Andrusida Care - Hampshire

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.

The service was in breach of legal regulation in relation to the governance of the service. Governance procedures were not always effective. The provider had not identified all the quality, or risk concerns we found during our inspection. This meant prompt action had not been taken to address shortfalls.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service 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 knew the aims and values of the organisation. The provider’s values were shared with staff through training and team meetings. The provider had policies in place to support equality and diversity.

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.

Following feedback some people, their families and health professionals were concerned about the organisation and management of the service. Thet experienced be inadequate and confusing communication between the registered manager, people who used the service and family members. We identified breaches of the legal regulations and concerns in areas such as safe care, staffing and governance. The provider had not independently identified and acted on these concerns prior to our assessment. Where concerns and issues were brought to their attention, they did not demonstrate a full understanding of the nature and seriousness of concerns identified and therefore provided limited assurances effective actions would be taken to address the issues.

Staff we spoke with felt supported by the registered manager and senior team. One staff member told us, “Management is approachable, and I feel I can raise concerns when necessary.” Another staff member said, “Overall, morale is good, and teamwork makes the experience rewarding.”

People did not always feel they could speak up and that their voice would be heard. We could not always be assured due to concerns raised by some relatives. The provider completed surveys of people and their relatives’ views. The provider had appropriate polices in place as well as a policy on Duty of Candour to ensure staff acted in an open and transparent way in relation to care and treatment if people came to harm. Staff we spoke with were aware of how to raise concerns and felt confident to do so.

The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them. Systems were established to make sure staff were supported when needed and had equal opportunities. The provider held regular meetings with the staff to discuss any concerns. The registered manager told us these were used to inform staff of any updates on people’s health and training opportunities. Records of meeting minutes showed these had been used to reinforce the values, vision and purpose of the service. One staff member told us, “Team meetings are held regularly each month, providing a space for discussion and shared learning. Staff morale is positive, and I value the strong sense of teamwork and collaboration within the company.”

The provider lacked understanding of their regulatory requirements and responsibilities. The provider had failed to identify through audits and provider oversight the issues we identified at this inspection. Including but not limited to, poor medicine and risk management, poor recruitment processes and lack of clear, detailed, consistent and up to date information within people’s care records. Some audits did not always drive improvements. For example, care plan audits, did not pick up gaps we found in care plans.

We found health and safety and infection control audits were completed using a care home based template and not a domiciliary care service. This meant we could not be assured audits were carried out effectively for this type of service.

There were no audits in place for the safety of medicines and staff recruitment files. We found concerns in both areas.

People’s records were not robust and did not always contain correct information. For example, in relation to people’s medicines. We noted several gaps in people’s daily care notes with no explanation as to the reason there were gaps. Information in people’s care plans such as relating to arthritis and diabetes were not comprehensive. This had not been identified by the service to ensure people’s needs were met safely. We were sent a contact list of people to contact which contained outdated information.

The service had a business contingency plan in place; however, this did not cover areas specific to the service being provided.

The service understood their duty to collaborate and work in partnership so services work seamlessly for people. They share information and learning with partners and collaborate for improvement. The leadership team and staff worked effectively with health and social care professionals to meet people’s needs. Staff had undertaken reviews with relevant healthcare professionals as people’s needs had increased and made referrals to occupational therapists, community nurses and GPs when needed.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. Although the provider was motivated to learn and improve the service, their overall ambition was limited by their lack of knowledge and understanding of current best practice in some aspects of care assessment and delivery. However, staff meetings and supervisions showed these were used as a way to make improvements to the service.