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 Requires Improvement. At this assessment the rating has changed to Good.

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 68 (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.

There was a positive and inclusive culture at the service. People and staff felt valued, listened to and were able to speak up about their experiences. Comments from people using the service included, "I'm happy with how it's managed" and "It's a lot better here than I thought it would be." Staff told us they were happy working at the service and would recommend it as a place to work. Their comments included, “Management is very supportive” and “I think everything is going well. I feel supported by the Deputy Manager. If I had concerns, I would be happy to share these openly and I know I would be supported with these issues.” The provider had recently acquired the service from another provider, but the transition had been positive with people feeling safe and secure with the new provider.

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 employed capable and inclusive leaders. There was no registered manager at the time of our assessment, however the service was supported by a team of managers and senior staff who undertook different leadership roles. Staff told us they felt supported by all managers. Their comments included, “Managers do listen and try and rectify any problems”, “The manager is friendly, and it is a nice place to work” and “I am supported well, I feel very happy and at home here.”

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

The provider had systems to enable staff and others to speak up if they had concerns. Staff told us they knew what to do and were confident speaking up. Staff said they felt managers listened to their feedback and acted on concerns. We saw the complaints procedure was visible in different areas of the service.

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 procedures to ensure workforce equality and inclusion. They considered individual staff needs when recruiting, training and supporting them. Staff told us their individual needs were met, and managers respected diversity. Staff understood their human rights and felt these were being upheld. Staff from different countries worked well together and communicated effectively.

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

Prior to the assessment there had been concerns about poor practice because of unclear responsibilities, roles and systems of accountability at the service. The provider had recently improved their governance and management systems. These systems still needed to be embedded. We found falls monitoring and PRN protocols needed to be improved.

The provider did not always understand their duty to collaborate and work in partnership, so services worked seamlessly for people. They did not always share information and learning with partners or collaborate for improvement.

Staff understood their duty to collaborate and work in partnership, so services worked seamlessly for people, however we found this had not always happened in practice. The provider had a dedicated community relations manager whose role was to integrate the service into the local community. The service had invited several local groups into the service to promote community links. There was a minibus which was shared with another service with the same provider; however, there were no upcoming outings on the activity calendar, and it was unclear if the minibus was going to be upgraded or decommissioned in the near future. The management team had not always effectively worked with people, their representatives and staff to build a culture that focused on the enablement of people to enjoy their lives, develop skills, have new experiences and live the life they chose. For example, the wellbeing coordinator told us they had free tickets to an event in a nearby village, but the service was not able to confirm use of the minibus for people to attend. We found limited opportunities for people to enjoy activities outside of the service.

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.

Staff and leaders worked together to make positive improvements to the service. Staff were involved in learning and were supported to understand what went wrong and what could be improved after incidents which put people and staff at risk. People were involved in how the service was run. Staff and leaders supported people to be involved in decisions about the service wherever possible. Clear systems provided staff with learning opportunities when things went wrong. For example, an incident had occurred due to a lack of appropriate recording and oversight. Improvements had been made as a result of the incident. This included auditing schedules for high risk care needs, such as for skin integrity and additional training had been given to nurses to enable them to make confident clinical decisions. This reduced the risk of a similar incident happening again. The provider investigated and acted following incidents to ensure a culture of safety and openness.