OSJCT Athelstan 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 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 82 (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.

Provider values were shared with staff during their induction and available on staff communication systems. The values were also available to people on the providers website. In the provider information return (PIR) the registered manager told us, ‘Our five values are at the heart of everything we do. We incorporate these values when we are recruiting new members of the team into the home, and we recruit people who share the same values as we do. We deliver the highest quality of care by taking pride in our work and being dedicated to everything that we do. Athelstan House has a diverse culture with many of our employees coming from different ethnic backgrounds. These cultures strengthen our values and experiences as a team and the care provided to our residents’.

The registered manager said, “Anyone visiting the home tells us the atmosphere is welcoming and friendly. I love coming to Athelstan, feels like it is going in the right direction. The residents deserve good care; everyone here has the confidence we provide a good service. We have an initial vision for the service; we want a good rating. But why should we stop there, why can’t we be a flagship home, we want to be outstanding. We want to build on empowerment for residents, we want room to grow that empowerment for people.”

Staff were all positive about working at the service. Comments from staff included, “I love it, I love everything about it”, “Every day is different, I enjoy it, it is a good team here” and “This place is good, there is no discrimination. It is a good working environment.”

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.

The management team at the service were very experienced and had a very high level of knowledge about people’s needs. This meant they could easily support staff to make sure people had good quality person-centred care. One relative told us, “I cannot praise this care home enough. [Person] has been there for about 2 years, and in that time, we have seen such an improvement in mental and physical health. The staff are amazing and nothing is too much trouble. [Person] has gone from being unable or unwilling to care for themselves to being more alert and caring about their appearance. [Person] has been given their life back.” Staff told us all the management team were approachable, inclusive and ready to help them with care if needed.

The management team were influential within the organisation which meant they could influence policy changes and take the lead on piloting new ways of working. The registered manager told us “Vision informs strategy, and I am always thinking strategically…how do I prevent that happening across the Trust.”

All the management team had achieved health and social care national qualifications appropriate for their roles. The registered manager had achieved a level 7 award for management of social care services. Succession planning was evident with a real focus on developing all within the team.

The regional manager spoke with pride about how the home had “turned a corner since the last inspection”. They told us they had focused on a renewed sense of purpose and worked hard with the registered manager to make improvements.

Feedback from people, relatives and staff about the management team were very positive and the management approach was really appreciated. Comments included, “The management team are excellent, staff are well directed and motivated to provide a loving, caring environment. This stems from the top” and “Athelstan House's excellence is its staff. Whether it be the management or the carers.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Staff felt the registered manager was approachable and would listen to them if they needed to raise anything.

The provider had a whistleblowing process which staff could use to raise any concerns if they did not want to approach management. The regional manager told us they carried out ‘listening events’ at the service with HR colleagues encouraging staff to come forward with any issues or concerns.

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 diverse team of staff working at the service. They were supported by systems to ensure equal opportunities and an inclusive working environment. Policies and procedures were in place to guide staff on equality, diversity and inclusion. Staff received training to ensure staff had the skills and knowledge to work inclusively.

Different cultures were celebrated. For example, an event had taken place at the service celebrating overseas culture. National costumes had been worn and food from that country prepared. We saw this event had been very positive for staff from that country and helped them feel included.

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.

Governance systems were effective in identifying areas for development or improvement. There were a variety of audits being completed by different staff. This helped to make sure checks for quality and safety were not completed with complacency. The provider had a central team of staff who also visited the service to complete audits, reviews and checks. This work had been completed unannounced and out of office hours to vary engagement of staff.

The registered manager was aware of their responsibilities to submit statutory notifications to CQC as required by law. All of management and the staff at the service had to complete data security training. The provider had an information governance department who helped make sure people’s confidential information was safely handled and stored.

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.

Since our last inspection, the registered manager had worked hard to improve relationships with local healthcare professionals. This hard work had resulted in a very positive working relationship with local GP’s, community nurses and other healthcare professionals. Collaborative working had helped to improve areas such as medicines management. Since our last inspection, staff had worked with local pharmacists to reduce the number of medicines errors happening at the service. This improved outcomes for people.

Local GPs visited the service every week and more often if needed. Feedback from professionals was very positive about the impact of a better working relationship. Comments included, “I feel we have a very good working relationship with the team at Athelstan House, and that the quality of care they give is good” and “Care of people with multiple comorbidities and vibrant personalities inevitably brings challenges and occasional conflicts. In these cases, the management will often approach me with a clear intention of putting the person and their needs in the centre to help them the best they can. A holistic view is taken. Equally they are open to me raising concerns with them and will endeavour to find solutions.”

The registered manager told us about work they were doing to improve outcomes for people in collaboration with healthcare staff from the surgery. They had been asked to help take blood pressures for people to share results with GPs. A practitioner from the surgery had visited and provided senior staff with training on how to do this. Once equipment was in place, senior staff would commence taking people’s blood pressures to share readings with clinical staff. This helped identify any health concerns in a timelier way.

The provider division director was on the board of a local provider forum. This was set up to support all care providers within Wiltshire to have a say in the way services are planned. The forum also provided advice and guidance on a range of issues including safeguarding. The registered manager attended meetings and events held by the forum.

Management had good links with local stakeholders and a large group of volunteers helped at the service. For example, the registered manager was invited to attend the local health and wellbeing forum chaired by local councillors. The registered manager said they were able to discuss and learn about what support was available to the people of Malmesbury. They also shared updates from the service with the forum.

Staff supported people to join in with community events and maintain their local links. For example, one person had joined the art group which had enabled them to grow in confidence. They had used their art skills to enter a local competition to design a banner which was then used to decorate the local high street.

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.

Since our last inspection the service had moved all care records to an electronic care plan system. This meant all records were now digital and easily accessed by people, relatives and staff. Where appropriate, records could also be shared with healthcare professionals.

Management had signed up to a shared records system with the local GP surgery. The registered manager told us this enabled them to access GP notes following a visit if they needed to check any actions or details.

The regional manager explained that an annual review for succession planning took place. They said, “We look at every staff member and how we can offer additional support and training…our values are very important.” They told us they felt lucky to have had the opportunity to take a different approach and support the team to grow. Staff told us of opportunities they had been given to grow in their role and gain additional qualifications. All staff felt supported and valued.

The provider held regular managers meetings to enable registered and deputy managers to meet frequently and provide each other with peer support. This was also an opportunity to share learning, innovation and good practice with each other and learn from good work taking place across regions.