Brunel 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 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.

The provider values were shared with staff during pre-employment interview stage and at their inductions. The registered manager told us they used staff supervisions to discuss values with staff and tried to embed them into every day working life. The values were on display in all areas of the service.

The registered manager said, “My ethos is to lead by example, to be democratic and make sure there is a management presence. I listen to staff, I am fair, and I coach staff to get the best out of them.”

The provider representatives such as regional directors and quality teams also visited the service regularly. They regularly monitored all systems and care delivery to make sure it met the providers standard.

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.

Since our last inspection there had been a change of registered manager. The current registered manager had also employed senior management within the service. For example, a new clinical lead and deputy manager. Feedback about the management of the service was positive. Staff appreciated the open-door policy and talked about how approachable the registered manager was.

The registered manager was also positive about the staff team at the service. They said, “The team is brilliant, from day 1 everyone has embraced my ethos. I see the potential of Brunel House and have found everyone to be supportive. I have experience in management but others in our team don’t. We are on a journey together; we blend together well.”

There was good support for management in their roles. The registered manager said they felt well supported by the provider. They also had support from other registered managers in the local area.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. There were processes available to staff to speak up if needed. The registered manager told us they had an open-door policy and encouraged staff to come to speak with them if needed. There was an email address and telephone number for staff to use if they wanted to raise any concerns outside of the service.

There had been some incidents which came under the duty of candour process. We found the registered manager had written letters of apology where 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 had policies and procedures to support equality, diversity and inclusion for the workforce. There was a diverse workforce employed at the service. The registered manager told us the organisation was inclusive. They said, “We welcome staff from all different backgrounds. We have a monthly celebration of cultures, at times dressing up in national dress and cooking meals from other cultures. Staff will support the kitchen staff to prepare different foods.”

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. At our last inspection we found a breach of regulation for good governance as systems were not effective. We found improvements had been made and the provider now had systems which were identifying and monitoring all areas of the service.

Various checks and audits were being completed by different members of staff. This included staff at the service and central office staff employed by the provider. Checks were being undertaken for areas such as medicines, care planning, mealtime experiences and people’s views and feedback about their care.

There was an environment audit and a weekly walk around completed by the registered manager. Whilst we saw this process had identified areas of risk, we found 2 hazards in the garden which had not been identified using these processes. The registered manager took immediate action to remove the hazards.

The provider held monthly risk and compliance meetings with central office staff who supported the service with compliance. They had access to all data on the electronic systems so were also monitoring for high risk and trends. For example, an area for improvement was care planning. Quality monitoring had identified improvement was needed to record keeping in people’s care plans. The providers clinical governance team were planning on supporting staff with this area of work to improve record keeping.

The management team carried out a visit out of hours every other month. They checked a range of areas during the visits including nighttime security procedures.

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 worked with a range of healthcare professionals, and we observed these professionals visiting people during our inspection. Feedback from professionals about the staff and management approach was positive. One professional told us, “The new management has had a very positive effect on the whole running of Brunel. I have suggested a few training needs, and this was put into place quite swiftly. They illustrated to me a very pro-active and keen approach to really improve the service.”

The registered manager told us they wanted the service to be part of the local community and staff worked to maintain and develop good community links with various agencies and services. For example, the service had good links with a local school. People visited regularly and spent time helping the children to read. Staff shared how beneficial this was to people’s wellbeing.

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. They actively contributed to safe, effective practice and research.

The registered manager told us they wanted to make improvements at the service and had plans to develop service provision. They wanted to develop staff knowledge and skills for end-of-life care and enhance links already made with end-of-life care specialists in the local area.

Staff were encouraged to share ideas and suggestions for better ways of working and improvements. For example, one initiative was to improve the dementia environment. The dementia ambassador at the service had suggested ideas for improvements and we observed these changes had been made. The registered manager said, “When I arrived here the corridors were bland and lacked engagement for people, we have filled corridors now with objects for people to interact with. I am encouraging the staff to try new things.”