Two Rivers

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.

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

This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 75 (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 and staff consistently described a positive, person-centred culture where people were placed at the centre of decisions about their care and support. Leaders promoted a culture that focused on improving people's quality of life by supporting them to maintain relationships, access their local community, participate in meaningful activities and experience opportunities that reflected their individual interests, preferences and aspirations.

Observations, care records and feedback from relatives demonstrated that people were encouraged to take part in activities, cultural and religious events, and community opportunities that reflected what was important to them.

Relatives and staff described significant improvements since the current provider assumed responsibility for the service.

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 consistently described strong teamwork and supportive leadership and told us they felt valued and supported in their roles. Leaders recognised previous challenges and improved communication, staff support and governance arrangements. Staff felt confident approaching managers for advice or to raise concerns.

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

The provider encouraged people, relatives, advocates and staff to share feedback, raise concerns and contribute to decisions about care and support. For people who were unable to communicate using words, staff used their knowledge of the person, communication guidance and family input to understand people's views and preferences. Relatives told us they felt listened to and involved in decisions affecting their family member's care. Staff described a supportive environment where concerns could be raised without hesitation. A relative told us, "They take me seriously and any concerns have been resolved to my satisfaction."

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.

Leaders promoted an inclusive working environment where staff felt supported, respected and able to contribute to the service. Staff described positive working relationships and told us managers listened to their views and supported their development. Leaders recognised individual learning needs and adapted support accordingly, including providing additional guidance, competency assessments and different approaches to training where required. Staff had access to supervision, training and progression opportunities, helping to ensure development opportunities were available fairly across the workforce. Staff also reflected the diverse backgrounds of people using the service, which helped support effective communication and understanding of people's individual needs and cultural preferences.

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

Managers monitored care quality through audits, competency assessments, supervision, training oversight and service improvement planning. Managers also held daily meetings to review people's needs, changes in health status and significant events. This helped managers identify concerns quickly, monitor the quality of care and respond to changes in people's needs.

The provider 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.

Leaders worked with people, relatives and professionals to plan and review care and support. Records showed their involvement in care reviews and best interest decisions.

Managers and staff described effective communication with healthcare professionals and other agencies, helping people maintain relationships, access opportunities and receive coordinated support.

The provider focused on continuous learning 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.

Managers and staff described significant improvements in communication, safeguarding, staff support and care planning since the provider change. Managers reviewed incidents, audits and feedback to identify learning and improve practice. Managers described how support had become more person-centred, with increased focus on people's preferences, cultural and religious needs and meaningful activities. Staff supported people to access a range of opportunities and experiences tailored to their individual needs and interests, which helped improve their quality of life and inclusion within the community.