Nightingale

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 good. At this assessment the rating has remained 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 service 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.The registered manager and staff were committed to providing high quality and person-centred care. Staff worked together to support people’s wellbeing, dignity, independence. They told us they felt valued and motivated. Feedback from people and their families was regularly collected and used to improve care. A relative commented, "Staff represent the values of the organisation." These were integrity, trust, empowerment, respect and care. During the inspection, staff were observed delivering care that respected people’s preferences, creating a homely and supportive environment.

The service 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 said the management team was approachable, visible, and involved them in discussions about supporting people. Managers were capable, understood their responsibilities, and acted to make improvements when needed. They spent time with staff and people using the service, forming open and trusting relationship by creating accessible environment.

The service fostered a positive culture where people felt they could speak up and their voice would be heard. Staff knew how to raise concerns and felt confident speaking up. A member of staff said, ‘’The registered manager’s door is always open.’’ There were systems, both internally and externally, to support staff in raising concerns. This included a dedicated ‘Freedom to Speak Ambassador’. This was a member of staff who could be approached in confidence to discuss any issues if they did not feel comfortable speaking directly with the registered manager. Staff trusted the registered manager to listen and respond correctly, a view shared by people using the service and professionals. Relatives also felt confident raising issues. A whistleblowing policy was in place, with clear process for learning and improvement when things went wrong.

The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them. The service promoted equality, diversity and inclusion with clear policies to prevent harassment and discrimination. The registered manager told us, ‘’I am proud of our staff team. We have a long-standing staff who go above and beyond. We work together as a diverse team.’’ Staff felt respected, valued, and supported to be themselves, describing a positive and inclusive workplace culture. These values were reinforced through regular training and consistent management support. A staff member said, “I love our staff team and management. They are very accommodating and make me feel at home.’’

The service 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 act on the best information about risk, performance and outcomes, and share this securely with others when appropriate. The service had a clear governance system, with identified roles and accountability to support person-centred care. Staff understood their roles and how their work contributed to the service. Regular audits and checks monitored performance, identified risks, and supported continuous improvement. The registered manager had oversight of action plans, made sure required notifications were sent, and shared information appropriately.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement. People enjoyed community activities with staff support, staying connected to their interests and hobbies. Evidence showed these activities positively contributed to their wellbeing. The service worked closely with health and social care professionals, building strong partnerships that supported person-centred carer and helped people feel included in wider community. A professional told us, “We have good communication between both, and they are always available to speak when needed.’’

The service 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 contribute to safe, effective practice and research. The registered manager was committed to learning and improving the service. They supported people with changing needs and used audits to maintain care quality and safety. Staff understood the importance of ongoing learning and contributed to service development. The registered manager promoted a positive culture on people’s wellbeing and helping them live meaningful lives.