The Fields

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 outstanding. At this assessment the rating has changed to 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 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had clear visions and values which were displayed throughout the service, including boards with slogans 'we work in your home'. However, we received mixed feedback from staff regarding the staff culture and morale. Some staff told us they were well supported, whilst others told us they didn't feel supported by the management team. A staff member said, “The support I have had has been incredible, including the support from my manager. I wouldn’t be where I am in my career now without them.” Whilst another staff member said, “They make me feel like a disappointment, they get onto us about such small things.” We also found 1 unit to have a poor culture. The management team were aware some staff had concerns and had recently undertaken a freedom to speak up exercise. The management team planned to improve staff culture and had increased staffing observations and considered skills mix during staff allocations.

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. People, relatives and professionals told us the service was well led, organised and met people's needs. A relative said, “The manager is a good manager, we have long conversations, and they have a good handle on things. They put the people first and care about all of them. We have no issues, they are approachable. The best thing is the freedom it gives people.” And a professional said, “The home, is exceptionally clean, safe, and well led.” Staff champions were in place for key topics, such as safeguarding, infection control, health and safety and infection control. Complaints were effectively recorded, investigated and actioned. A staff member said, “I would be happy for a family member of mine to live here.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Information posters, cards and leaflets were in place, to give people, staff and visitors information about how they could raise concerns, give compliments, raise suggestions and contact regulators. Staff told us they understood their roles and responsibilities to raise concerns, and they felt comfortable to do so. A staff member said, “I have never had to report any safeguarding concerns, but would definitely do so if needed, I would be listened to. The managers are easy to talk 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. Policies and procedures were in place in relation to promoting equality and diversity within the workforce. Staff received regular supervisions and appraisals and were given opportunities to raise concerns or suggestions. Nursing staff were offered clinical supervisions, to support them with their clinical practice.

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. Audit systems were in place, to monitor the quality and safety of the service. The provider had regional quality managers, who regularly visited the service and audited their compliance. Business continuity plans were in place, which detailed how the service responds in untoward and emergency event. Staff attended daily handovers and daily flash meetings, to ensure people's needs and changes in the service were communicate to the team.

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. Staff told us they felt like a part of people’s family. Records evidenced people had complimented the service. We received positive feedback from people, relatives and professionals about how the service communicated with them and supported people well.

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. Feedback surveys were in place for staff, professionals, people and relatives. Surveys showed positive overall feedback. Following surveys action was taken to address any concerns or make changes following suggestions. The service had a redecoration plan in place and had a decorator on site throughout the week. The management team were passionate about involving people in their care and making continuous improvement in the service.