The Brambles Apartments

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 service. This key question has been rated Outstanding.

This meant service leadership was exceptional and distinctive. Leaders and the culture they created drove and improved high-quality, person-centred care.

This service scored 89 (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 very clear shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the challenges and the needs of people and their communities.
The management team demonstrated an exceptional approach to the culture, openness and transparency of the service. Without exception people, staff, relatives and professionals said the service had an open, inclusive and welcoming culture, where people using the service came first and their satisfaction was a priority. All staff followed a set of agreed values, which supported them to continually aspire to achieve good outcomes for people and led to high-quality care being delivered. Staff understood The Bridge values of Changing perceptions; Take a different outlook; Be nice, kind, patience, resourceful, open minded, resilient and forgiving; Understand why situations occur, and; everyone’s opinions matter. We saw staff work in line with these values when supporting people who used the service. Staff consistently showed patience and kindness in their interactions with people and took the learning and understanding of why things may have occurred to prevent further incidence where possible. We saw evidence throughout the documentation, links to best practice guidance and staff told us about seeing things from the person’s perspective.
Staff spoke with passion for providing outstanding outcomes for the people they supported and were proud of the difference they made to people's lives. A staff member told us, “I Enjoy

working here very much, seeing the impact on the lives of the people we support, some don’t have a family so like to think we fill that gap and support people's independence.” Another staff member told us, “I am proud of being able to support people to live their best life."

Managers led by example and created a trusting environment, where learning and improvement was strongly promoted. Staff were clear about their role in ensuring people had a good quality of life.

The manager promoted and fostered an open culture, and we saw evidence of this in practice, for example, everyone without exception was welcome in office bases and could approach the management team at any time. We saw a person giving their own handover information to staff in the manager’s office. Staff gave the person time to express themselves and asked if they needed help, before giving any information. We also observed people undertaking activities in the kitchen area that staff used, and we were told how some people liked to cook in there instead of in their own apartment at times.

Staff spoke positively about working at the service and described a culture where they felt valued and supported. A staff member told us, “I enjoy working here, it is a safe place for people. The manager has an open-door policy and I like how we care for the people we support, how they are included in decisions and the attention given to ensure the right support is given.”

The registered manager told us about the support and training they had given to staff, recognising people had different learning styles and needs to ensure staff understood the values and understood the challenges that people could face whilst establishing a shared culture. They told us how it was important to help staff understand how to do things properly and not how quick.

The willingness to engage, listen and respond to feedback enabled the service to continually adapt, resulting in continuous improvement. Feeback from people, their family members, staff, and the reviewing of records and our observations evidenced the success of this approach.

The provider had exceptionally 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 always did so with integrity, openness and honesty.
The registered manager and management team were highly experienced and had worked at the service since it was first registered. The management team provided high-quality leadership and believed in in leading by example. This had resulted in planned and continuous improvement within the service to facilitate the provision of good quality care and quality of life for people.

We saw evidence of the commitment to the development of staff, through training and career progression, which demonstrated the provider’s investment in successive management planning. In addition, we saw examples of how the management team had promoted continuous learning at handovers and on notice boards in staff areas, for example “Theme of the month” and “medication of the week.”
Staff felt there was a visible managerial presence throughout the service. Staff consistently reflected upon how the managers led by example, through working alongside staff in the delivery of care. Staff spoke of a positive rapport with the management team. A member of staff said, “Wow, my manager is very professional, they are top-notch. They have the qualities of a good leader and will work alongside us.” Other staff said, “Registered manager is very good with staff and the people we support, they are very kind and supportive,” and “I feel proud of my manager, they bring the best out of people."
People, family members, staff and external professionals were overwhelmingly positive about the registered manager and management team.
Relatives told us, “Registered manager is really nice, lovely, [person] loves her, really friendly and helpful,” and “Managers are very good.”
A health professional told us, “Managers are very good,” and “I have seen The Brambles really develop over last 2 years.”
 

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.
The provider implemented a positive and open culture where speaking up was not only promoted but actively encouraged. Staff were empowered to drive improvement, and encouraged to raise suggestions, ideas and concerns in the knowledge that these would be listened to and acted on. This was evidenced by staff feedback. Comments included, “Manager has an open-door policy, any complaints we can speak 1:1 or by email, we also have QR code we can use to report anything. We always get feedback, there is a you said, we did board in staff area, we are listened to,” and “Manager has open door policy for any work or personal issues, if any family issue they will try and sort it with flexible working.” Another staff member told us, “We are asked about our welfare, anything bothering us, any issues – they would be sorted, able to ask questions and put things on agenda it’s like having a shoulder to lean on."
Whistleblowing processes were well understood and accessible, which reinforced trust, safety and accountability across the service.
People knew what to expect, and staff understood what was expected of them. This contributed to consistently high-quality, person-centred care, with people’s needs being met in the way they wished.

