Appleton Court

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. This is the first assessment for this newly registered service. This key question has been rated requires improvement. This meant the management and leadership was inconsistent within the service.

The service was in breach of legal regulation in relation to record keeping and governance at the service.

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 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 staff team were passionate about a shared culture of promoting independence and learning within the service. The registered manager had worked hard to instil a culture of openness and honesty, and this was mirrored by the staff team. Staff told us they felt empowered, and they wanted to ensure people had the best opportunities at Appleton Court. One staff member said, “I am super proud of the team, people are empowered, and we all work well together.” Another staff member told us, “We work together to give people the life they deserve.”

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 and deputy manager were passionate about providing good care to people. People and staff told us the management team were capable and inclusive leaders. One person said, “It’s very well managed. [Registered Manager] is really good. They listen to us all and give us advice.” One staff member said, “[Registered manager] is good, very approachable and will always follow things up. They give us the opportunity to explore new ideas and will say, lets just try it and see if it works.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.Managers lead with an ‘open door policy’ which meant people, staff and families could approach management at any time if they had any concerns.Opportunity to speak and share views was offered within the staff meetings with managers taking on board people’s comments and acting on them when needed.

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 an inclusive and fair culture with equality and equity for staff. All staff were positive about working at Appleton Court and felt they were treated with respect.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

Governance systems were established in the service however we found that not all expected areas of care records had the appropriate quality checks in place to ensure these were accurate and to a consistently good standard. For example, audits were not in place to review the quality, safety and accuracy of the care plans. We found care plans varied in quality and did not provide all the information needed in relation to people’s health needs. For example, information around specific health concerns were missing, information on how many people to safety manoeuvre people was inconsistently recorded and care plans lacked information around how staff should safety use people’s equipment. Risk assessments were missing where required and this had not been identified by the services internal governance systems. Care notes had no formal review process so the quality of the staff records when completing a care task varied. For example, when staff assisted a person with their meal preparation they did not always record what meal was provided.

The providers audits gave an overview of care standards within the service, but these had been ineffective in addressing the concerns raised during the inspection. We found that insufficient and outdated care information within the people’s records had been identified as a risk by the provider, however the service failed to follow the provider’s own risk assessment to ensure mitigation was in place for the standard of the care records. The registered manager and provider took feedback on board from the inspection and started work to review the records within the service, implementing an ongoing improvement plan.

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.The management team expressed an open positive attitude to receiving support and understood how and where they could access support, to ensure continuous improvement to the service.Appropriate referrals were made to local authorities and other health care agencies to support where needed and to build relationships in the area.

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.

Even though shortfalls were found during the inspection in relation to records and governance, the provider and registered manager were accepting of the feedback provided and took this onboard to learn and improve. Improvement plans were in place to help address the concerns and new processes were implemented to provide assurance of action and improvement.

The provider had invested into the service to help innovate and improve. For example, a new electronic care record system had been introduced which needed more time to embed good practice around the standard of records.