Appletree Grange

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 requires improvement. At this inspection the rating has changed to good. This meant the service management and leadership were consistent. Leaders and the culture they created supported the delivery of high-quality, person-centred care.

This service scored 79 (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 members’ comments included, “Teamwork has improved massively, we lead from the front” and “I think Barchester’s values are lived by staff, they show respect.” New staff received support and training which helped them to demonstrate the provider’s values in their daily work with people. Staff members’ comments included, “I completed the usual induction, 2 weeks of shadow shifts including a night shift so had a 24hr understanding of the care home” and “I have done training about dementia care and distressed behaviours, the training is good, it helps with doing the job.” People and professionals said the service encouraged people to regain or maintain their independence, achieve exceptional outcomes and extend their abilities. There was a cycle of learning, improving and always striving for the best care and support so people's needs could be met effectively.

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. The registered manager recognised and celebrated staff contributions, where staff worked to help ensure people received person-centred care. For example, a recognition event took place with residents and staff to celebrate the activity co-ordinator’s creativity and dedication. Staff from overseas were supported to continue their professional development and achieve leadership positions. Staff members’ comments included, “I am deeply grateful to Barchester Healthcare for making it all worthwhile, and for contributing to my personal and professional growth” and “I have recently completed level 5 in management and leadership.” A motivated and enthusiastic staff team was in place. This was led by a motivated management team that worked together to follow best practice and achieve positive outcomes for people. Several staff said they “loved” coming to work and some said, “The best place I have worked.” Staff and relatives’ comments included, “Staff morale has boosted since the manager came into post, employee of the month has been restarted, and they add positive feedback via Loop”, “The managers look after the staff”, “The leadership is the best I have worked with”, “The manager is very energetic and approachable” and “The manager is brilliant.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.The provider had a clear whistle blowing policy. Staff could raise concerns, and written information was available of how to do this. Staff meetings took place, and staff had the opportunity to share comments and give feedback. People were informed of the complaints procedure when they started to use the service and at meetings. A person commented, “I have never needed to complain, we all get on ok.”

The provider valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them. Staff told us they were able to ask for reasonable adjustments to be made to their working patterns for specific needs, for example to incorporate family commitments.

The provider ensured the governance was effective and robust, including the monitoring of the quality-of-service provision. The service had clear responsibilities, roles, systems of accountability and 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. Regular audits and checks were carried out in the main areas of the service, such as, around care records, health and safety and staff practice. Audits showed action was taken where areas of improvement were identified.

Staff at the service 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. The provider and registered manager had grown their networks with partnership agencies and charities. They took a pro-active and practical approach to involving themselves in local and national projects and initiatives. A range of care professionals described the very positive working relationships the staff had promoted for the benefit of people who used the service. The management team were positive about their links with local partners and health and social care teams.

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. There was evidence of changes that had been made to the service to make improvements and to address checks and audits outcomes and in response to people and staff feedback. A staff member commented, “There is a good culture of learning.” External quality assurance arrangements were in place to monitor the internal governance systems.