Alandale Residential Home

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 Inadequate. This meant there were widespread and significant shortfalls in leadership. Leaders and the culture they created did not assure the delivery of high-quality care.

The service was in breach of legal regulation in relation to good governance.

This service scored 32 (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 did not have a shared vision, strategy and culture based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not understand the challenges and the needs of people and their communities.

There were significant risks posed by the culture at Alandale, which leaders had not identified or taken steps to act upon. Feedback from staff highlighted cliques or divisions within the workforce which risked information and concerns not being raised appropriately. People had picked up on disharmony within the workforce with one person saying, “Staff don’t seem as happy now. There’s a bit of an atmosphere and I'm not sure why”. There was a poor safeguarding culture where incidents were not consistently reported, and where there were inadequate policies and training to ensure the safety of children and young people who visited or were employed at the service.

The provider did not have inclusive leaders at all levels who understood the context in which they delivered care, treatment and support, or who embodied the culture and values of their workforce and organisation. Leaders did not have the skills, knowledge, experience and credibility to lead effectively, and they did not do so with integrity, openness and honesty.

Although we received positive feedback about leaders, they had not understood or followed their responsibilities to consistently safeguard people, staff and visitors from harm. Significant errors of judgement had been made regarding certain staffing decisions, and they have not recognised situations that posed significant risks to people including a closed culture, child safeguarding and of people falling down the stairs and seriously injuring themselves.

People did not feel they could speak up and that their voice would be heard, and risks of a closed culture had not been identified or acted upon.

We received mixed feedback from staff about how comfortable they would feel raising concerns, and some raised concerns that the culture and number of closely related staff made this difficult. One staff member told us, “When concerns or incidents are reported, confidentiality is not always maintained. Information can become the subject of gossip within the home”. Some staff stated they would have no concerns with sharing concerns. However, the provider had not recognised the significant risk of a closed culture where unconscious biases, friendships and power dynamics made it far more likely that information would not be shared or that appropriate challenge would happen.

The provider did not always value diversity in their workforce. They did not always work towards an inclusive and fair culture by improving equality and equity for people who worked for them.

Staff raised concerns about inequality and favouritism within the staff team and did not always feel they were supported equally. One staff member said, “It can get a bit lonely as many staff are related so naturally close to each other”. However, staff did share positive feedback that when they needed additional support due to their personal circumstances this was always available. One member of staff told us, “Alandale is generally very supportive when staff need time off for appointments, childcare, or other personal circumstances, and that flexibility is appreciated”.

The provider did not have clear responsibilities, roles, systems of accountability and good governance. They did not act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

Although governance arrangements were strong in some elements, the provider had failed to ensure that people were safeguarded from harm and that appropriate risk assessments, staffing arrangements and oversight where in place to make sure this happened. There were regular checks on the safety of elements such as the environment, however incidents were not being consistently reported or learned from to ensure peoples safety. Governance arrangements had not ensured appropriate policies and training were always in place in line with safe practice, or that staffing decisions were made in way that was structured to prevent a closed culture.

The provider 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.

The provider had not always acted with openness, or shared information with partners including people, families, staff and safeguarding authorities where appropriate. There was a closed culture which had prevented information sharing in some cases. However there was positive relationships with local health services, including regular visits from stakeholders such as the GP practice, community nursing teams and mental health services to review people’s needs. When people’s health deteriorated a referral was made for appropriate support as required, for example to mental health services for one who had recently become distressed. One partner organisation told us, “I found communication with the staff to be appropriate, and they were generally willing to work collaboratively with us to ensure that residents received the care and support they needed”. Another stakeholder shared with us, “The staff at Alandale are really lovely to work with. They let me get on with my job but are always there to assist if I need any help with a resident”.

The provider did not focus on continuous learning, innovation and improvement across the organisation and local system. They did not encourage creative ways of delivering equality of experience, outcome and quality of life for people.

Although some improvements had been made since the last inspection, the provider remained in breach of legal regulations and continued not to offer a standard of care that was safe in all regards. There was poor culture of incident reporting, analysis and learning to drive improvements at the service. Risks to people had not been identified, although were acted upon once raised during the inspection. The provider was working with an external consultancy to identify further areas for improvement prior to our visit, however this was at an early stage and had not mitigated risks to people’s safety and concerns around a poor culture.