Hardwick Dene

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 assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to governance at the service. 

This service scored 57 (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.

Leaders demonstrated an understanding of the challenges facing the service and promoted a culture of openness and continuous improvement. During the inspection, leaders were receptive to feedback and spoke openly about areas requiring improvement. They described the actions being taken to improve people's experiences and the quality of care provided.

Staff understood the provider's vision and values and described a culture focused on providing person-centred care and improving the service. Staff consistently described leaders as approachable and supportive, and their feedback reflected leaders' commitment to listening, openness and continuous improvement. A staff member said, "The managers are open to feedback and always encourage us to share ideas about how we can improve the service."

Not all leaders understood the context in which the provider delivered care, treatment and support. They did not always embody the culture and values of their workforce and organisation. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively, or they did not always do so with integrity, openness and honesty.

Leaders did not always demonstrate effective leadership oversight to ensure the quality and safety of care. Although leaders were visible within the service and staff described managers as approachable and supportive, significant concerns relating to care planning, risk management and monitoring remained unidentified until the inspection. This reduced assurance that leaders had effective oversight of the quality and safety of care and were identifying and addressing concerns in a timely way.

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

Staff felt able to raise concerns and speak openly with leaders. Staff described managers as approachable and accessible and told us they felt comfortable raising concerns. They described positive working relationships with leaders and said they felt listened to.

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.

Staff spoke positively about working at the service and described an inclusive working environment. Staff told us they felt respected and supported by colleagues and managers. Staff had completed equality, diversity and inclusion (EDI) training to support inclusive practice. These arrangements helped create a positive and inclusive working environment.

The provider did not have clear responsibilities, roles, systems of accountability and good governance. They did not act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

The provider had governance, auditing and monitoring systems in place; however, these were not always effective in identifying and addressing concerns affecting the quality and safety of care. During the inspection, we found a number of issues that had not been identified through the provider's governance processes. These included inaccuracies within care records, gaps in care planning and shortcomings in risk management.

Governance systems had not identified shortcomings in the oversight of people's health needs, despite governance, auditing and monitoring processes being in place. These issues had not been identified or addressed through the provider's own governance arrangements prior to the inspection, reducing assurance that leaders had effective oversight of the quality and safety of care and that risks to people were consistently identified, monitored and managed.

The provider did not always understand their duty to collaborate and work in partnership, so services worked seamlessly for people. They did not always share information and learning with partners or collaborate for improvement.

Opportunities to develop wider partnerships and make greater use of community resources had not always been fully explored. There was limited evidence of the service engaging with community organisations and local resources to promote people's wellbeing, social inclusion and opportunities to participate in community life.

The service worked appropriately with healthcare professionals, including GPs, district nurses and specialist services, to support people's healthcare needs. However, partnership working beyond statutory healthcare services was less well developed. This reduced assurance that wider partnerships were consistently used to improve people's experiences, wellbeing and quality of life.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not always actively contribute to safe, effective practice and research.

The provider had begun implementing improvements across the service; however, these had not yet become fully embedded or consistently improved the quality of care provided. The provider had recently introduced an electronic care planning system and was supporting staff to transition from previous recording methods. Leaders also told us they planned to introduce an electronic medicines administration record (eMAR) system once the electronic care planning system had become established.

The provider was also undertaking environmental improvement works and had identified further opportunities to enhance people's safety and experiences. Although leaders demonstrated a willingness to improve the service, the improvements were still at an early stage and had not yet consistently translated into improved outcomes for people.

There was limited evidence that the provider had adopted innovative approaches or wider opportunities to improve people's experiences, outcomes and quality of life. This reduced assurance that continuous learning, innovation and improvement were consistently driving sustainable improvements across the service.