Tuscany 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.

The provider was previously in breach of the legal regulation in relation to good governance. Improvements were found at this assessment and the provider was no longer in breach of this regulation.

This service scored 71 (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.

Following an incident in 2024 in the provider’s other service next door which identified failings in the culture and management of the service, a new management team had been brought in who were working hard to make positive changes to the service. Staff had noticed the improvement, with 1 or a member of staff telling us, “I could really tell the difference between the old and new management. The new ones are making great changes. They advocate highly for the tenants - it’s not our house, its theirs.” Equally, the management team were very complimentary of the staffing team. The manager told us, “The culture is open. Staff genuinely care about the lads in there. They want to do better. They’re aspirational. They’re not scared to ask a question.” The provider’s health and wellbeing lead told us, “Staff are always so welcoming, they’re proactive. The people are out having fun, you can hear they’re happy. Staff feel more empowered. They feel more trust. Documentation has come along, its more person-centred then perhaps before. Everyone’s singing from the same hymn sheet.”

The service was meeting the best practice guidance of Right Support, Right Care, Right Culture. The model of care maximised people’s choices and independence, and the care provided was person centred. The ethos, values, attitudes and behaviours of leaders and care staff ensured people using services lead confident, inclusive and empowered lives.

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.

On the whole, staff members had trust in the management team and their commitment to doing the right thing for people. A staff member told us, “The management are very good. [The manager] is a very good team member and a very important one. She is so friendly and polite all the time and she’s so great in the team. And I only have good things to say about [deputy manager], she’s a problem solver. You know you only have to ask once and between the both of them its sorted.” Another staff member told us, “It’s been all positive changes. They’re dotting the I’s and crossing the T’s. They’ve made some excellent changes. They are wonderful.” A further staff member commented, “The managers are welcoming and if they think there is something wrong, they check up on us and support us.”

The deputy manager was hands on and involved in people’s care. This included supporting people to access the community. The told us they enjoyed doing this as it allowed them to know and understand people better. The health and wellbeing lead told us “[Deputy manager] is brilliant, she is so amazing with the people we support. Her engagement is great and is brilliant for the team as she’s such a positive role model.” This was the deputy manager’s first post in a management position, and we were informed by staff they had embedded positive changes within the service. They were undergoing further training to upskill them in other areas of leadership, such as people management and having difficult conversations.

Equally, the deputy manager felt supported by their line manager and others. They told us, “I feel really well supported. If I have a question I will speak to [manager]. When I’m on-call [the regional manager and manager] always say I can call them. They both have an open-door policy. I have gone to [the health and wellbeing lead] and she has always helped. I was updating all the medicine profiles and she came over to help me.”

The health and wellbeing lead also spoke highly of the manager, saying, “She is very proactive and listens. If she doesn’t know something she asks the right person the right question. She’s high energy and gets things done. I give her feedback, and I know it’s going to be sorted. She doesn’t stop until its done and that give you so much confidence.” Relatives were also complimentary of the management team. One relative said, “There's more communication and better feedback.” The manager had been at the service for 4 months at the time of our assessment and was in the process of completing her registration with CQC.

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

The deputy manager told us, “When I first stated I explained I have an open-door policy. We’ve had a staff member come to me in confidence and tell me about a concern. I asked if they wanted to stay anonymous or not. I spoke to the other staff member, and we resolved it. I don’t want staff to feel they have to hide something for fear of getting in trouble.”

Staff reiterated this and had noticed improvements in the service around being able to speak up. One staff member said, “I used to be scared to come to work, because we were scared of saying anything in case we lost our jobs. We used to just do our job and go home. We were depressed. If I compare then and now, the people are happier because if the staff are not happy, how can they deliver quality care. Concerns raised were swept under the carpet. I lost confidence in raising any concerns. I wrote a letter of concerns to previous management, nothing was done.”

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

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.

Regular audits were completed to identify any issues within the service that needed resolving. This was done for areas such as environment, care plans, and mental capacity assessments. We observed that where issues had been identified, these had been rectified in a timely manner. The deputy manager told us, “We did the medicine audits and picked up medicine competencies needed to be done. We’ve done a fire door audit. Some of them need to be replaced. We’ve had an internal audit done so we’re working on the actions form that currently.” Staff were involved in making improvements within the service, with any issues identified being discussed in team meetings and supervisions and actions taken to improve.

There was a robust contingency plan in place. This included actions to be taken in the event of an emergency such as a loss of access to the building or adverse weather.

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 service had been working closely with the local authority quality assurance team. This was to make the improvements required to the culture that had been identified at the end of 2024. The local authority was complimentary of the management team’s engagement with them, and commented on how responsive they were in resolving the issues.

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.

Regular staff meetings and supervisions took place to engage staff members in the culture and running of the service. A staff member told us, “We have regular staff meetings. We talk about everything; what we’ve learnt from mistakes, how to solve them.”

People were also able to have their say on the running of the service through quarterly quality surveys.