Hailey 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

At the last assessment, the provider was in breach of the regulations because they had failed to ensure effective monitoring and management of the quality and safety of the service, oversight of incidents and safeguarding concerns, staffing, maintenance of the premises and people’s access to social and leisure activities. At this assessment, significant improvements had been made to the overall management, governance and quality of the service. Systems had been introduced which were effective and sustainable and involved people and staff in the development of the service using a collaborative and inclusive approach. The provider and manager had created a caring and inclusive culture for people and staff who lived and worked at the service.

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 culture of the service promoted people's individuality. People's care was person-centred, and staff focussed on their needs, wishes and quality of life. Staff told us how supportive the provider and manager were and how opportunities were available for their personal and professional development. The manager led by example to ensure they created a positive culture which placed people's needs at the heart of the service.

The provider and manager had created a shared direction and positive culture at the service. This included revisiting the values and behaviour of the service and how everyone could work collaboratively with respect and honesty to make Hailey House a quality place to live and work.

The manager had been employed at the service for many years but in different roles. They had been in the role of manager for a year and were applying to be registered with CQC. We found them to be a capable, compassionate, knowledgeable and an inclusive leader and role model. They were well respected by people, family members and staff who found them approachable, communicative and transparent. A family member told us, “I can always go to [manager’s name] as they know [relative] so well and I can talk to them about anything.”

Staff told us the manager had made improvements to the service, and they felt able to discuss their views and ideas with them. A staff member told us, “My manager is approachable and fair to all staff. They are always supportive and always ready to help.” We were assured the manager had the appropriate skills and experience to manage the service.

Staff felt they could speak up and discuss issues and concerns and report to the manager. They told us they would be listened to, and action would be taken. A staff member said, “There is information about whistle blowing on poor practices. I do not do it because I don’t feel any need to do it but I know the process to take.”

The provider had invested in opportunities for staff to feel valued and supported in the workplace. Resources were available to assist staff with their physical and mental health. Staff get a blue light card, access to an assistance programme which has a legal advice and mental health helpline, an employee of the month award with a financial reward for staff doing something out of the ordinary. Staff had the necessary support to thrive in their roles.

Staff told us the provider and manager were supportive and inclusive. They had a thorough induction and shadowing and were welcomed into the team. A staff member told us, “My suggestions are welcomed, and I feel like they hear what I am saying. I get feedback on my competency sheet. I always feel part of the team and involved, never felt neglected.”

Staff came from diverse backgrounds and experiences which helped to shape the service and create a more equitable and inclusive organisation. There were effective and proactive ways to engage with and involve staff, with a focus on hearing the voices of staff with protected equality characteristics. Support and flexibility and reasonable adjustments were made for staff as and when needed.

The provider's processes for monitoring the quality and safety of the service were effective and responsive. People were kept safe, their rights protected, and they received good quality care and support. We saw audits completed which checked all parts of the service were working well and actions were taken to remedy any shortfall or negative impact on people. The manager demonstrated they had oversight of people's current needs and risks to their health and safety. Risks to people's safety were well managed and monitored. Information in care plans and risk assessments was up to date and there was a process to effectively audit people's care records. There was robust oversight of incidents, accidents and safeguarding concerns. Actions taken to investigate and analyse incidents, and safeguarding concerns were recorded and lessons learnt as a result. These were shared with staff in team meetings to ensure all worked together to improve the service.

The provider was developing systems to actively involve people and their families in the service. Improvements in the service had been made but needed to be sustainable and embedded going forward. The provider’s development plan for the improvement of the internal and external building work was comprehensive and had clear timescales. The provider was transparent about the financial implications and timescales involved in reaching their goal of making Hailey House a fully accessible and well-maintained place to live and work.

People spent time in the community, alone or with their families and with staff. People had visits from local schools and entertainers who provided entertainment and social engagement.

We saw evidence of effective communication and collaboration with healthcare services and referrals were made in a timely way. There was good communication with a range of professionals who worked together with the staff and manager as partners to enable people to keep well and access health and social care services.

The new collaboration with a local primary school showed a positive approach to working more with community organisations and forming mutually beneficial relationships.

Work was underway to access more opportunities for partnerships, joint working and mutual collaboration with community groups.

The provider and manager supported staff to develop their skills and speak up with ideas for improvements. In the 2024 staff survey, areas for improvement were noted as creating and more engaging atmosphere, fostering stronger teamwork and addressing the infrastructure and care quality. It was evident from our assessment that staff had been listened to and were helping form the development of the service. There was a sense of trust and commitment between the leadership of the service and staff which had helped to make the culture and future investment in the service a positive journey.

Improvements to the service had been implemented following evaluation of the culture, policies and processes for the governance and quality of service delivery and people’s outcomes and experiences. The provider and manager had a good understanding of how to make improvements happen. Their approach was consistent, collaborative and inclusive. There were processes to ensure that learning happened when things went wrong. The manager encouraged reflection and collective problem-solving.