Total Health Support and Training Services Limited

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.

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 demonstrated a shared vision, strategy and culture aligned with principles of transparency, equality, diversity, inclusion and respect for people's human rights. Staff spoke positively about the organisation's values and understood their role in delivering safe, person-centred care.

There was a positive culture within the service, with staff consistently describing the management team as approachable, supportive and receptive to feedback. Staff demonstrated a good understanding of people's individual needs and spoke positively about supporting people to maintain their independence, choice and wellbeing.

Feedback from people, relatives and staff confirmed caring and compassionate support was embedded within day-to-day practice. The management team showed a commitment to continuous improvement and encouraged open communication and learning. Systems were in place to obtain feedback from people, their representatives and staff to help shape and improve the service.

The provider had leaders who understood the context in which care and support were delivered and who promoted the values and culture of the organisation. Leaders demonstrated the skills, knowledge and experience required to effectively oversee the service and support positive outcomes for people.

The management team was open, transparent and responsive throughout the assessment process and provided information in a timely manner. Leaders demonstrated a commitment to delivering safe, person-centred care and supporting staff to provide high-quality support.

Staff consistently spoke positively about the leadership of the service and told us managers were approachable, supportive and available when advice or guidance was needed. Staff felt comfortable raising concerns and were confident they would be listened to and acted upon appropriately.

Records showed staff had opportunities to share feedback, discuss concerns and contribute to service development through supervision, team meetings and ongoing communication with managers. Leaders promoted an open and inclusive culture where staff felt valued and supported in their roles.

Governance and oversight arrangements had strengthened since the previous assessment, providing leaders with improved oversight of quality, safety and service delivery. Leaders demonstrated a commitment to continuous learning and improvement and used monitoring systems to identify and address areas for development.

The provider fostered a positive culture where people felt able to speak up and were confident their views and concerns would be listened to and acted upon.

Staff were encouraged to raise concerns and demonstrated an understanding of how to do so. Policies and procedures were in place to support whistleblowing, speaking up and the reporting of concerns.

Staff told us they would feel comfortable approaching managers if they identified unsafe practice or wished to discuss concerns about people's care, their role or the service. Regular supervision sessions, team meetings and ongoing communication with managers provided opportunities for staff to share feedback and discuss issues affecting their work.

Feedback from staff was overwhelmingly positive and confirmed a culture of openness, transparency and support. Staff felt able to raise concerns without fear of repercussions and were confident management would respond appropriately. Systems were in place to ensure concerns, feedback and learning were considered and used to support service improvement.

The provider valued diversity within its workforce and promoted an inclusive and fair working culture. Policies and procedures supported equality, diversity and inclusion and helped ensure staff were treated with dignity, respect and fairness.

Staff spoke positively about the support they received from managers and told us they felt valued within the organisation. The provider demonstrated a willingness to make reasonable adjustments and consider individual circumstances to support staff wellbeing and retention. For example, working patterns were adjusted for staff returning from maternity leave, staff who were pregnant and other employees with health related needs.

These examples demonstrated the provider's commitment to creating an inclusive workplace where individual needs were recognised and supported, and where staff from different backgrounds and circumstances were treated fairly.

The provider had systems in place to monitor the quality, safety and effectiveness of the service. These included audits, spot checks, reviews of incidents and accidents, staff supervision, care plan reviews and the collection of feedback from people, relatives and staff.

Information gathered through governance processes was used to identify areas for improvement and support learning across the service. Where concerns or shortfalls were identified, action plans were developed, implemented and monitored to support continuous improvement.

The provider maintained oversight of key risks and demonstrated an awareness of issues that could impact on people's care and support. Leaders worked with relevant professionals and external agencies where appropriate to ensure people received safe and effective care. Required notifications had been submitted to CQC, and referrals were made to external agencies when required.

Governance and oversight arrangements had strengthened since our previous inspection, audit and monitoring processes showed issues relating to medicines, incidents and accidents were reviewed, and appropriate action was taken where necessary. Feedback from people, relatives and staff was also used to inform service development and improve outcomes. Governance systems, including audits, spot checks and care reviews, helped leaders maintain oversight of the service and identify opportunities for improvement.

Governance arrangements provided assurance the quality and safety of the service were being monitored effectively and opportunities for learning and improvement were identified and acted upon in a timely manner.

The provider understood the importance of collaborative working and maintained effective partnerships with a range of health and social care professionals to help ensure people received coordinated and person-centred care. This included working with GPs, community healthcare teams, social workers and other professionals involved in people's care.

Feedback from a healthcare professional was positive and confirmed the provider was responsive to professional advice and worked collaboratively to support positive outcomes for people. Records demonstrated professional recommendations were incorporated into people's care and support where appropriate.

Information was shared appropriately with relevant partners to support continuity of care, effective decision-making and the timely response to changes in people's needs. This helped to ensure people received coordinated support and access to the services they required.

Overall, the provider demonstrated a commitment to partnership working and recognised the value of collaborative relationships in maintaining and improving people's care, support and wellbeing.

The provider demonstrated a commitment to continuous learning and improvement. Systems were in place to review incidents, accidents, complaints and feedback to identify learning opportunities and improve practice. Lessons learned were shared with staff through meetings, supervision and ongoing communication to help promote safe and consistent care. Regular quality assurance audits reviewed key areas of service delivery, including incidents and accidents, to identify themes, trends and opportunities for improvement.

Where improvements were identified, actions were implemented and monitored through the provider's governance processes. This helped support continuous improvement and provided oversight of the quality and safety of the service.