Apple Trees Care & Reablement Centre

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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

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.

The provider had established clear policies, protocols and comprehensive training for staff, all of which were closely aligned with their overarching vision and strategic goals. These governance arrangements ensured staff were well-equipped to deliver consistent, person-centred care. Staff demonstrated a strong understanding of the provider’s values and strategic direction, which was reflected in their day-to-day practice and contributed to positive outcomes for the people they supported.

Staff were able to articulate the provider’s vision for the service and the outcomes they aimed to achieve. One of the provider’s core values, as outlined in their quality statement, was to uphold people’s rights and empower them to maintain control over their lives. Staff consistently demonstrated how this value was embedded in practice. For example, 1 staff member described how they supported a person who experienced difficulty communicating verbally. To ensure the person remained empowered to make their own decisions, staff used a range of strategies including visual prompts and allowing sufficient time for the person to respond. This approach enabled the person to continue making choices and maintain autonomy in their daily life.

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.

Throughout our assessment, staff consistently told us they felt supported by both the registered manager and the deputy manager. Staff described the leadership team as approachable and engaged, with one staff member stating, “They make time to talk to residents. They talk to staff regularly and you can have a good conversation with the registered manager. I think we have struck it lucky with them.”

Our evidence supported what we were told about the leadership of the service. Both the registered manager and deputy manager were visible within the service and operated an open-door policy, which enabled staff to seek support when needed. This contributed to a positive and inclusive working environment.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.People, relatives, and staff were supported to speak up if they had any concerns.

Throughout the assessment, we saw multiple examples of how the registered manager and provider encouraged open communication. The manager worked proactively with families to address any issues they raised. One family member told us, “I can go to the office at any time if I have any concerns.”

Staff reported feeling confident to raise any aspect of care with the management team, knowing they would be listened to. There were records of regular meetings held with residents, relatives and staff. Staff received regular supervision and one-to-one sessions. The registered manager operated an open-door policy. One staff member said, “Yes, if you have any issues you are able to go speak to leaders without repercussions.”

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.

The provider had clear policies in place to promote equality and diversity within the service. Staff consistently reported feeling well treated by the management team, including team leaders and senior staff. One staff member stated, “Yes, happy with the way I am treated by the service and trust,” and went on to express satisfaction with their role.

Another staff member shared they felt listened to by management. A senior carer highlighted the flexibility offered by managers, saying, “The managers have worked with staff to be flexible, for example, if a member of staff needs to drop their child off at nursery and it doesn’t open as early as their shift starts, they can, by arrangement, begin work later.”

The registered manager reported feeling well supported by the provider’s Human Resources team, indicating a strong framework of support for leadership and staff.

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.

The service had a comprehensive quality monitoring programme in place. This involved various staff members undertaking regular audits to ensure that both care standards and the physical environment were consistently maintained. Where issues were identified, appropriate actions were taken, with clear documentation outlining responsibilities and expected completion dates.

A dedicated quality assurance team supported staff on site. During the inspection, a health and safety audit was observed, conducted jointly by the quality assurance manager and the in-house maintenance person. This collaborative approach ensured a thorough and effective audit process.

The registered manager and deputy manager reported that they had worked closely together since taking up their roles to strengthen quality assurance practices. Key areas of focus included care planning, medicine management and the reporting and review of incidents and accidents.

Clear processes were in place to communicate audit findings to staff, enabling timely improvements and promoting accountability across the service.

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.

Staff at the service had established strong working relationships with health professionals who regularly visited the service. One unit operated as an active recovery unit, supporting people to regain independence and return to their own homes. One family member said, “[Management] do seem to have forged a good relationship with the local GP, District Nurses, Paramedics and the local authority, which is always helpful when you need something quickly.”

There was effective involvement from professionals including physiotherapists, occupational therapists and social workers. During the inspection, we spoke with visiting health professionals who reported that staff were responsive to guidance and worked collaboratively to support positive outcomes for people using the service.

The provider focused on continuous learning, innovation and improvement across the organisation and local system.

There were clear processes in place to support learning and continuous improvement across the service. This included learning from incidents and events, as outlined in the ‘Safe’ section of this report.

Staff reported regular opportunities for professional development through the provider’s structured learning and training programmes. These included mandatory training, refresher courses, and access to specialist modules tailored to the needs of the people using the service. Training was delivered through a combination of online platforms and face-to-face sessions, and staff were encouraged to pursue additional learning relevant to their roles.

The provider monitored training compliance and ensured staff remained up to date with key areas such as safeguarding, infection control, moving and handling and medicine management. Staff also had access to more advanced training, including dementia care, end-of-life care and mental health awareness.

The registered manager actively participated in the provider’s regular registered managers’ meetings, using these as a platform to network and share best practice with peers. The provider also employed specialist staff, such as end-of-life care nurses, to ensure teams across all services were supported in delivering care aligned with best practice guidance.