Aland Healthcare Agency

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

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 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 71 (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 provider’s vision was to deliver high-quality, flexible and responsive care tailored to each person’s needs. Its values focused on dignity, respect, safety, equality, independence, informed choice and person-centred care. The provider aimed to embed these values through staff induction, training, supervision, care planning and partnership working. Staff understood person-centred care and described an open relationship with the manager. People valued familiar care workers who knew their routines, and a professional described a respectful and constructive working relationship with the service. This showed that the provider’s vision and values were reflected in day-to-day care.

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 and staff said the manager was available and involved. One person said the office was “very on the ball”. Staff said the manager listened and provided clear support. A professional described the manager as careful, helpful and easy to work with. The registered manager knew people receiving care and coordinated assessments, staffing and contact with other services.

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

Staff had opportunities to raise concerns through supervision and team discussions. In one supervision record, a staff member openly raised that limited time affected their interaction with a person. They also suggested better timekeeping as an improvement. This showed that staff felt able to identify concerns and suggest changes to working practices.

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 an equal opportunities approach to recruitment and employment. Its Statement of Purpose confirmed that recruitment decisions should be fair and that staff should not experience discrimination. Staff completed equality, diversity and human rights training, and these principles were embedded through induction and supervision. Staff told us they were treated fairly and had equal access to training and development opportunities.

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 governance systems in place, including care plan reviews, medicines audits, staff supervision, appraisals, spot checks, recruitment checks and training oversight. These systems supported generally reliable and person-centred care. People received consistent support from staff who knew their needs, and staff described an open and supportive relationship with the registered manager. However, governance systems were not always operated effectively. Some care records contained conflicting information about access arrangements and responsibility for medicines. One care plan did not match the medicines administration record. There were also duplicate records, incomplete oversight forms, a training certificate filed under the wrong staff member’s name and a recruitment record without management sign-off. Audits had not identified all these issues, and action records did not consistently show what managers had completed or subsequently checked. This reduced assurance that leaders had effective oversight of the service. Inaccurate or inconsistent information could also confuse staff and affect the safe and consistent delivery of care.

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 with commissioners and health and social care professionals. A professional described communication as clear, courteous and timely and said the manager responded constructively. The local authority reported no recorded compliance issues, complaints or safeguarding referrals in the previous 12 months, although it had not completed a quality assurance visit during that period. The evidence showed positive partnership working.

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 used learning from quality monitoring and day-to-day issues to improve the service. The registered manager shared relevant updates with staff by telephone and during face-to-face team meetings. Staff also completed refresher training to keep their knowledge current. The provider gathered feedback from people and staff and considered suggestions for improvement. Staff described how learning helped them adapt their approach to people’s communication, sensory needs and routines.