Agincare Enable Limited (Wiltshire and Swindon)

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 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 good. At this assessment the rating has remained good. This meant the management and leadership was consistent. Leaders and the culture they created supported the delivery of high-quality care.

This service scored 68 (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 vision, strategy and culture however this was not cascaded down to leaders and staff. The registered manager could not tell us about the provider’s values. We informed the provider that their statement of purpose did not contain the organisation’s values. The provider took immediate action to rectify this.

During conversations for this inspection, the registered manager demonstrated limited knowledge about the regulations and regulatory guidelines required to be followed by such a service. This meant we were not confident the registered manager could demonstrate they were able to deliver and develop the service in line with statutory requirements.

However, leaders, managers and staff understood the challenges and the needs of people and their communities and it was evident staff were demonstrating person-centred practice. Staff displayed transparency, equity, equality, human rights, diversity, inclusion and engagement.

Right Support, Right Care, Right Culture was evident in the ways that staff worked with people but the provider did not embed this within staff culture. Staff and leaders we spoke to were unsure of the regulations that they were required to work toward.

The organisation’s values were not clearly visible and staff and managers were not able to talk to us about them. The registered manager said ‘I know where to find them [the values]’ but did not tell us what those values were. We were assured that staff and leaders were working towards positive values as we saw kindness and compassion when staff were working with people. The provider took action to hold discussions about fast tracking a “culture wall” for staff and people so that these values were displayed in the foyer of the main office.

Managers and staff were working to the Right Support, Right Care, Right Culture model, but we were not assured that this guidance was embodied into the organisation’s knowledge and values. This meant there were gaps in some staff’s knowledge about why it is important that guidance is followed.

However, staff told us the registered manager was supportive and provided them with the support they needed to do their job well. The service was focused on supporting complex people to lead active lives as members of their communities.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. The registered manager told us the service had speaking up procedures, which staff could use if they needed to. Details of these procedures were shared with staff during their induction, team meetings and supervision sessions.

Staff told us they knew how to raise concerns and they were confident leaders would listen to them and respond. Staff had supported people to assert their rights as tenants, for example, ensuring landlords made repairs to their home and where applicable following up with landlords when issues were not rectified.

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 supported staff to make reasonable adjustments to their working patterns where needed, to support them to remain at work. One member of staff told us “I wanted to change my hours and management were great”. Staff told us they felt well supported by the leadership team.

Staff told us they were treated as individuals by the provider and they felt listened to and encouraged to speak up in team meetings and share ideas.

People were included as part of the recruitment process for new staff and were involved in interviewing all candidates. People were offered the final say as to whether or not new members of staff came to work for the provider.

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.

Leaders completed a range of audits and observations of staff practice to monitor the quality of the service. This information was used to plan improvements to the service. Leaders fulfilled their duty to ensure they followed all the principles of the Mental Capacity Act where people did not have capacity to consent to their support. The provider assured themselves they were making best interest decisions which were the least restrictive.

At the time of our inspection, the provider told us they were in the process of switching over to a digital system so not all information about people was in the same place. This meant some information required reviewing before uploading onto the new system and there were duplicates of information in some areas. This meant that there were two version of a mental capacity assessment available for a person.

The registered manager was not able to clearly define the governance process and when asked could not provide examples of how themes are evaluated from the system that was in place. We were informed that weekly governance meetings took place on a Tuesday but the registered manager was not able to demonstrate how decisions are documented due to these meetings not being recorded.

Staff had received supervisions but there were inconsistencies with the frequency of them. Some staff had them every three months while others had them every 6 months. When we asked the registered manager they informed us supervisions were held every 3 months. However, we reviewed records of staff supervision sessions which had been previously held and noted them to have outcomes and learning opportunities clearly identified.

The provider facilitated feedback with staff and introduced quality spot checks. Families and professionals were able to access a portal to see information relevant to their family member while being mindful of data protection.

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 provider’s area manager told us they worked with a range of other professionals to help make sure people received continuity in their care. This included handover and transition periods for people coming into and leaving the service.

People told us how happy they were and how the provider had worked hard to find them jobs in the community that were suited to their needs and abilities. We saw evidence of people working in local cafes, garden centres and charity shops. One business informed us that without [a person’s] positive commitment to their job, the dynamic in the workplace would be so much worse off. That business then added ‘They’re just great with customers’.

People were supported to attend clubs and activities of their choice. For example, they attended weekly evening social events. People were able to tell us about the activities they were supported to attend and why they enjoyed them. They said what work they did and two people told us staff had helped them to travel independently. One person said, “I even fly to Scotland to see my family”.

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 people’s individual needs so that they could deliver bespoke support to staff.

People were enabled to enjoy a full life and be active members of their community. The registered manager and staff had established links with organisations representing people with specific conditions. This ensured staff had current information on best practice for supporting people.

In one house we visited where the provider did not have documents in place for specific issues we found senior support workers had printed off guidance found online in order to best support people. We saw guidance on supporting people with relationships and healthy eating.