Ambleside

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. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff were committed to providing good standards of care that promoted positive outcomes for people. Staff understood the importance of person-centred care that enabled people to live the best life possible. Comments included: “The care we give the residents; I think we give quite a high level of care, and they seem quite happy and always have something to do." “I would say if you asked family and individuals, they would say it is a very caring home. It is nice to be proud of where you work." One relative said of staff, “They are angels.” However, many staff spoken with said communication within the home was an area for improvement. Comments included: “Communication is quite good, but sometimes we don't get relayed back what happens in the 11 at 11 meetings so there can be a bit of miscommunication in that, but otherwise the communication is good." "I think communication is good amongst team leaders, but I am not sure it always filters down."

Not all leaders understood the context in which the provider delivered care, treatment and support. They did not always embody the culture and values of their workforce and organisation. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively, or they did not always do so with integrity, openness and honesty. Most staff felt managers were visible and approachable, but a minority of staff told us there were some managers they felt more comfortable to approach when they needed support. Some people’s feedback to us showed when concerns, ideas or feedback was shared with managers, they felt they were not heard. A typical comment was, “In 2 meetings I fell out with the temporary manager for not advising us about the garden plans. [Registered manager] is on maternity leave.” Two other people commented about the leadership in a negative way. Staff knew who the managers and senior staff team were. Day to day staff practice and the management of shifts was overseen by the unit leads. Staff told us they regularly met with their direct line manager to discuss their role and responsibilities.

Most staff told us they felt confident to speak up to share concerns and make suggestions about the service. One staff member told us, “100% - there is always someone I can go to if I feel something is wrong." Another staff member commented, “If I feel something is not right, I tell them.” However, this confidence was not expressed by all staff we spoke with. One staff member was not aware if the provider had a whistleblowing policy.The provider confirmed to us they did have a policy that staff had access to and freedom to speak up and the policy that supports this formed part of staff's induction.

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. Systems to promote diversity and equality were in place. Some staff told us they felt supported and valued such as making reasonable adjustments to support staff. However, a sense of being valued was not reflected by all staff. Staff received training relevant to their roles. This included training on equality and diversity. The provider had incentives to reward staff which recognised each individual staff member for their contributions.

The provider had clear responsibilities, roles, systems of accountability and governance. Staff could access all required policies and procedures. Managers held regular meetings with staff, during which they discussed any concerns and emerging risks. Managers recorded any actions arising from these meetings and ensured they shared these with staff. The provider had a system for monitoring incidents and analysis of those helped ensure any trends and patterns where known. Completed audits were shared with the provider who also oversaw any trends and patterns. People told us they were contacted to ask for feedback, however there was mixed responses to how that drove change for them. We found a system of regular checks, monitoring and oversight from the manager and provider. However, some of the issues we found had not been fully identified by the manager. For example, accuracy of records, care plans and risk assessments were not accurate or sufficiently detailed and we found people’s feedback did not always shape the service to them Following our feedback, the provider’s operations director was confident actions would be taken and some action had already been taken during our assessment visits to improve the quality of records.

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. Refurbishment of the home was designed with people in mind. This included the addition of a redesigned café and reception area that would be for people, families and local communities to meet up, enjoy and maintain important local connections. The provider worked with other healthcare professionals to ensure people’s needs were met. The provider had developed relationships with other groups in the local area to ensure people had spiritual and community support. For example, a local nursery school had recently been involved in planting a fresh herb garden at the home. Regular events were held at the home to which members of the local community were invited. This included a monthly Fish Friday for veterans and a monthly community café. Ambleside was officially a ‘veteran friendly framework’ accredited home which meant they achieved standards of care expected by the armed forces community. The week of our assessment, staff were sleeping outside to raise awareness for homelessness. People and their relatives were signposted to other organisations who could provide them with guidance and support.

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. Staff told us they were encouraged to undertake training and further qualifications to support their practice. Some staff also told us there was a pathway they could follow with the provider to take on further responsibilities and more senior roles in the home. One staff member told us, "I have started my NVQ, and I am looking to get into the team leader position. I would like to work through the levels." During our one site visit, the provider had collaborated with a supplier of tea drinks. A head of services told us Care UK had undertaken studies into how some thickened fluids took time to get the right consistency level but may not always hold taste. A planned ‘tasting’ session saw a high number of people and visitors sampling teas before or after modifying to increase their learning and knowledge of maintaining safe hydration. We provided feedback to the director and regional support manager following our assessment. They took steps to make improvements to the areas we identified that were not always demonstrating personalised care. The director was committed to making improvements.