Apple Tree House Residential Care Home 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. 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 a legal regulation in relation to governance.

This service scored 61 (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. However, the challenges and the needs of people and their communities were known and understood by staff.

Although staff had a shared vision and ethos this had been developed by them and not the provider. There was no clear strategy for the service. The registered manager and staff demonstrated a positive and compassionate listening culture, centred around the people living at the service. There was a person-centred culture at the service, which was led by the needs of the people living there.

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 new registered manager was experienced in delivering person-centred care. However, feedback from staff suggested communication from them was not always clear. The provider had arranged for experienced support staff to work alongside the registered manager to assist them develop their skills. The registered manager regularly worked alongside staff and modelled inclusive behaviour. People were involved in the recruitment of staff. Appropriate checks were in place to ensure recruited staff were safe to work with vulnerable people.

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

Staff were confident to speak up and provided examples of where they had done so and managers had taken appropriate action. However, lessons learnt were not always shared with the staff group. The registered manager told us they would ensure this took place. Regular staff meetings were planned and took place.

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 registered manager was aware of the Equality Act. Staff rotas were planned to take account of staff’s caring responsibilities outside of work.

The provider did not have clear responsibilities, 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.

The service had increased the number and type of checks and audits they undertook. However, these had not been reviewed to make sure they provided an overarching view of the service or used to improve the quality at the service. Action plans were not in place. This meant there was no consistent view of the actions needed to be taken to review and improve the service’s performance. Timeframes for updates to work being undertaken had not been agreed or communicated. This meant staff were unaware, for example, when information about people’s care plans would be fully available on the new electronic system. Regular reviews about people’s DoLS applications had not always taken place. Templates had been produced for the provider and senior managers to undertake quarterly checks on the service. However, these had not been utilised.

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.

People accessed the community and made contributions towards their local community by undertaking voluntary work. For example, some people worked in local charity shops. Some people had also expressed an interest to join the local litter picking group. The service had worked with partner organisations, both locally and nationally, to secure additional funding for activities. For example, the service had been awarded funds to purchase a greenhouse with funds left over to buy soil and plants for the coming spring.

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 service did not have a cohesive action plan in place. This had impacted on the ability of the service to consistently learn and improve. However, work had commenced to provide a monthly summary of activity from the checks and audits undertaken. Following our discussions with the registered manager they planned to ensure there was a clear overarching service plan in place.