Access for Living

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 inspection we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the service was not always consistently managed and well-led.

The provider is in breach of legal regulations in relation to good governance.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a shared vision, strategy and culture. Staff and leaders were passionate about providing person-centred support to enable people to be part of their community. Staff were positive about how the culture of the organisation and the spirit of teamwork enabled them to provide safe and effective care. Comments from staff included, “It is very open and transparent culture. Communication is good and everything is out in the open” and “What I like about Access for Living is the main focus is the people we support.” There was a strong culture of openness, transparency and inclusivity. There were a range of meetings and forums arranged to ensure people receiving care and staff had opportunities to discuss the shared vision and strategy. The provider had also recently increased engagement between the board of trustees, people receiving care and staff.

Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty. Staff we spoke with gave positive feedback about the leadership and management of the service. They told us the registered manager was responsive, listened to concerns raised and took the necessary action to resolve issues when they occurred. The provider had identified a range of training and development goals for the management team to enhance their leadership skills and abilities. The registered manager and nominated individual told us, “We have ensured the management team are far more involved in organisational decisions and are taking more responsibility within their appointed areas of development. We have arranged meetings with the management team and the Board of Trustees to plan strategically for the company.”

The service fostered a positive culture where people felt they could speak up and their voice would be heard. Staff were regularly reminded about whistleblowing and they were encouraged to raise any concerns they had. Staff told us members of the management team were all approachable and they were confident any concerns raised would be listened to. A staff member said, “The managers do listen to us when we make suggestions.”

The service valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who work for them. There was an equality and diversity policy in place which described general ambitions to ensure all staff would be treated fairly. The provider also offered flexible working to support staff with disabilities and/or caring responsibilities.

Senior leaders were present and available and had a good understanding of people’s day-to-day care and individual needs and risks. However, the quality assurance systems and process were not robust and had not identified the issues we found with risk management, documentation, medicines and capacity assessments. People’s relatives told us managers checked-up on them on a regular basis but the provider did not always record these routine checks. The registered manager told us wellbeing checks were being done regularly but not always documented. We discussed these issues with the provider and they have taken a range of immediate actions to address the shortfalls we found. The provider sought feedback from people through regular satisfaction surveys and action plans put in place to address any issues raised.

The service understood their duty to collaborate and work in partnership, so services worked seamlessly for people. Professionals who worked with the service were particularly positive about how well they communicated and worked in partnership to support good quality outcomes for people. One professional told us, “Access for Living are a good partner, they are really good at collaboration. They have worked with us on a range of projects aimed at improving outcomes for people with learning disabilities generally.” Relatives also told us the provider communicated with them well and kept them up to date via a range of communication methods and forums. Comments included, “They always keep me well informed with what’s going on” and “We get invited to meetings at the office. It is a good opportunity to meet managers and staff.”

The provider was committed to continuous learning and improvement across the organisation. However, the systems and processes in place did not always support learning and improvement. For example, people told us the provider was responding to concerns raised but we found they did not have a process for collating these to identify themes and trends. The provider told us most issues were raised informally and resolved as soon as they were raised. However, they have now put in place a process to gather and collate all issues and concerns raised to help identify themes and drive improvements. The provider also told us they were about to introduce an electronic care planning/monitoring system which would help make care records more consistent across the organisation and enable staff attendance and punctuality to be monitored.