HF Trust Gaston 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.

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 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. The registered manager told us that since their appointment in September 2024 their focus had been on building a permanent staff team who prioritised person centred care and encouraged people to live their best life possible. They explained, “It is getting staff to be more person-centred and that is my focus day to day; we talk about it a lot at team meetings. We are getting there, but it is going to be continuously promoted." Staff understood the move to focusing on people’s outcomes and felt engaged in delivering good standards of care. One staff member told us, “[Registered manager] came in and was very open minded. It has been nice having management come in and actually listen to ideas and different ways we can improve the service. She has empowered the staff. If we think something would be good for the people who live here, she takes it on board and makes it happen.” Managers spent time with people and observed staff to ensure they supported people in a person-centred way. The deputy manager mainly worked supernumerary but also had allocated shifts on the rota when they worked alongside staff supporting people. The registered manager explained, “[Deputy manager] is doing a lot of mentoring about how we want staff to work and to lead by example. It is leading by example and giving direction.” One staff member told us, “It is nice to have [deputy manager] on the floor sometimes, it is good for staff morale."

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 registered manager and deputy manager had recently been appointed and had brought consistency after several changes in management. The registered manager told us, “Staff lacked having a consistent manager. I did come into a negative and deflated staff team, but I think morale has improved from the fact they are seeing consistent management every day.” Staff reflected on the benefit of having consistent and available managers who listened to them. One staff member told us, “The staff feel they have more input. [Registered manager] works a lot better for the team and brings fresh ideas and her management style works with the house." Another staff member commented, "The managers are very good; they check in and ask if there is anything I need support with. There is no problem if I need to talk to them. They are very approachable." The registered manager told us they had received support from their line manager and the provider’s quality assurance team during their induction into the service. They also described the processes in place to provide peer support from other registered managers within the provider group. They told us, “I was mentored with a buddy, and we have weekly management calls on a Monday morning and then we have longer managers meeting every month.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. One staff member told us, “If I need to speak up it is not in a negative way. If an issue starts to arise, I feel I can speak up before it becomes something serious. The boundaries are there but at the same time, I know if I need to have a chat, then I am able to." Managers understood the importance of providing feedback, so staff knew their concerns had been responded to. The registered manager told us, “The main thing is being present, answering them and getting back to them if they need anything." One staff member told us how this approach gave them confidence to raise issues and give feedback. They told us about an issue that had been raised and explained, “Staff had said we are not coping, and it was addressed, and we are being updated in staff meetings, so it is nice to know it has been acknowledged and it is in hand. That makes such a difference."

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 registered manager promoted equality and inclusion by speaking with staff and understanding their individual workplace requirements. Where a need was identified, they supported flexible working and introduced reasonable adjustments to support staff at work. One staff member told us how this benefited them, the staff team and ultimately people who lived in the home. They explained, “I was never made to feel an inconvenience and it makes my working day much better. The way staff feel, the people we support always pick up on that, so I think it has made a different feel in the house."

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. At our last assessment of this service, we identified quality assurance processes were not always effective. At this assessment we found improvements had been made. The provider's internal quality assurance team had completed a compliance audit in December 2024. Issues identified in that audit were being addressed and the service improvement plan was monitored to ensure actions to develop the service further were implemented. Governance processes had ensured improvements in the delivery of person-centred care and that the previous breach in regulations had been met.

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 registered manager and staff team worked in partnership with people's relatives and representatives, health professionals and commissioners to ensure people were supported appropriately and achieved positive outcomes. An external healthcare professional told us, “When [registered manager] recently took over as the manager, we had an initial meeting setting out expectations of communication and team working which has proven to be very effective.”

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. The provider had effective systems and processes to help ensure lessons were learnt when things went wrong. Any issues or concerns about the service were discussed during team meetings and staff supervision meetings. The registered manager reviewed people’s needs to ensure staff had the training they needed to support people with a learning disability and/or autistic people. Where a need was identified, further training was arranged, such as in dementia and end of life care. The registered manager was proactive in supporting and developing staff learning and practice to ensure the delivery of good standards of care.