Athlone Care

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 the same.

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 good governance.

This service scored 62 (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.

There was a clear vision and values. These were shared with staff and were based on themes such as communication, equality and promoting choices. The care staff and office staff were positive about their managers and how they were valued and supported. One staff told us, “I enjoy working for Athlone Care because of the positive work environment and the opportunity to provide quality care to clients. I appreciate being part of a team that values and supports its staff.”

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.

The provider had been in care for a significant length of time and had the knowledge and experience to lead the service. Staff were also encouraged to undertake leadership in areas. There were a number of ‘champions’ in areas such as manual handling, medication and training. A ‘champion’ is a member of staff responsible or who has a special interest in the certain subject area and will lead on good practice projects. Staff completing diplomas were also encouraged to undertake service improvement projects. For example, one was looking at how to make the complaints system more accessible.

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

Staff told us they were able to speak to management if they needed to. Staff were also confident they would be listened to if they raised concerns. One staff told us, “I have had a very positive experience working as a care worker with Athlone Care. Since I started, the management team has been supportive, approachable, and always willing to provide guidance whenever needed. Their support has helped me develop my skills and confidence in my role.” Another staff said, “I have not been long with Athlone care but it’s a good environment to work as a team. The managers are prepared to listen.”

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 offered staff cultural awareness training to support staff who were new to the UK to learn about the country and local norms and traditions. This helped staff settle into their role and understand how to support people.

The provider also took time to understand staff and their cultural support needs. For example, staff were able to ask to work with people of their own gender if this was important to their religion. One staff told us, “Great employer with equal opportunities for everyone and keeps their clients safe and happy.”

The provider did not have clear roles, systems of accountability and good governance. They did not act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

Although systems were in place to audit and assess quality, they were ineffective and were not used consistently to protect people from harm. For example, the electronic care planning system had an artificial intelligence function which had identified patterns of concern, such as declined care, and had alerted staff to missed tasks, including medicine administration. Leaders had not acted effectively on this information. This demonstrated a serious failure to use available systems and intelligence to identify, manage and reduce risks to people. As a result, people missed doses of medicines even though this had been clearly flagged up and was preventable.

Another person was prescribed a medicine 3 times a day in a pre-made pharmacy blister pack, but administration was recorded only twice on some days. This had been the case for at least 5 months. However, auditing had not identified this as a concern so the provider could check the person was actually getting their medicine. Staff also recorded one person’s cream as ‘unavailable’ after it had been changed to an alternative cream. Quality assurance systems had not identified or resolved this. Consequently, some staff recorded the task as completed and used the new cream, while others recorded it as not completed and did not apply it. These inconsistent practices created an avoidable risk that people would not receive medicines as prescribed.

Body maps were available for staff to record the application of medicated patches, including patches used to deliver pain relief. However, office staff could not review these records to check whether patches were applied and managed safely and prior to the inspection staff were not aware of this. The absence of effective monitoring meant leaders could not assure themselves that staff followed the correct processes or that people were protected from harm. Overall, governance arrangements needed significant improvement and did not provide effective oversight of medicines or the quality and safety of care.

The provider had identified significant areas where improvement was required, including care planning. Despite being aware of these concerns, they had failed to take timely or effective action. As a result, known shortfalls remained unresolved and people continued to be exposed to avoidable risks. For example, there were no risk assessments in place where people were at risk from constipation. This left people at increased risk as staff did not have any information about this concern.

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 worked in partnership with the local authorities and health and social care professionals as needed. Feedback from partners was positive and they told us staff communicated with them well.

The provided needed to ensure there was more effective oversight of standards of care and service improvement was ongoing. These were not always well maintained across the board.

There were gaps where the basics such as care planning and medicines management needed to be prioritised and improved.

The provider did have a focus on encouraging creativity and development within the staff team. They were active in local forums and networks and shared their learning, best practice, continuous learning, innovation and improvement across the organisation and local system.