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• 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 Inadequate. 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 registered manager had a clear vision for the service based on individual person-centred care and shared this with staff. There was a positive culture and staff told us they felt motivated and fairly treated in their role. One staff said, “I feel valued in the role. I get support any the time I need. I try my best; we try to perform our best.”.

The registered manager worked alongside staff to enable them to understand and support staff with their practice. They also ensured they spent time at the service with the night staff, so they were included in monitoring and any communication.

Feedback from people and relatives about the culture at the service was positive. One relative told us, “The atmosphere at the home gives a lovely welcoming vibe and the residents are always smiling and happy.”

The registered manager had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty. The registered manager had worked up through the care system to develop in their role. Previously they were the deputy manager. They told us they felt supported by the provider and was able to access learning and training as needed.

Feedback about the registered manager was particularly positive. Staff and relatives told us they were inclusive, accessible and communicated well. Comments from relatives included, “Excellent, the manager is so caring and supportive of both of [my relative] and me” and “[The registered manager] has an open-door policy which makes her available to us when we visit. I can ring her any time and she will always take my call” and “I think [registered manager] has picked the job up, run with it and is the best of herself. She asks for advice when needed. She knows when to ask questions.”

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

Staff told us they felt able to speak up if there were concerns and felt the registered manager would listen to them. One staff said, “If there are concerns, I can speak to [registered manager] and it’ll get sorted.” Another staff told us, “[The registered manager] has an open door policy, I feel very comfortable going to her.” Staff met daily to raise day to day issues. There had also been a recent survey for staff. Some staff had made suggestions, and these were being worked through at the time of the inspection. For example, staff had suggested a staff holiday calendar was made available and this had been put in place.”

The registered managers office had been moved and was now more accessible to staff and people. People came and spoke to the registered manager throughout the day and clearly knew who they were. Relatives told us, “Anything we bring up and we find [the registered manager] listens and moves things forward.” People and their relatives had also been invited to give feedback and there were regular meetings with people their and families. Feedback was positive. Comments included, “Very good caring skills and communication with residents. Residents are treated with respect. There is always a member of staff in the lounge.”

The registered manager valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them. For example, where people with a disability needed reasonable adjustments in place to support them with their work these were put in place. Staff and people were invited to learn about and celebrate each other’s customs and cultures. Staff told us they felt included and appreciated. One staff told us, “The staff and manager here are very supportive.”

Registered manager 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.

There were now systems in place to ensure there was effective governance. There were regular audits of areas such as medicines and the environment to ensure concerns were identified. The provider also undertook a audit monthly to ensure there was an overview of quality. An action plan was in place to ensure concerns were addressed in a timely manner. For example, the medicines audit had identified a body map was missing for one person. This was to provide staff with the information on where a person needed cream applying. This was now in place and the action plan had been updated.

The rating for the service was on display in the hallway in a place which was accessible to people and their relatives. Notifications were submitted to CQC as required by law. The registered manager understood their duty under duty of Candor to be open, honest and transparent if things went wrong.

Staff 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 staff worked closely with staff from other organisations to ensure people received joined up support. For example, the service made regular referrals to the frailty team to support people when their needs increased. Staff had made strong connections with partners and there was a close working relationship with healthcare staff who visited weekly and worked with staff to support people. Feedback from health and social care professionals was positive about the service and how it was being managed.

Feedback from relatives about partnership working was also positive. For example, one relative told us how staff had worked with partners to reduce their relatives’ medicines, which had had a positive effect on them.

The provider, registered manager and staff had focused on improving the service for the people who lived there.

The registered manager went to local management meetings to share best practice. The service had also learnt lessons from the previous inspection and had made improvements to a number of areas. This improved the safety of the service. One relative told us, “There has been huge changes and we couldn't be happier.”

There had been a focus on improving staff learning and skills as well as organisation within the service and this had had a positive effect. Staff were in the process of introducing champions such as a medicines champion and moving and handling champion to continue with improvements. For example, the moving and handling champion had just completed train the trainer for moving and handling so they could support other staff in their learning.