The provider strongly valued diversity in their workforce. They had an inclusive and fair culture which had improved equality and equity for people who worked for them.
Without exception staff felt respected, supported, and valued within all roles. Staff said they could raise any concerns without fear. They said the service continuously promoted equality and diversity in daily work and provided opportunities for development and career progression.
The Bramble Apartments had a strong multicultural identity, with staff from different nationalities and people using the service from a range of cultural backgrounds. Cultural celebrations, such as Eid and Christmas, were recognised within the service and everyone celebrated them together. People, staff and visitors spoke positively about these events, which promoted inclusion, social engagement and meaningful experiences. Staff told us, “Everyone, staff and the people we support all have different beliefs and backgrounds and everyone’s needs are catered for,” and “We are treated equally, there is no discrimination. We see ourselves as a family, it doesn’t matter what race or beliefs we have, we all celebrate together, for example Christmas and Eid, we all celebrated them together.” This promoted an inclusive environment where staff felt part of a one team and were valued.
Staff were incredibly supportive of each other and worked collaboratively. The staff team displayed compassion, kindness, and empathy towards each other. Staff told us, “We are a team and support each other,” and “We are here for each other, staff support each other, it is lovely working here.” Another staff member told us, “We really work well together, help each other, team spirit.”
Communication and engagement were a clear strength of the service. Regular team meetings, supervision, and frequent formal and informal discussions ensured staff felt listened to, supported and involved in shaping the service.
Reasonable adjustments were made for staff experiencing short-term health issues or for those with long-term conditions, for example, risks assessment had been completed for a staff member who was provided with alternative duties to support their recovery and enable them to continue working safely.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver high-quality, sustainable care, treatment and support. They always acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.
There were clear governance processes in place in the service. The registered manager carried out regular walkarounds, reviews, audits and daily spot checks were completed by the management team to observe practice, assess the quality of staff interactions with people, and that person-centred care was being delivered. Where actions were identified, these were acted on promptly and evidence showed learning was consistently shared with the staff team to ensure improvements were implemented and maintained.

The performance of the service was subject to continuous and systematic review, with strong collaboration with key stakeholders and partner agencies supporting ongoing quality improvement and risk mitigation.

The management team were developing their own case management system to include people’s outcomes and link the PERMA and Vitality records together. Vitality is the aspect of the PERMA framework that focuses on physical wellbeing, health promotion and maintaining a healthy lifestyle. As an example, during a PERMA review, staff identified an opportunity to strengthen the Vitality element of a person’s outcomes. Whilst the person regularly accessed walks and community activities, staff noted that they typically took nuts as a snack. Through discussion it was agreed to introduce fruit as part of their walks to support healthier eating and increase nutritional value. A communication was issued to staff; fruit was added to shopping lists and containers were purchased to ensure fruit could be prepared and taken on outings. Healthy eating discussions and 5-a-day awareness were also delivered with the staff team.
The registered manager told us they ensure any changes and improvements to people’s outcomes are sustained by reviewing actions agreed in reviews, management oversight, team meetings and quality assurance arrangements to ensure the change remained in practice rather than being a one-off intervention. Any improvements identified through incidents, audits, complaints, feedback, reviews or management oversight were allocated to staff for clear ownership and revisited through support plan reviews, risk assessments, observations, supervisions, team meetings and lessons learnt. This is further supported through independent Quality Team oversight and quality audits.
External professionals spoke positively about the quality of care provided, the registered manager and management team. A professional said the leadership and management of the service was “very good.”

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 commitment of staff in supporting and encouraging people to be active participants within their local community, had a significant and positive impact on their wellbeing. The diversity and frequency of activities, enabled people to stay connected, participate in community life, and maintain relationships.
The registered manager and staff team had developed excellent relationships within the local community. The service was praised for their care and the positive impact on people. People’s care records clearly demonstrated how responsive staff were to changes in individuals’ care needs, showing both proactive monitoring and timely reactive actions
The registered manager had developed good working relationships with external professionals, including health care professionals, who spoke well of the quality of care provided by the service, and the commitment of staff in responding to and meeting people’s needs through their pro-active monitoring or people’s needs.

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 a strong culture of learning, openness and continuous improvement at the service and provider level.
The registered manager was committed to continuous learning and improvement through ongoing monitoring to measure the outcomes and impact of the service provided. Systems and processes were in place to learn from events when things went wrong, and the registered manager worked in collaboration with other professionals and agencies to review the effectiveness of the service to ensure positive outcomes and an improved quality of life for people.