Wood Hill Grange

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 good. At this assessment the rating has changed to requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care. The service was in breach of legal regulation in relation to governance at the service.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service did not consistently have a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not always understand the challenges and the needs of people and their communities. The management team had failed to implement improved systems to deliver a positive experience and a good quality of life for people. Areas for improvement were required. The provider had implemented a change in the management team, which had occurred 4 weeks prior to our inspection. The new team did have a clear shared vision and strategy. However, the systems were new and had not been fully implemented into practice. The manager also acknowledged that they needed to work on the staff culture, as staff had not been supported, supervised or managed effectively.

Not all staff understood the context in which the service delivered care, treatment and support. They did not always embody the culture and values of their workforce and organisation. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively, or they did not always do so with integrity, openness and honesty. Poor quality of paperwork and systems had been identified. The management team had recently changed, and the team was being further strengthened by new recruitment. The new team were aware they needed to make improvements to the organisational governance systems and support other unit managers to embody the values and culture to drive improvements.

People did not always feel they could speak up and that their voice would be heard. We received mixed feedback from people and relatives. Some said they could approach staff and felt listened to, while others said they did not know who the manger was and did not feel they could raise issues as they were not dealt with. One person said, “I have reported things, but had a very delayed response, on one occasion two staff were arguing between each other in front of me.” The manager said they were improving this and had arranged a meeting to introduce herself to relatives. One relative said, “I have met them, they are a nice person.” While another said, “They have not introduced themselves.”

Staff said they felt more positive with the new management team in post. They felt they could talk openly and were listened to.

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 processes in place to ensure staff were treated in an inclusive way. For example, robust recruitment processes and processes which helped to protect the rights of staff under the Equality Act. Risk assessments and any reasonable adjustments measures were utilised if required.

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. New systems introduced at our last inspection in March 2024, had not been sustained or embedded into practice. The issues we have identified regarding lack of person-centred care, infection control and medicines management and governance was not robust and is a breach of regulation. However, there was a new manager in post who had previously been the clinical lead at the service, they had been in the managers post 4 weeks at the time of our visit. The told us they had identified shortfalls in governance and quality monitoring of the service. They had since their promotion, been introducing new more robust quality monitoring to cascade to staff and drive improvements. Many of the new systems were being used for the first time and had not been fully reviewed or monitored. However, what we saw was robust and if followed would identify issues promptly to ensure action was taken and lessons learnt.

The provider was also looking to further strengthen the team by recruiting a new clinical lead. The regional manager told us they were taking their time with the process to ensure they recruited the right person for the role who would complement the existing team.

The service 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. We evidenced this had not always been happening and staff had not worked in partnership to share information. This was being improved by the manager to improve outcomes for people.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not always actively contribute to safe, effective practice and research. Lessons learned were not always identified or communicated with the wider staff team to mitigate and prevent repeat occurrences. Staff were not supported, supervised, mentored or effectively deployed to ensure improvements were embedded into practice. We discussed with the new management team how the identification of lessons learned and clear communication of learning with the staff team could be improved. This was being improved by the new management team and new systems and processes were being implemented.