Affinity Trust- Domiciliary Care Agency- Central

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 assessment we rated this key question good. At this assessment the rating has remained 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 71 (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 told us how they were proud working for the service. Staff comments included, “I have worked here for a long time. It’s a rewarding job knowing at the end of my shift I have helped [Name]” and “We are encouraged to be innovative. Our ideas come from the people we support. We can think outside the box to help people achieve new things and experiences. “Staff received information on the requirements of their role and the systems in place to meet people’s needs in the employee handbook, training, policies and procedures, spot checks and supervision. Systems were in place to share learning and good practice across the provider’s locations, including lessons learned.

Relatives and staff described most managers as inclusive leaders who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. They were also positive about the registered manager. However, some relatives lacked confidence in service managers. Relative comments included, “Managers are brilliant. They know what’s going on, what the problems are. They can only go with what they have got,” “We are happy with the manager; they always say to ring up with anything,” “The manager is very nice but not very confident. We feel they need more support” and “The manager does not always intervene (with staff) when they should. They need support." We raised these concerns with the registered manager who told us they would review this feedback. Staff were complimentary about the registered managers of the service. A staff member told us, “[Registered manager] is a really good manager. They encourage us to be creative and try new approaches to help people achieve the best possible outcomes.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. The provider had forums and processes where staff could raise concerns or make suggestions. We saw that management actively promoted staff to speak up to drive improvement. They encouraged staff to raise concerns, share ideas and learning and promoted the value of doing so. Staff were confident that their voices were heard. There was evidence to show managers investigated any concerns or issues sensitively and confidentially; lessons were shared and acted on. There was a whistleblowing policy in place and senior managers visited people and staff in services to have a visible presence and direct line of communication. People were supported to understand their tenancies and staff advocated for people to ensure they had the right care and environment to meet their needs and wishes.

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. Service managers encouraged teams to understand every team member’s diversity to promote tolerance and acceptance. The provider supported staff emotional and physical wellbeing which enabled individual staff to contribute equally in their roles. This included flexibility to attend appointments, balance caring responsibilities and follow cultural and religious needs. For example, the registered manager told us how sponsored staff were struggling to learn about British culture within their roles and responsibilities. They had arranged training and given information in how to cook traditional British foods and in understanding key aspects of British culture and other foods and cultures that were important to people. This would support them in their personal and professional lives. Staff were recognised for their achievements and contributions within their roles, and these were celebrated and rewarded with people and staff on a regular basis.

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. Legal and regulatory requirements at the service were met and the registered managers undertook a range of audits, checks and analysis which enabled them to have good oversight of the service. For example, the registered manager was aware staffing needed to improve in some services and had begun to make improvements to address people’s concerns. The provider had introduced new data led systems and processes which facilitated improved oversight at provider level. For instance, a significant incident pathway supported monitoring and analysis at provider level to help ensure people were receiving safe care and risks were mitigated. Service managers played an important role in identifying improvements and ensuring these were embedded into staff working practices. There were robust systems in place to ensure regular reviews of people’s care plans and needs and to provide assurance people were being supported in the least restrictive way. The concerns we identified during this assessment were responded to by the registered manager in an open and transparent way.

The provider understood and carried out 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 leadership team had established good partnership working with various organisations and external stakeholders to provide positive outcomes for people. They knew who to contact if people required additional support from other healthcare professionals such as GPs, district nurses. They had established positive relationships with landlords which helped people to maintain their tenancies and worked with commissioners of supported living to advocate for people in ensuring they had sufficient support to meet their needs. The provider and staff had a ‘singing for the soul’ group for people and this had been extended to include people in the surrounding communities, cumulating in a concert that involved people, staff and the community. This forged positive community relationships and gave people a sense of belonging.

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. The provider focused on continuous learning, innovation and improvement across the organisation and local system. There were a range of monitoring and audit tools to assess and monitor the delivery of care and support to people. The service had systems in place for learning and improvements with feedback being sought from, people, relatives and staff to ensure there was a culture of continuous improvement and to support the registered managers on enhancing overall service quality.