Nurtured Care NE

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 remained 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 previously in breach of regulation 17 (good governance). Improvements were found at this assessment, and the provider is no longer in breach of this regulation.

This service scored 57 (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 always have a clear, shared vision and culture that was consistently understood or embedded across the service. Although leaders had set out values and expectations, these were not always reinforced or reflected consistently in day‑to‑day practice, which led to variable staff understanding of priorities and standards.

Some staff were able to describe the provider’s values and how these influenced their work. However, others were less clear about the service’s direction or how their role contributed to wider objectives. Leaders did not consistently communicate or model the vision, which limited the development of a unified and inclusive culture. A staff member said, “Not everyone is clear on the direction of the service.”
 

Leaders were not consistently effective, visible or inclusive, which limited their ability to drive improvement and maintain staff confidence. Leadership arrangements were in place, but these were not always embedded or experienced consistently across the service.

Staff feedback reflected mixed experiences of leadership support and engagement. While some staff felt listened to, others reported limited access to leaders or delays in addressing concerns. This inconsistency reduced leaders’ ability to build trust, sustain morale and provide clear direction. One staff member told us, “I’ve reported a few issues which I have never heard back about.”
 

People did not always feel able to speak up or have confidence that raising concerns would make a difference. This resulted in reduced confidence that concerns would lead to meaningful action and limited assurance that an open culture was consistently embedded across the service. One staff member told us, “I am not listened to or taken seriously.”

The provider promoted equality, diversity and inclusion, and staff felt respected, supported and treated fairly. Leaders recognised the importance of inclusive practice and considered equality in recruitment, training and staff support. Staff told us they felt valued, and where adjustments were needed, leaders responded positively to support staff wellbeing and inclusion. A staff member told us, “I feel respected and treated fairly at work.”

Governance and oversight systems were not always effective, which meant risks and areas for improvement were not consistently identified or addressed in a timely way. Although quality assurance processes were in place, these did not always provide leaders with sufficient oversight of performance and risk.

Audits and monitoring activity did not consistently identify shortfalls, or actions were not always followed through. Leaders did not always use information effectively to drive improvement, which reduced assurance that the service was well governed and sustainable. One staff member commented, “Monitoring doesn’t always lead to improvements.”

The provider worked well with partners and the local community to support people’s care and improve outcomes. Leaders maintained positive relationships with external professionals and worked collaboratively to support joined‑up care. This helped ensure people received coordinated support with timely responses when their needs changed. A healthcare professional said, “The service works well with us to review and adapt support.”

The provider did not consistently learn from incidents, feedback or monitoring activities, which limited opportunities for sustained improvement. While some learning took place, this was not always analysed in depth or shared effectively with staff.

Leaders did not always identify themes or evaluate whether actions taken had led to improvement. This reduced the provider’s ability to embed learning and demonstrate continuous improvement and innovation in practice. A staff member told us, “Learning isn’t always shared consistently with staff.”