Chesham House

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.

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 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 promoted a positive culture that focused on delivering person-centred care and support. Staff feedback indicated managers were approachable and available to provide guidance and support when needed. Staff described regular team meetings, opportunities to discuss concerns and a culture that encouraged communication and collaborative working. Staff told us there were opportunities to discuss issues affecting people’s care and support and to raise concerns where required.

The provider’s vision was reflected in the care people received. Support plans, daily records and observations demonstrated a focus on promoting choice, independence, dignity and wellbeing. People were supported to maintain relationships, access community opportunities and make decisions about their daily lives.

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.

Leaders demonstrated an understanding of the needs of people using the service and the staff supporting them. Staff described the registered manager as approachable, supportive and available for advice and guidance. One staff member told us the registered manager was “so supportive” and “always there for you.” Another staff member said they felt supported, received regular supervision and could make suggestions, describing the service as “always open to suggestions.”

Staff gave examples of compassionate and inclusive leadership, including support with personal circumstances, emergency leave, counselling and wellbeing checks during supervision. Staff email feedback also described management as “understanding and supportive” and said staff felt able to go to management “anytime” they had a question.

External professional feedback was also positive. For example, one external professional told us communication was positive and that concerns were raised quickly.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Staff understood their responsibilities to raise concerns and described a culture where they felt able to escalate issues affecting people’s safety and wellbeing. Staff were able to explain safeguarding procedures, incident reporting processes and how concerns would be raised with managers or external agencies where required.

Staff described opportunities to discuss concerns through supervision, team meetings and day-to-day communication with managers. Examples provided by staff demonstrated they understood the importance of escalating changes in people’s health or wellbeing and seeking professional advice when needed.

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. The provider promoted an inclusive culture that recognised the diverse needs of staff and supported their wellbeing. Staff described receiving support from managers and highlighted opportunities to discuss concerns and wellbeing. Staff consistently described management as approachable and supportive. Staff gave examples of leaders supporting individual circumstances, including emergency leave, counselling support, wellbeing discussions during supervision, flexible working arrangements and adjustments to working patterns. One staff member told us the registered manager was "understanding and supportive."

Leaders demonstrated flexibility in supporting staff with individual circumstances. Examples included emergency leave, counselling support, wellbeing discussions during supervision, flexible working arrangements and adjustments to working patterns to support childcare, religious observance and family commitments. Staff told us they felt able to approach management for advice and support and felt valued within the staff team.

The provider had systems in place to support equality, diversity and inclusion through training, supervision and workforce policies. Staff feedback indicated people worked well together as a team and that managers promoted a culture where staff felt respected, listened to and supported to undertake their roles.

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. The provider had governance systems in place to monitor the quality and safety of the service. Evidence reviewed included audits, quality assurance systems, environmental monitoring, staff supervision arrangements, training oversight and medicines governance processes. These systems enabled leaders to identify areas requiring improvement and take action to address concerns.

During the assessment, questions were raised regarding actions arising from a specific environmental risk report. The provider explained that concerns had already been escalated internally and acknowledged there had been weaknesses in some oversight arrangements. The provider explained that concerns had already been escalated internally and acknowledged there had been weaknesses in some oversight arrangements. Once identified by the provider’s internal teams, actions were implemented to strengthen monitoring, accountability and tracking of future environmental works.

Overall, governance systems provided reasonable assurance that risks were monitored and that leaders took action when concerns were identified.

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 provider worked with healthcare professionals, family members and other stakeholders to help people achieve positive outcomes. Records reviewed demonstrated involvement from GPs, pharmacies, community healthcare services and other professionals where required. Staff understood when professional advice was needed and described working collaboratively with external agencies.

People were supported to maintain relationships with family, friends and partners and to participate in community activities. Daily records evidenced people attending appointments, shopping, social activities, family visits and community outings. This promoted inclusion and helped people remain connected to the people and communities important to them.

The provider focused on learning and improvement. Leaders encouraged staff to identify concerns, share learning and improve practice where issues were identified.

Leaders demonstrated a willingness to learn and improve. Staff understood incident reporting processes and described escalating concerns when they identified changes in people’s health, wellbeing or safety. Examples provided during the assessment demonstrated that concerns were reviewed and acted upon by managers and relevant professionals.

The provider demonstrated openness during the assessment and acknowledged where further improvements were required. For example, leaders had recognised weaknesses in some environment oversight arrangements and described plans to improve how environmental reports were received, monitored and followed through to completion. The provider responded positively to inspection feedback and took action to address identified concerns.