The Mill 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 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 changed to requires improvement.

This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to good governance.

This service scored 50 (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 did not have a shared vision, strategy and culture based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not understand the challenges and the needs of people and their communities.

Inspection findings demonstrated a lack of provider level learning between their services to ensure where risks and concern was identified at other inspections, lessons were learnt and changes implemented at their other services. We received assurances from the provider that they were implementing shared learning between their services in this area to overcome services working in isolation.

Not all leaders understood the context in which the provider delivered care, treatment and support. They did not always embody the culture and values of their workforce and organisation. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively, or they did not always do so with integrity, openness and honesty.

We identified the need for the registered manager to have a greater level of oversight of the service, particularly in relation to colleagues completing delegated tasks to ensure the registered manager held overall accountability. We received positive feedback from staff in relation to leaders having an open-door policy and approach to the support provided. A person also told us they spoke with the registered manager on a daily basis.

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

Staff told us they felt able to contribute ideas and feedback to the running of the service. We observed staff to speak openly during the shift handover meeting we attended. We did however identify some areas of concern in relation to culture within the staff team, which the provider assured us would be looked into further as an outcome of our feedback.

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 really valued working as part of a diverse team, where individual strengths and skills were recognised. We observed staff to support each other and give each other confidence during the inspection process.

The provider did not have clear responsibilities, roles, systems of accountability and good governance. They did not act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

The quality audits and monitoring systems in place were found to be ineffective. Risks and concerns identified during this inspection had not been found as a result of the provider’s own governance systems. Change only happened within the service as a result of inspection feedback, which raised concerns around the sustainability of the current governance processes in place to effectively drive improvements within the service.

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, people and relatives gave positive feedback regarding working in partnership to support people living at the service. We observed good communication between people and staff. People were supported to access the community and use the service’s transport to go on outings.

The provider did not focus on continuous learning, innovation and improvement across the organisation and local system. They did not encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not actively contribute to safe, effective practice and research.

Inspection findings demonstrated a lack of learning and improvement from our last inspection, as the overall rating has deteriorated. Where incidents had happened within the service, the quality of investigations and analysis was found to be basic and lack analysis to determine learning and mitigation of reoccurrence.