Ladden View

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 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.

When we visited Ladden View, we found the atmosphere and culture to be positive and welcoming, with warm, respectful and caring interactions throughout the home. Staff we spoke with were dedicated and committed and told us they trusted the leadership of the interim management team.

The management team were clear about their role in supporting staff to provide high quality and effective care for people. The provider had clear responsibilities, roles, systems of accountability and governance. The team used these to manage and deliver good quality sustainable care and support.

The provider had clear values which focused on caring, passionate and teamwork. We saw staff putting these values into practice and people were at the centre of their care. Provider policies and procedures supported a positive culture in the service.

Most staff and relatives felt the service was moving in a positive direction, but some staff told us they felt unsupported and did not feel listened to. They gave mixed views about recent operational changes. The management team had recognised changes and improvements were needed. A development plan was in place and we saw actions were underway and changes being made.

The provider had inclusive leaders at all levels who understood the context in which they delivered care 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.

The registered manager was absent at the time of our inspection; however, the service had an interim management team to provide cover. They were consistent and were committed to quality, improvement and compassionate leadership. A clear management structure, with defined roles and responsibilities helped ensure the service met expected standards.

People and relatives said they knew the management team and felt comfortable approaching them. They were positive about the interim management team, with one relative noting, “Over the last few months it’s come on leaps and bounds and it’s improving all the time.”

Staff were positive about the interim management team. Comments included, “[Name] has been good at boosting morale. I feel this is much better now” and “[Manager name] has been fantastic.” Members of the leadership team were visible around the service and led by example. As a team, they had the skills, knowledge, experience and credibility to lead effectively. Leaders told us they received support and supervision to help develop their skills and knowledge, with one telling us, “The support network is amazing.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Some staff felt their voices had not always been heard, although other staff said, “If you go to a manager, things are resolved. The team have made lots of improvements.”

This range of views were reflected in a staff survey, where feedback showed staff were committed to providing good care, proud of their work, and supportive of one another. However, the survey responses also described reduced confidence in leadership and staff not always being assured that feedback would lead to action. The interim management team were aware of these challenges and the need to continue developing the service and culture. They were actively addressing this and one manager told us, “I feel the trust is getting better.”

The service had effective systems and processes to support the sharing of information and obtaining the views of staff, people and relatives. This included meetings, surveys and complaints. The chef regularly spoke with people to receive feedback and suggestions about meals. Relatives felt confident to speak up and raise any concerns or feedback they may have. The service had a complaints process and the management team investigated, responded to and audited concerns to identify learning and drive improvements.

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 were positive about their colleagues and the team was diverse, made up of individuals from a wide range of backgrounds, ages and experience. One staff member said, “The team is lovely. We help each other, that’s very good.”

Staff told us they had been supported when they needed adjustments because of personal circumstances, for example with leave in an emergency. The provider had policies and procedures in place regarding equality, diversity and inclusion and staff had received relevant training.

The provider had clear responsibilities, roles, systems of accountability and governance processes. However, governance systems had not always been effective in identifying and addressing issues to ensure the consistent delivery of good-quality, sustainable care, treatment and support. The provider had not always acted on information relating to risks, performance and outcomes. Information was shared securely with relevant partners when appropriate.

The service had governance arrangements to monitor the quality and safety of the service and support the smooth running of the home. Audits helped the management team oversee standards, identify shortfalls and drive improvement and analysis of these were robust. Senior leaders monitored the service during regular visits and quality assurance checks. We found recent audits were comprehensive and accurate, although some older checks had not always identified concerns or areas requiring improvement.

When shortfalls were identified, action was taken to make improvements and learning or changes were shared with staff, although this had not been consistently achieved in the recent past.

However, staff were clear about their role and responsibilities in keeping people safe and providing them with effective, person-centred care. The interim management team understood their responsibilities relating to regulation. Information and notifications were shared with CQC and other external organisations as required.

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.

The management team had good relationships with other organisations and professionals to ensure people received effective support and joined up care. Professionals gave positive feedback about the service.

Where possible, staff supported people to access community resources such as garden centres and outdoor spaces. The provider also encouraged people from the local community to come into the home. For example, by offering refreshments to emergency services staff, hosting a weekly coffee morning and providing workshops about understanding dementia. The service worked with a local community group to hold an open Christmas event celebrating people's traditions and memories at the service.

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.

The team demonstrated a willingness to develop and continue to improve. Lessons learnt were identified and shared with the team to support improvement and positively impact people’s experiences, although some changes were still being embedded and evidenced at the time of our inspection.