Prestige Nursing- Ashby De La Zouch

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 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 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 89 (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 registered manager had developed a clear vision and strategy for the business. This involved providing the right care at the right time and working with people, families and other agencies to improve people’s quality of life in their own homes. These values were central to the service structure and governance framework, and we found they were present in the culture and vision of the service; ensuring people received a flexible service that met their needs. A relative told us, “They are really good at personal care and interaction. They look after [Name], treat them like one of their parents. They are particularly good; I would recommend them.” A person told us, “I lost my keys (outside of a visit) and somebody came to help me find them.” The registered manager had instilled clear expected behaviours and actions associated with these values and staff understood and applied these in practice. Staff told us, “I feel each individual staff is supported to put their best into the job; to get the best possible outcome for each person. It is a really good service to work for” and “I don’t ever go home disappointed because I know I am able to do my best here.”

The provider had exceptionally 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 always did so with integrity, openness and honesty. The management team were passionate and ambitious. They had a clear drive to provide high quality care and there was a commitment to continuous development. The management team demonstrated the provider’s values and behaviours and modelled an open and approachable team culture. They were skilled, knowledgeable and had high expectations. They went out of their way to meet people using the service and ensure they received a personalised service. Staff felt extremely well supported by the management team. They felt managers were knowledgeable, skilled and professional. They commented that managers were approachable and they felt comfortable speaking with them and assured they would be listened to. A staff member said, “[Registered manager] is an excellent manager. Always listens and chases up what needs to be done. They are very fair and do a really good job of supporting staff.” Care staff worked in partnership with their management team. They felt involved in the service and able to contribute to service improvement and development. A staff member told us, “[Clinical lead nurse] is a massive support for staff. They take time to train, educate and work with staff. They work through things with us and discuss issues, solutions and changes.” People and relatives felt the management team were friendly, compassionate and approachable. They took time to get to know the people receiving support and checked in to ensure they were happy with how they were being supported. People and relatives told us, “I don’t have any problems whatsoever with the management. [Registered manager] is on top of everything. They act pro-actively before it becomes an issue;” “It’s exceptionally comprehensive as a service. [Registered manager] is very good at following up on other paperwork DOLS, MCA etc. They regularly make sure the care plan is up to date and reviewed. They will always copy me into emails” and “It’s managed very well; they are always there for me if I need anything.” The provider worked in partnership with the people receiving care and their relatives. People, relatives and staff were encouraged to complete satisfaction surveys and feedback about service delivery. This feedback was analysed and used to inform service development. People and their relatives felt well informed and there was good communication with their care team and the office staff. A relative said, “I’ve just filled in a questionnaire. I regularly get a call, how is it going, are you happy with everything.” There was a drive and passion within the staff team, and it was evident from conversations with staff, that there was a clear partnership with people and families. Staff took the time to get to know people and understand their priorities to develop that partnership working.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. People and relatives told us they felt staff and the management team listened to their concerns or requests and action was taken promptly. A person told us, “I can speak to any of the staff or the office. They get back to me, they ring me back all the time if it’s engaged." A relative said they felt able to speak to any staff or the registered manager if they needed to. Staff told us there was a culture where they were given opportunities to speak up, both formally and informally.

The provider strongly valued diversity in their workforce. They had an inclusive and fair culture which had improved equality and equity for people who worked for them. Policies were in place to protect staff welfare and ensure equality and diversity in the workforce. Various policies were in place to accommodate flexible working and ensure staff’s individual needs were supported. The management team supported staff to adjust their working arrangements to accommodate their personal needs during difficult or challenging times, or in times of ill-health. The management team had introduced initiatives to promote team working and staff morale. This included recognition and reward for hard work, achievements and contributions. There was a cohesive staff team and staff felt supported by their colleagues. Staff told us there was no tolerance towards discrimination and all staff were welcomed. One staff member said, “It is very important that, as a person’s staff team, we all get on and communicate well. Managers are really good at putting together compatible staff teams that work well and provide a high standard of care.”

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate. Systems were in place to track compliance with key governance systems, including regular programmes of telephone calls, visits, medicine and care reviews. We saw these were used to ensure staff were meeting people’s needs and to monitor people’s wellbeing. Staff liaised with people’s relatives if they identified a dip in the person’s emotional health. A governance framework was in place which included a programme of audits, quality and risk meetings and governance committees to review key performance data and review the quality and safety of service delivery. Throughout the inspection we saw the impact of this oversight in delivering excellent safe care to people. For example, medicines were well managed, reviewed and individualised to ensure good outcomes for people. Timely action was taken when audits identified the need for improvement. The registered manager was proactive in developing the service. For example, they had identified improvements were needed to processes around mental capacity and systems to capture information and assessments. They were developing new systems to improve this. They had identified gaps in the provider’s processes for ensuring the safety of staff lone working and driving for work. They had implemented more robust processes and contingency planning to ensure staff were fully supported and safe. Office staff and support staff worked well together and understood how their duties impacted and supported the other. The registered manager worked well with the management team and respected each staff member’s abilities and contributions. This supported staff to undertake work to their best abilities and created an effective team.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with families and partners and collaborated for improvement. Staff worked with external agencies and the local community to ensure people could access the services they needed and had equal access to facilities and opportunities in the local community. This included links with education and community facilities.

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. Staff were supported to undertake ongoing refresher training which contributed to safe, effective care. Staff developed their skills so they could support and train other staff. The culture was an open one in which staff could ask questions and were supported to reflect on their experiences. The providers’ systems supported openness and learning. The electronic records system was understood by staff on a day-to-day basis. The registered manager was continually developing systems to interrogate the system further to understand the learning it could help provide. They kept updated about best practice and shared information and learning with staff.