive, forward-thinking and dedicated to promoting education, awareness and holistic support within the wider community.

There was clear evidence of effective collaborative working with the wider multi‑disciplinary team involved in supporting people’s needs. The service worked closely with health and social care professionals, ensuring information was shared appropriately and care was well coordinated. This joined‑up approach supported timely decision‑making, consistency of care and positive outcomes for people using the service.

The service also ensured people were kept well informed about opportunities and events in the wider community. Information about what was happening locally was shared through regular newsletters, supporting people to stay connected, make informed choices and engage in community life in ways that mattered to them.

The provider had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

The service demonstrated a strong and embedded culture of continuous learning, improvement, and innovation. Leaders actively promoted professional development, and staff were encouraged to build their knowledge and skills in areas of personal interest as well as those relevant to their roles. The registered manager, who had a background in training, played a key role in championing this approach, supporting staff both in the office and in the community to develop and grow. This commitment ensured staff remained engaged, knowledgeable, and confident in delivering high-quality care.

The service went beyond the traditional expectations of a domiciliary care provider, taking a proactive role within the local community. They aimed to act as a hub for information and support, helping people and families access guidance and resources beyond their immediate care needs. This innovative approach demonstrated a commitment to improving wider outcomes and supporting community wellbeing.

There was clear evidence of reflective practice within the service. Leaders and staff regularly analysed the care and support provided, identifying what worked well and where improvements could be made. Learning from experiences was embedded into practice, enabling the service to continuously refine and enhance the care delivered.

This strong focus on learning and innovation ensured the service remained forward-thinking, responsive, and committed to delivering consistently high standards of personalised care.