APT Care Central Bedfordshire & Bedford

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.

Staff consistently described a positive and open culture. One staff member said, “The culture is supportive and professional. Staff are encouraged to speak up about concerns, ideas, or safeguarding issues without fear of blame. Open communication helps improve care and maintain safety.” Others said, “The culture is open and supportive, staff are encouraged to speak up,” and “Team culture is honest and supportive.” This showed staff felt confident to raise concerns and contribute to improvements.

Leaders described a culture focused on honesty, learning and continuous improvement. The provider’s values and expectations were also set out in information shared with people, supporting transparency and respectful relationships.

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.

People's experiences of leadership were varied. Many people described management as approachable and supportive. Comments included, “We have a good relationship with management and office staff. They are very helpful, especially when my relative’s health needs require more attention,” and “Management is excellent and very contactable. We would highly recommend APT to everybody.”

However, some people raised concerns about communication, responsiveness and invoicing. One person said, “The management make promises, but they don’t always follow through.” Another told us, “I keep asking the office when I will receive a bill, because I’m concerned it’s mounting up. I keep contacting them, but nobody ever gets back to me.”

The provider had recently strengthened leadership arrangements. An experienced registered manager had transferred to lead the service shortly before this assessment. Staff spoke positively about the visibility, oversight and support provided by leaders. One member of staff told us, “The office staff are really helpful in all situations. If we are stuck or there is an emergency, they work as a team and are always there to help us.” Staff said managers were approachable and that they felt confident raising concerns and would be listened to.

Professionals were also positive about leadership. One professional described the service as “well led and supportive,” while another said coordinators were “receptive to feedback, and consistently take on board suggestions to improve practice.”

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

Staff consistently described an open and supportive culture. One member of staff told us, “The culture at the service is open and supportive, where staff are encouraged to speak up without fear of blame.” Another said, “Management are approachable, supportive, and responsive when concerns or questions are raised.”

Staff were confident concerns would be listened to and acted upon. One member of staff said, “Yes, if I notice concerns, I report them following the correct procedures. Management listens and takes concerns seriously, investigates appropriately, and provides feedback where needed. This helps maintain a safe environment for both staff and residents.”

There was evidence concerns raised by staff resulted in action. One staff member told us, “I have raised a few concerns like one time a client wasn’t getting their medication refilled from the pharmacy, so I raised a concern with the office who then notified the client’s GP, and the GP was able to send the medication needed.”

Records showed the provider had systems in place to support speaking up, including a whistle blowing policy.

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.

Systems and processes were in place to promote equality, diversity and inclusion across the workforce, including induction, training and staff support arrangements. Practical steps supported inclusion, including a dedicated prayer space, celebration of cultural and religious events and flexible working arrangements to help staff balance work and caring responsibilities.

Staff told us they felt supported and valued. Comments included, “I feel supported and valued at work” and “Management supports well-being and workload.”

The provider promoted equality through fair recruitment, development opportunities and tailored arrangements for new staff. New carers were allocated a buddy supervisor, and overseas staff received additional assistance to understand workplace expectations and cultural differences.

Records showed information was adapted to meet staff needs. For example, training materials relating to consent, safeguarding and the Mental Capacity Act had been translated into Urdu and Bengali to promote understanding.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to deliver good quality, sustainable care and acted on information about risk, performance and outcomes, sharing this securely where appropriate.

At the last assessment, we found a breach relating to governance systems. At this assessment there was clear improvement in oversight, quality monitoring and leadership. Structured audit systems and regular analysis enabled the provider to identify risks, monitor performance and take action to improve outcomes.

People and relatives told us the provider regularly sought feedback, which supported ongoing quality monitoring and service improvement. One person said, “The management team are okay. Now and again, they will ring up and I’ve had a few visits, so they stay in-tune. One day a senior staff member came to visit while a carer was present, to oversee things. I can confidently call the manager if I need to.”

Records showed a comprehensive quality assurance programme was in place. This included regular audits of care notes, medicines, care planning and incidents. Findings were analysed to identify themes, with learning shared and improvements made. Electronic care systems supported real time oversight and secure information sharing. While some audit themes, particularly recording accuracy, recurred, improvements were evident.

Business continuity plans were in place and regularly reviewed to maintain safe care during disruption.

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.

Feedback demonstrated effective communication and partnership working with health and social care partners, helping to ensure people received joined up care and support.

Professionals described positive working relationships with the provider and told us partnership working supported coordinated care. One professional said, “Over time, we have built a positive and collaborative working relationship.” They confirmed the service was responsive and engaged, including during periods of change, which helped support continuity of care.

Staff understood the importance of working with others involved in people's care. Staff told us, “We work with families, GPs, district nurses, and palliative care teams” and “External professionals are involved in care planning and support.”
 

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 and effective practice.

Feedback, surveys, audits and quality assurance processes were used to identify areas for improvement and monitor service performance. Records showed complaints, compliments and other performance information were reviewed to support service development.

Digital systems supported oversight and innovation, including electronic care and medication records. Systems were being further developed to identify potential risks and concerns more effectively.

Records demonstrated a focus on continuous improvement. Complaints, audits, surveys and quality assurance activities were reviewed to identify themes and monitor performance across the service.

Several areas, including medication management, on call support and quality assurance arrangements, had been strengthened. Plans were in place to further develop electronic systems and introduce an automated rota system designed to support continuity of care, particularly for people with more complex needs.