Amplelime Healthcare Limited

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.

The service was in breach of legal regulation in relation to governance at the service.

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 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 registered manager told us their vision was to grow the business and to support this. The provider had recognised the need to improve the service they delivered. However, actions identified to make improvements including recommendations from the last inspection report, had not been made or in some cases they had made changes, but these had not been sustained.

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. Leaders had not ensured staff recruitment systems were operated effectively, despite this being a recommendation in the last inspection report. Leaders had updated the policy and procedures however they had not ensured all staff recruitment had been undertaken following this policy which meant leaders had not been successful in embedding this change to the service.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. People and their relatives told us they were able to raise concerns with the management team if they were worried about anything. Staff were aware of the providers policy which was in place to support them to speak up if they were concerned about anything. Staff could describe how they would raise concerns and felt these would be addressed. The provider had a policy in place which supported this practice.

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. The provider had a policy in place to support staff and ensure they received equal treatment, regardless of their protected characteristics. Staff told us they felt supported by the provider and had received training in equality and diversity.

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 systems in place to monitor the service. However, these were not being used effectively to ensure actions were taken and recorded when incidents were identified. For example, the system had identified where people’s medicine administration records were not completed by staff. The system required the registered manager to investigate, take action and document the outcome on the system we saw this had not been completed on several occasions and we could not be assured the medicines oversight systems were effective. In another example, an alert was sent to a system when staff logged into calls late or did not log in at all. These alerts were reviewed live in the system and the registered manager told us they took actions to ensure people received their care. However, the system was not consistently being used effectively to provide a documented explanation as to why a call was showing an alert or if the call had been received. This meant we could not be sure the alert system resulted in action being taken to avoid missed calls and reduce late calls.

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 provider told us they had systems in place to work in partnership with other health professionals to provide people’s care. There was information included in people’s care plans about the support they received from different professionals and staff could describe how they worked in partnership to deliver care. The provider was keen to develop the service and was hoping to develop contractual arrangements with commissioners in the future.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not always actively contribute to safe, effective practice and research. The systems in place to have oversight of incidents which occurred were not operating at the time of the inspection. This was because the provider was moving to a new system in the near future and had stopped commissioning the old system ahead of the new one becoming operational. This meant there was no oversight system in place at the time of the assessment, and we could not be sure the provider had oversight of when things went wrong in the service creating a missed opportunity to learn when things went wrong.