The Apuldram Centre

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 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 68 (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.
People, staff, and relatives commented on the positive values of managers and staff. We found the values of the organisation were clear and put people at the centre of the support and care. Throughout the induction of new staff, the values of care and kindness were repeated. The emphasis on promoting independence, choice and dignity were clear in all staff training and followed through in supervisions and practice support.
Systems and processes including meetings and staff supervisions promoted a listening culture and equality, and diversity were recognised and supported.
 

The provider had 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 did so with integrity, openness and honesty.

People benefited from the support of leaders who were visible in the service and modelled inclusive behaviours.
Staff told us they were able to talk with the provider and leaders when they needed to. We saw managers leading by example and saw friendly and familiar interactions between managers and staff.
The registered manager and provider understood their responsibilities in relation to their registration with CQC.

The provider had invested in learning opportunities for the managers, and this had a direct and positive effect on the service delivery.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.
People and staff told us they had the freedom to say what they thought and be heard. Staff were proud of the service, this was reflected in staff surveys. Staff said they felt able to raise anything with the provider and felt they would be listened to. One staff member said, “I can speak up. The manager is very approachable.”

The management team ensured everyone was treated fairly and were not discriminated against due to any protected characteristics. There were processes in place to support staff to speak up, such as a whistle blowing policy and information containing contact details of the local authority and CQC. Staff confirmed they had access to the information.
 

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.
People, staff, and relatives commented on the positive values of managers and staff. One staff member said of the registered manager, “They are very open and easy to talk to, so are the team leaders.” Another said, “I feel very supported.”
Systems and processes including meetings and staff supervisions promoted a listening culture where equality, and diversity were recognised and supported.
 

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, or share this securely with others when appropriate.

The provider had been aware not all people had real tenancies and were open in telling us there was no separation between the landlord and care provider. This meant people did not have the right to change their care provider without having to move from their home. This had been known for some time and effective action had not been taken before we raised the issue at this inspection. This only applied to 3 of the support living houses where the provider supported people. The other properties had appropriate separate landlords. Following our assessment, the provider demonstrated they had sought a registered social landlord to create real tenancy. The provider demonstrated they are working with the local authority commissioning team to address the issue. They had been transparent and had sent the affected tenants an amendment to their tenancy which allows them to change their support provider in some circumstances as an interim measure whilst waiting for the social landlord to take on responsibility.

However, systems were generally robust enough to raise awareness with the provider when there were issues with the service provided. For example, when a risk assessment required reviewing. Audits covered a number of topics including emergency planning, fire safety, and data protection as well as detailed monitoring of people support needs.
The management team worked together to ensure there was oversight and effective governance at the service. There were computerised systems and processes to assess, monitor and improve the quality and safety of the service provided. This included health and safety, accidents, incidents, complaints, medication management and staff documentation.
The registered manager told us they were continuing to review and develop auditing systems to get the optimum benefit from the online monitoring system they had in use.

The provider did not always collaborate and work in partnership, so services worked seamlessly for people. They did not always share information and learning with partners or collaborate for improvement. This is in relation to communication with some relatives. We had mixed feedback from relatives/ Some felt the communication needed to improve and they wanted more detail about their loved one’s life, while others were satisfied with the communication from the registered manager and the team. The registered manager demonstrated they were working to improve the areas of communication with relatives.

Communication with external professionals was clearly demonstrated and people received ongoing support from various external health and social care professionals who represented them. Staff and leaders understood their responsibilities to work in partnerships with external care professionals to ensure people received joined up care.
A professional told us, “Leadership was open, proactive, and improvement focused.”
 

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.
The provider focused on continuous learning, innovation and improvement across the organisation and local system.

The manager told us of lessons learned from carrying out audits. They said, “From the audits, we have learnt that staff need to be more detailed in their note writing on the online monitoring system and include more information for example, to include how long was the activity, how did they engage, were they prompted/supported/assisted/independent etc.” This demonstrated the provider and managers commitment to continued improvement and learning.