Archived: Adelaide House Residential Care Home

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. At our last assessment we rated this key question requires improvement. At this assessment the rating has remained 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.

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 provider’s vision and values were displayed in the entrance to the home and encouraged staff to prioritise people’s wellbeing. All staff spoken with told us they enjoyed working at Adelaide House because it was a small home with a consistent staff team who had time to get to know people well. One staff member told us, “We are very small. It is a very home from home type of service, and we have a really good team of staff. If someone rings in sick, another member of staff will pick the shift up.” Another staff member told us about the way they were led and said, “[Senior staff] want quality care for residents and for the staff to do the right thing. The best thing about working here is that the communication is good, and we look after each other.” A third staff member told us they enjoyed their role because, “Things are done in a proper manner, we follow the plans and the rules. People are getting the care they need, and [staff] are not stressed.” A health and social care professional who regularly visited the home told us, “Staffs’ hearts are in the right place, and they are passionate about what they do and they learn quickly.”

The provider had 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. Leaders led with integrity, openness and honesty but needed to ensure consistency in completing some leadership tasks.

The registered manager was committed to Adelaide House, the people who lived there and supporting the staff team to provide good standards of care. However, the registered manager acknowledged they needed to prioritise their time to ensure audits and checks were consistently carried out as planned to evidence robust quality assurance processes.

Staff spoke positively about the support they received from the registered manager and deputy manager. One staff member said of the registered manager, “She is lovely and reasonable.” Another staff member told us, “If I need anything, I know I could go to [registered manager and deputy manager].” A third staff member explained how senior staff took time to thank them for their hard work and included staff in Christmas and Easter gifts.

Ancillary staff said they were invited to attend full staff meetings which gave them opportunities to discuss people’s needs and made them feel included and supported.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff were positive about opportunities they had to speak up and said they were listened to. One staff member said, “You can speak up here, I am known for this. We have time to speak, and lots of meetings here. You talk [to colleagues] about what has or has not been done, and the gravity of it.” Another staff member was not sure what whistleblowing was, but said, “Here we all work like a team, we work together, so there are no problems.”

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.

Staff said senior staff were inclusive in their approach to supporting staff. One staff member said, “We are all treated equally here.” Another staff member told us they had requested a change of shift pattern, to support their own domestic arrangements. The staff member said their request had been listened to and acted on.

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.

The registered manager told us there had been some significant changes to the leadership at the home and at provider level. The registered manager told us they had temporarily paused some of their governance processes in response to this. However, some basic checks continued to be undertaken by senior staff, so they could be assured people received safe care. The registered manager gave us assurances they would reintroduce the more in-depth quality assurance systems they had previously used. This would help to ensure good oversight of the care provided to people and proactively improve standards of care.

The registered manager told us the provider visited the service and was contactable, however, they did not record any checks on the care being provided. The registered manager acknowledged this was an area for improvement and recognised the importance of external scrutiny. They told us they had approached an external consultant to review some processes and procedures and provide them with guidance and advice.

Staff said they were subject to spot checks of their practice and given feedback about their performance.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people.

A visiting health and social care professional described effective joint working with the service and told us the prompt actions taken by staff had led to a reduction in hospital admissions. The health and social care professional said people quickly got the help they needed because staff used agreed tools to monitor people’s deteriorating health and promptly escalated any concerns. For example, in relation to falls and infection prevention. The health and social care professional gave examples of meetings they had been involved in with staff, so people’s needs would be fully identified and actioned.

Relatives told us they were included and engaged in their family member’s care and were positive about the care provided. One relative told us, “When [Name] was poorly, staff were asked to keep an eye on her. They checked on her every 10 minutes, and when she became unresponsive, they called an ambulance. I think they saved her life.”

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system.

The provider’s processes to help ensure lessons were learnt when things went wrong were not consistently effective at the time of our inspection. For example, accident and incidents were not being analysed to identify any trends or patterns or where systems needed to be improved. However, healthcare professionals told us managers and staff were motivated to improve and listened to any advice provided. Staff told us key areas of training were repeated over time, and they were supported to complete further qualifications in health and social care.

People, relatives, staff and external healthcare professionals had been asked for their feedback about the service through questionnaires, but these had not been analysed to identify areas for improvement and celebrate good practice.