Pear Tree House

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.This is the first assessment for this newly registered service. This key question has been rated 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.

There was a clear focus from all to provide a high-quality service for the person. Leaders and all staff had adopted the philosophy and culture of the service and created a person centred, safe and individual environment for the person to live in.

There were processes in place that were emphasised and continually reviewed to ensure the service promoted a positive culture for both staff and the person they supported. Staff embedded the providers ethos of ‘The difference that defines us’ by continually working to make the service individualised. Staff were encouraged to and embraced the culture that the provider and the registered manager had created and shared the vision of the home. Staff were proud to be part of the team that created a positive environment for people to live and thrive in.

The culture leaders had created had allowed the person to thrive in their environment and staff were continually encouraged to challenge themselves and develop how they worked with the person to make things better. Through individual supervisions, staff were actively asked to participate and answer questions on the culture and vision of the service along with suggesting ways this could be developed and embedded for the person who was supported. This made staff feel like they were valued members of the team.

There was a whistleblowing policy in place and staff were aware of this and the procedures they needed to follow. They were actively encouraged by the registered manager and other team members to identify and raise concerns if needed to create an open, honest and transparent culture within the home.

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.

All relatives, staff and professionals spoke positively about the management team and how the home was run and the culture that had been adopted. The person’s interaction showed they engaged and were trusting of the management team. A relative told us, “I know all the managers they are all great.” A professional told us, “The nominated individual is the go-to person for coordination, oversight, and problem-solving. His leadership style strengthens the homes. He works closely with each team. Supports managers effectively. Ensures consistency across services. Drives forward quality and compliance. Stakeholders frequently comment on how responsive, knowledgeable, and helpful he is.” Another professional commented that the registered manager’s contribution led to, “Exceptional outcomes for people.”

The registered manager was focused on delivering care based on the provider’s philosophy of ‘The difference that defines us’ and in line with the right support, right care, and right culture guidance. The culture focused on the person being at the heart of every decision, a focus on the person’s strengths and encouraging and supporting the person to live a meaningful life.

There were systems in place to ensure all staff understood their roles and responsibilities and there were clear lines of delegation. We had been notified of events that had happened within the service in line with the provider’s legal responsibility to so do.

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

No concerns were shared with us and relatives confirmed they knew how to complain. They spoke positively about the home and the support their relation received and told us any complaints would be addressed. The feedback we received and reviewed about the home was all positive.

Staff felt able to report any concerns and confirmed they would be supported during any such time.

The provider valued diversity in their workforce.

Staff felt they were treated in an inclusive way, and their diverse needs were considered. Staff spoke positively about their experiences and shared that it was a good place to work. One staff member told us, “I am so happy, everyone is chilled and enjoying life, it’s a great place to work”. There were processes in place to consider staffs individual needs.

The provider had clear responsibilities, roles, systems of accountability and good governance.

There were audits in place which monitored the care the person received, including the safety of the environment and the management of medicines. There was a system in place to monitor and review accidents and incidents that had occurred. Provider audits were also completed and shared with the registered manger to ensure a more robust oversight. All audits were effective in identifying areas of improvement and making changes where needed.

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.

From the start of the person’s journey, the leadership team and staff worked collaboratively with families and professionals to ensure a safe and smooth transition into the service. The team at Pear Tree House had continued this from the first day up until the current day ensuring they continued to adapt and learn, working alongside a variety of professionals where needed to meet the continually changing needs of this person.

In the development of the service, they told us they had worked closely with local commissioners and health and social care colleagues. The partnership had been pivotal in aligning service offerings with the local area plan and market position, ensuring that care solutions were tailored to the person’s individual needs and resonated with the broader community health objectives. By engaging with these local authorities, they said they had gained valuable insights into the specific requirements and challenges within the area.

There were systems in place to ensure the provider worked in partnership with other agencies and professionals to ensure care was safely delivered to people. As part of this assessment, we asked the Local Authority for feedback, they told us they did not find any concerns and that the home did not have an action plan in place. We received overwhelmingly positive feedback from professionals that had been involved with the person’s care and the home. They had confidence in the provider to deliver beyond their expectations and felt they would advocate to them on behalf of the person when needed.

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.

We found an exceptional culture of innovation and learning at the home. Quality improvement checks and audits which were completed at the service, were then analysed by the compliance team and the nominated individual. Other tools such as CQC’s quality of life tool was used to benchmark the care people received. Information, trends, patterns and findings were then shared with the registered manager through a weekly meeting where detailed discussions took place around what these findings meant for the person living in the home. There was focus on learning and improvement and how this information could be used moving forward to drive improvements. Records confirmed the actions that were discussed and taken, and the changes this had meant for the person.

There were systems in place which were used to drive improvements throughout the home. For example, when incidents had occurred, the registered manager ensured lessons were continually learnt from this and there was a continual emphasis on developing the service for the person. The lessons learnt document that had been developed for the service was individual for the person living there and had been designed and adapted to ensure it was relevant to their individual needs. The process ensured all members of the staff team were actively involved which gave them ownership of the changes that were introduced.

The nominated individual told us how they had also approached wider stakeholders and partners for support, to ensure as a provider they were continually learning and growing. This included liaising with a consultant specifically around the implementation of the Mental Capacity Act and positive behaviour management support, which had been specifically considered in relation to the person who was being supported. In addition, they attended and delivered workshops and presentations where they could share their skills and knowledge and showcase their areas of good practices, including safeguarding and person-centred care.