Aurem Care (Glebe House)

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• 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 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 68 (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 strove to provide a consistently good, high quality service to people and people and relatives spoke highly of her. A relative told us, “[Registered manager] would have a chat with mum after she visited dad as she knew she was upset. She also rang mum a couple of times after dad died to see how she was. The experience was positive and he was definitely in the right place.” They went on to say, “[Registered manager] leads a good team. They are hard working and dedicated and a credit to Glebe.”

Staff were happy working at the service and said the culture within the staff team was one focused on people. They told us, “I really like it here. It’s a good team. I feel very privileged to work here. The team is the strong foundation of the home”, “I love this place. It’s a good environment for working. We do things for the best of the person” and “Staff are lovely and staff members here work very, very hard.”

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.

It was clear the registered manager knew the people they looked after very well. During our introductory meeting they were able to tell us specific information about each person (including times of their medicines) without consulting any records. They were genuine in the way they spoke about people, their needs and how they supported them. They told us, “I want a team who comes to work in the morning with the same goal and that is to look after the residents. Our priority is their safety and I need staff who know people and don’t case them together as a group.”

The feedback we received was consistently good in relation to the registered manager and how she managed the service, looked after people and their family members and cared for her staff. Comments we received included, “I am really impressed with her [registered manager]”, “The leadership is brilliant. [Registered manager] is visible, she is there”, “[Registered manager] knows everything about the home”, “[Registered manager] is amazing how she handles things, she is so supportive” and “[Registered manager] is respected because she gives respect.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff were confident in being able to speak up should they notice something or have concerns. Comments we received included, “We have a whistleblowing policy in place. We remind staff all the time about safeguarding. We encourage them to whistleblow”, “We know how to raise concerns and also outside of here, but this would not be needed”, “I would speak to the nurses or [registered manager] if I was worried about anything. I can talk to head office if needed” and “There is a whistleblowing policy here. We have a number to call if action has not been taken.”

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.

Staff undertook equality and diversity training and the culture within the service was one of equal opportunity. The registered manager told us, “Sometimes I interview someone who may not be an immediate fit for the role, but I want to give the opportunity to the person to grow and work as part of a team. I look for talent, someone who is kind and caring. I don’t look at where they come from.” Staff felt there was equality within the staff team, telling us, “[Registered manager] encourages staff to develop” and “We are all from different countries, we all get along, no conflict.”

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.

There were robust governance arrangements in place within the service. These were used to regularly check the quality of the service being provided and for the registered manager to know where focus was needed to improve standards. The registered manager told us they had identified some delay with staff answering people’s call bells through a call bell audit. They showed us how they were addressing this, with reminders to staff, and consistent following up. Other audits included care plans, medicines and health and safety and the regional director also undertook regular ‘inspections’ of the service to check its quality. We read in the health and safety and regional directors audits the environment and furnishings had been highlighted as needing attention. The result of this was the refurbishment action plan which was shared with us following the inspection.

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.

Although the registered manager said they had links to the local area, such as the church and local schools, further work was needed to develop these to support people more in going out as people had told us they would like the opportunity to go on outings.

Strengthening community links would help ensure people had more opportunity and engagement with the local area. It would also support people’s wellbeing, and quality of life by enabling them to participate in outings and activities that reflected their interests and preferences.

The service worked well with external agencies such as the GP practice, district nurses, tissue viability nurses and the dieticians. This helped ensure people received the support they needed when they needed it.

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. They actively contributed to safe, effective practice and research.

The registered manager said it had taken time for the move to the new provider to become embedded within the service, as it had previously been family run. However, they explained that, with support from the regional director, they had adapted to working for a larger organisation, the new systems and ways of working. This included moving over to electronic medicine administration records within the last couple of days.

Although they felt supported with the day-to-day operations, their vision for the service was to improve the fabric of the building. They told us, “I want the building improved to mirror the care. I enjoy what I’m doing, but the environment needs to match this. People deserve to live in a nice place. This now my focus.” The provider had committed to refurbishing the premises but they were yet to commence it.

We spoke with the regional director about this, and following our visit they provided us with a copy of refurbishment plan. However, while a few of the actions had target completion dates, much of the plan did not include clear timescales or end dates for completion. This meant there was limited accountability regarding when improvements would be carried out, and no clear assurance that the required works would be completed within a reasonable timeframe. We will continue to touch base with the registered manager to monitor progress on this improvement.

Notwithstanding this however, the registered manager was committing to learning and improving. Following our visit they took immediate action to address any areas we had highlighted to them, developing an action plan in the process. This included running hand washing training sessions for staff, dignity supervisions with staff and exploring opportunities for people to go out more.