The Cotswolds

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

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 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 had a clear aim which embodied the nature of the service they were providing, which included maximising people’s potential.

We found during our assessment there was an open culture, and one which highly regarded person-centred approaches. This filtered through all teams, including their maintenance team. Whilst their maintenance team were not directly involved in people’s care as standard, we found examples where they had gone above and beyond.

There was room for improvement to ensure their culture, vision and strategy was applied to every aspect of the service. For example, some language used in are plans was not always person centred. This was shared with the provider, and they were able to show they were already working to remove this language in documentation.

We encountered the phrase “Our residents do not live in our workplace, we work in their home,” multiple times in our assessment, including from staff feedback, and on displays and information boards within the service. The provider actively worked to embed this sentiment into the culture.

The provider was working to an action plan in which many things we highlighted during our assessment had already been identified. Some aspects had already had some action taken to rectify and improve.

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.

The provider operated an initiative called “shared roles to meet goals”. This was delivered via their management and multi-disciplinary team. It recognises that everyone has a different role, background and expertise, but they are all working together to create a positive rehabilitation service for people.

Staff mostly felt positively about leaders, one telling us “I think since the [registered] manager has been here, they have been really supportive” and “I’ve seen a lot of positive happen since [registered manager] has started.” Others felt that as there was such a large overhead team, they weren’t always sure on people’s responsibilities and accountabilities. Additionally, some staff members did not feel all managers were supportive, particularly after an incident or accident had occurred. This was shared with the provider during feedback, and we were assured they would reflect on their approaches to ensure it is consistent across the staff team.

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

The provider promoted whistleblowing procedures and had a freedom to speak up champion in place. Their policy directed people on where to go externally and how to raise concerns anonymously.

Most staff told us they felt confident to raise concerns of all natures and were aware of the freedom to speak up champion. They felt encouraged to speak up. This was not the experience for all staff however, and one staff member told us “Staff are frightened to speak up”. This was fed back to the provider during our assessment, we were assured that leaders, and their freedom to speak up champion were going to reflect and develop their processes to ensure all staff felt safe to speak up.

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 operated champion schemes, which enabled staff to develop their knowledge and skills. This included diabetes and epilepsy champions for example. They also had a staff mental health support champion in place as well.

We saw evidence that where staff had a change in their circumstances, the provider worked to adapt their working pattern or duties to support them. Additionally, we saw evidence that the provider promoted the diversity of their staff team, and utilised the differing cultures, backgrounds and languages to help people with the same diversities to feel more at home.

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 had good oversight of the service, including regular walk arounds, audits such as infection control, personalisation and restrictive practice to name a few, and regular multi-disciplinary team (MDT) meetings. Leaders appeared to be clear on their roles and responsibilities within this team and from the meeting minutes shared with us, all of them had a shared vision and goal for the service.

The provider was quick to action feedback from us and other external organisations, where prompt action was appropriate, and embed longer term improvements and recommendations to an action plan the MDT were working towards. As previously mentioned, their active oversight of the service meant many aspects found in our assessment had already been identified and included in the services action plan.

There was room for improvement to ensure all actions were taken promptly, as, for example, there appeared to have been some delay in sourcing and organising some training for staff.

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.

The provider affiliated themselves with other local organisations, such as school and community centres, including making donations to local community events and taking part in schemes. For example, they had taken part in a recycling plastic scheme, where money raised went to a cancer charity.

We saw evidence that the provider was working to improve their service with the Integrated Care Board and local authority. Additionally, they were part of their wider organisations ‘Safe Hands’ initiative which focused on sharing learning, tips and advice to organisations to improve experiences for people using care services.

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. There was a clear drive within the provider to improve people’s experiences of care, within their own service and wider.

Managers and leaders would utilise local care-based groups, such as Northamptonshire Association of CQC Registered Care Providers (NORARCH), which enables providers to meet and share learning and practices to improve care on a wider level.

The provider was keen to learn from internal and external events to improve care. They were part of a working group within the wider organisation to develop safety weeks. They developed a falls awareness week which included making amateur videos to raise awareness and shared presentation around the prevention of falls.