Avondale 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 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 changed to Outstanding. This meant service leadership was exceptional and distinctive. Leaders and the culture they created drove and improved high-quality, person-centred care.

This service scored 89 (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 very clear shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the challenges and the needs of people and their communities. There was a clear focus on providing high quality mental health support that focused on rehabilitation and recovery. People we spoke to explained how they were no longer dependent on drugs or alcohol, could maintain healthy relationships or were able engage with their wider community. The service were creative in using topical themes as an opportunity to focus on mental health in a safe and accessible way. For example during our visit, people were creating mental health themed pumpkins and were using Halloween as an opportunity to reflect on themes such as fear, trauma and belief. Staff were constantly challenging themselves about how to further support people, and develop the support they received. One example explained to us were plans to create a dedicated post box where people could write down and post reflections on their own mental health that they did not feel comfortable in speaking about. People would then get together to burn the contents, to symbolise letting go of anxiety and worries. Staff universally knew people well and as individuals, promoting independence, choice and delivery of care in the least restrictive way. For each person there was a clear plan on what they wanted to achieve from their life at Avondale, and staff worked collaboratively to make this happen.

The provider had exceptionally 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 always did so with integrity, openness and honesty. All the people we spoke with were highly complimentary of the leadership at the service, and how they role modelled the values of care and compassion to their team. They had a strong understanding of the principles of Right Support, Right Care, Right Culture and had embedded this with the service. There was a culture focusing on people’s strengths and as individuals with their own rights and freedoms. All leaders we spoke to emphasised the ability of people to make their own choices, and had worked to put in place effective and innovative systems to enable people to live life on their own terms. One person spoke strongly about the impact the manager had on them personally and explained “I trust staff and can talk to people here. Especially the manager”. A stakeholder told us “The manager knows people inside out. They are faultless and set the standard for all managers”.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Staff spoke with confidence that if they had concerns, these would always be listened to and acted upon. There were a wide variety of ways for staff to speak up including through surveys, team and individual meetings. We saw staff actively and passionately be enabled to advocate for people at these meetings. For example at a recent meeting staff raised concerns about one person’s sugar intake, and the staff team discussed together ideas they had about how they could work with them to manage this safely. This has since resulted in this person having a healthier diet and diabetes that was more effectively controlled. One staff member told us “I really enjoy how proactive management are and how closely they work alongside staff”. Another told us “The company is really good and is support always available, including group chats with other Avondale services so we can access support and guidance when needed”. Staff knew where to find the whistleblowing policy and could explain other agencies they could contact to speak up if they felt they needed to.

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. There was a strong culture of equality and diversity amongst the workforce. Staff felt supported regardless of their background, were treated with respect and could access help and guidance both professionally and personally when needed. All staff received equality and diversity training and role modelled this in all their interactions as a team.

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 strong and robust governance systems in place to manage all areas of the service. This included systems to regularly review people’s care needs and wishes with them, to ensure up to date and comprehensive plans were in place to provide the support they needed. There were checks on the safety of the service, staffing knowledge and competence, and on people’s experiences to ensure the service continued to operate safely. Systems ensured all staff were strongly aware of people’s most acute needs and how to respond to them through a red, amber, green (RAG) rating which was reviewed regularly. There were clear responsibilities amongst the staff team, which empowered staff to take ownership and actively contribute to the ongoing improvement of the service.

The provider clearly understood and carried out their duty to collaborate and worked in partnership, and services worked seamlessly for people. They always shared information and learning with partners and collaborated for improvement. Partner organisations spoke highly of the positive relationships they had developed with the provider, and with confidence about how the service worked with them proactively to advocate for and ensure timely support was provided to the people in their care. There were clear robust pathways in place between organisations, for example a standard agreed procedure for one person between a number of services that ensured they would receive consistent care from each organisation during a mental health crisis. This ensured all staff this person would engage with would understand how to communicate with them, reassure them and protect them from harm. The provider engaged closely with the wider community and we saw evidence of the close relationships developed with a wide range of partners. The registered manager led a local group of mental health providers who came together to share best practice and learning with each other to support continual improvement. One stakeholder commented “Avondale, in my view, is the pinnacle of what support should look like. The manager and the team are creative in their approach to the residents, flexible, considerate, and very person centred. I know, if a resident is recommended to move to Avondale, they will be in safe and caring hands”. Another professional stated “The people I have met from Avondale have always been first class and make joint working very easy”.

The provider had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research. We found an exceptional culture of learning at the service, where opportunities for continuous quality improvement were actively sought and taken. There was a detailed analysis of incidents to identify where there may be support needs were not being met, or could be managed more effectively. For instance, there had been recent incidents where people had not been managing their finances safely so the provider worked closely with these people to develop safe spending plans, and developing important life skills around money managed. They had developed their own in house resources specifically tailored to the people at the service, and enabled staff to use these tools to proactively explore people’s mental wellbeing and work together to plan for the future. The service actively contributed to research and innovation, for example during our visit there was a focused session for staff and people around how to report side effects from medicines to the Medicines and Healthcare Products Regulatory Authority (MHRA). Staff had empowered people to discuss their own medicines, and encouraged them to be observant of any side effects to both support their own health and to contribute the national evaluation on the effectiveness of medicines.