Twyford 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 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 remained 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 provider told us all staff members completed an initial Induction which included equality, dignity, respect and the provider’s mission, vision, and values. The provider shared a regular newsletter with staff to keep the, up to date with news, policy changes and initiatives.

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. People and staff were positive about the management of the service. They felt managers were approachable and supportive. Since coming into post, the regional and clinical managers had actively supported the registered manager. They were open to ongoing learning and improvement.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. The provider had a whistleblowing policy and staff told us a ‘Speak Up’ posters were on display. A staff member commented, “They [managers] are welcoming for you to bring any concerns forward.” The registered manager scheduled regular meetings for staff, including one to one meetings where staff could raise any issues or make suggestions.

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 an equality, diversity and inclusion policy in place. Staff described an inclusive culture, where they were treated fairly. One staff member told us, “We are a team, I like the way we are treated here.”

Overall, 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. Staff undertook numerous checks and audits on a regular basis. The provider had an action plan in place for continuous improvement. Staff recorded the support they provided to people in real time using the electronic system. However, the provider had identified this was any area for further improvement. During our visit we saw staff did not all have access to individual devices which could impact on their ability to review and record information straight away. Managers told us they had ordered more devices and would ensure each staff member always had access to a device. We also found the provider’s governance had not identified that CQC had not always been notified of certain incidents as legally required.

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 provider invited various community groups to hold meetings and events at the home. The registered manager was arranging for a local dementia café to be held from the home and was working with Dementia Friends to provide dementia training for staff and families. There was a hair salon where visiting hairdressers offered hair and beauty treatments, which people enjoyed.

The provider had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcomes, and quality of life for people. They actively contributed to safe, effective practice and research. Following a successful pilot, the provider was working in partnership with a care technology company, to roll out the use of sensor equipment to help improve safety. In another example, the provider had implemented a trial, whereby with consent, people drank decaffeinated drinks, as research suggested this may reduce the risk of falls. They were evaluating the impact of this but believed it had been successful.