Autism East Midlands Supported Living

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 changed to 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 regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the provider did not always act on the best information about risk, performance and outcomes.

This service scored 54 (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 did not have a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not always fully consider the challenges and the needs of all the people they supported.

Some relatives did not feel the management team were effective. They didn’t feel confident that any concerns raised would be listened to and addressed promptly. This impacted on the relationship between some families and the management of the service.

There was no registered manager at the time of our visit. The acting manager was in the process of registering with the Care Quality Commission. Some staff told us they didn’t feel valued or that their feedback or any concerns they had would be taken seriously by the management team. The provider took action to address these concerns with the staff team.

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, nor they did not always do so with integrity, openness and honesty.

Comments from some relatives and some staff regarding the management of the service confirmed they didn’t feel the service was led effectively. This related to how risk was managed. One relative said, “Our concern is the oversight of behaviours from the management team and how there is never a resolution. These behaviours aren’t something new they have been going on for years.”

People did not always feel they could speak up and that their voice would be heard.

As reported earlier, both staff and relatives were not always confident the concerns they raised were taken seriously. The provider advised us they will be addressing these concerns.

Since our assessment one person using the service who had capacity and cognitive ability raised concerns about a person they lived with, and this has been taken seriously and action taken. However, there is no evidence that people who do not have the cognitive ability to articulate their views, regarding who they live with have been effectively considered.

The provider valued diversity within the workforce and promoted a culture that supported staff wellbeing.

Staff felt supported by the management team regarding their work life balance.

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 notified CQC of significant events in a timely manner, in line with statutory requirements. However, we were not confident that all significant events had been reported. The provider has advised us they are taking action to address this.

The provider did not always understand their duty to 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.

It was identified that incidents that should have been reported to the police had not been . The provider requested further information regarding the reasons for doing this. The local authority has confirmed they will contact the provider to clarify this.

Relatives confirmed they were invited to participate in care reviews and were kept informed of any changes in their family member’s care.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always actively contribute to safe, effective practice and research. For example, regarding the safety of everyone using the service from the behaviours of some people using the service.

Systems of oversight included regular health and safety audits across key areas.