South East London

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.

This is the first inspection of this service. This key question has been rated 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.

The provider’s policies and procedures reflected best practice in care and support. Staff demonstrated a clear understanding of the service’s values, culture, policies and procedures.

Staff were provided with opportunities to discuss best care practice and regulatory requirements during regular supervision sessions. Records of staff supervisions and management meetings demonstrated equality, inclusion and the needs of people and their communities were considered. The provider had recently introduced a ‘policy of the month’ process. This was designed to refresh staff awareness of key policies and procedures and to enable discussion about how these related to their roles in supporting people.

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 and staff spoke positively about the management of the service. They told us managers were approachable and accessible at any time. The registered manager and other senior staff were considered knowledgeable, professional and responsive. Staff told us they appreciated the support they received. The registered manager had significant experience and knowledge of the social care sector. They understood the importance of honesty and transparency and their duty of candour responsibilities.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

People and staff told us they could raise concerns at any time, and these were dealt with promptly and effectively.

Staff spoke positively of the support they received and were confident their views were listened to and acted upon. They were aware of the provider’s whistleblowing policy.

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 had all received equality and diversity training and felt they were treated fairly and equally. The service’s policies and procedures reflected this approach.

The workforce was diverse and represented a range of backgrounds and cultures. The registered manager told us they would always seek to make reasonable adjustments for staff who required flexible working patterns or other adaptations to enable them to carry out 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’s records showed regular quality assurance monitoring had taken place and issues identified had been addressed promptly. At the time of our inspection the provider was moving records to a new electronic monitoring system to enable monitoring of records to take place in ‘real time’. People and staff had been asked for their views of the service, and the feedback we saw was positive,

The provider had ensured information about concerns had been shared where appropriate, with, for example, Local Authorities and the CQC.

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 and managers understood the importance of engaging with relevant health and social care providers to achieve the best possible outcomes for people.

People’s care plans contained details of other professionals involved in their care and support. The registered manager and other staff met on a regular basis with the multi-disciplinary team of professionals involved in people’s care and support. The records showed evidence of this.

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.

The registered manager spoke of the importance of continuous improvement and development of the service. They actively sought out information about good practice to share with staff. Staff told us they had opportunities to contribute ideas and suggestions in relation to the way people’s support was delivered.