GUTU

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 requires improvement. 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.

The provider was previously in breach of the legal regulation in relation to good governance. Improvements around how the provider monitored and improved the quality and safety of the service were found at this assessment, although some of the new systems and processes needed further embedding and there were further improvement actions which were still being completed at the time of the assessment. The provider was no longer in breach of this regulation.

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 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. Staff commented the culture of the service had improved since the management structure changes and the increase in the support offered for staff. Staff were complimentary about the ongoing improvements being made to the service. Staff told us how the provider now communicated with staff directly supporting people in better ways and the range of support which was on offer. The managers spoke positively about staff teams and could explain how the changes made helped to build a culture which supported delivery of person-centred and effective support to people using 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 explained how the governance, leadership and accountability structures were reviewed by the provider and the additional support they now received from senior and line managers. Although the management team structure changed significantly, staff were positive about improvements this brought. For example, around communication, availability of support from senior management or improvements in support planning and reporting systems, and staff training in the service. Staff felt involved in making those changes and listened to, although they commented it was challenging at times to continue with making the improvements. New leaders felt supported by their line managers and there was specific management training offered to staff in the months prior to the assessment.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. The provider now had clear freedom to speak up structure and policy with champions staff could contact, as well as an anonymous way of raising concerns. Staff told us this improved their confidence in raising any concerns and comments and those who used the freedom to speak up complimented how the communication was responded to and addressed.

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 told us they felt valued and encouraged to develop in their roles. A staff member said, “There is room for growth, we are given equal opportunities.” Multiple staff members told us how the provider supported them around their roles and additional training they received.

The provider now 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 information about risk, performance and outcomes, and shared this securely with others when appropriate. The provider had significantly changed and improved their auditing, reporting and governance structures. A dedicated role of head of quality and governance was put in place and provider’s operational structure was reviewed to ensure clear lines of accountability and management. New electronic systems for reporting, recording and support planning were implemented which resulted in the provider having better oversight of quality and safety of people’s support in real time. A range of action plans was implemented, and external feedback was sought and actioned to improve the service, for example, around risk management or staff training. A staff member said, “[The provider] has brought [new electronic system] to ensure any actions from concerns or incidents are followed up. Generally, there is more leadership structure and oversight. Previously [managers] were “ticking own homework”. They used to do audits but didn’t follow them up (now they do) and the head of quality and governance is also proactive in following up.” Another staff said about how the new systems helped them to maintain a better oversight of people’s support, “I can see things better now and prioritise. I do not need to wait to be (in someone’s home) to spot things.” There was now a clear auditing and spot-checking structure, and we saw senior leadership monitored the effectiveness of those systems and progress with established actions. However, not all actions were fully completed or embedded yet. For example, around ‘Right support, right care, right culture’ guidance, people’s mental capacity or PRN records and some planned but not yet completed staff training. The changes made in governance and quality monitoring brought good results to people and staff, but required further embedding into day-to-day practice.

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. People’s relatives told us staff worked well with other services and healthcare and social care professionals. Professionals working with the service to support individual people overall complimented how staff kept them up to date, listened to their input and asked for support when required.

The provider focused on continuous learning and improvement. They encouraged delivery of equality of experience, outcome and quality of life for people. The provider had made a range of improvements in the systems and processes they used for support planning, recording, reporting, identifying and actioning improvement needs and lesson learnt which had a positive impact on people’s safety and staff ability to support people well, even in difficult situations. Staff were able to discuss individual examples of how support they provided to people brought good outcomes for them, for example, helping them to become more independent and to reduce the severity of risky behaviours they might have engaged in when distressed. The provider had clearly identified priorities for ongoing improvement and development of the service and now had robust governance structures which improved the way they were able to monitor the quality and safety of the service. The provider encouraged staff to engage with local networks and forums supporting community care providers to keep up to date with any changes to the national best practice and providing peer support.