Alpine Lodge

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

We found one breach of the legal regulations relating to Good governance. The provider had not taken sufficient action since our last inspection to improve the service. Some areas of governance had improved, we saw analysis, lessons learnt and review to ensure good practice regarding falls. However, we found many concerns, most had been identified as part of the quality assurance process, but staff were still not consistently following processes and guidance. This placed people at risk of harm. The provider had appointed a new manager and the peripatetic manager was based at the service to support. More robust systems were being implemented to monitor the quality of the service. However, we found some areas were not identified as part of this monitoring. The culture at the service required some improvement so people received person-centred care. The management team told us they encouraged staff to raise concerns and promoted the value of doing so. Staff told us they had been raising concerns but did not feel listened to. Partners told us the peripatetic manager was working with them to try to improve the service. They could see improvements being made by them, but staff were still not embedding them into practice.

This service scored 46 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The culture at the service required some improvement so people received person-centred care. The peripatetic manager understood the challenges and was transparent and open in their approach. The management were trying to improve things but finding it challenging with the current staff.

The provider had appointed a new manager and the peripatetic manager was based at the service to support. More robust systems were being implemented to monitor the quality of the service. However, we found some areas were not identified as part of this monitoring. For example, medicines were not managed safely. We also found concerns regarding infection control, the management of people's risks and person-centred care. The management team told us they encouraged people and relatives to express views and concerns. However, feedback we received from relatives was mostly negative. They told us they did not know who the management were, did not get invited to meetings although one relative said they had been to a meeting in the past. Relatives also did not know who to go to if they had any concerns. The peripatetic manager told us they were improving the communication with people and relatives.

Staff did not feel confident as there had been so many changes in management, they did not always feel supported.

The management team were aware of their roles and responsibilities and the lines of accountability. However, there had been a number of changes of management. There was no registered manager, the newly appointed manager had started in April 2024 and the peripatetic manager had been supporting the service since October 2023.

The management team encouraged staff to raise concerns and promoted the value of doing so. Staff told us they had been raising concerns but did not feel listened to.

The regional manager told us they actively sought peoples and their relative’s views by holding meetings. However, relatives told us meetings did not take place regularly. We also received no evidence meetings took place. The provider's complaints process was displayed in the service. People and relatives told us they did not know who to approach to raise any concerns.

We received mixed feedback from staff, some said they worked well as a team others said they did not and did not feel listened to and were frustrated with changes and high agency use.

The processes in place to ensure staff felt empowered and were confident their concerns and ideas resulted in positive change required improvement.

The new management team had a strong commitment to improving the service. The peripatetic manager had introduced new improved systems to monitor the service, drive improvements and embed good practice. However, not all staff felt confident in the management team, as there had been so many changes and inconsistencies. One staff member said, “We have asked for things many times and do not get them.”

Some areas of governance were improved, we saw analysis, lessons learnt and review to ensure good practice regarding falls. However, we found many concerns, most had been identified as part of the quality assurance process, but staff were still not consistently following processes and guidance putting people at risk of harm.

Most of the people and relatives spoken with felt the service was not particularly well managed. They didn’t know the manager, didn’t know who to raise issues with and did not feel listened to.

Staff told us they worked in partnership; referrals were made when required and guidance sought to meet people’s needs. We saw evidence of this in people’s care plans.

Partners told us the peripatetic manager was working with them to try to improve the service. They could see improvements being made by them, but staff were still not embedding them into practice.

We saw processes in place to work with partners collaboratively. To ensure good practice was shared and lessons learnt. This was newly implemented and was still a work in progress.

Some staff spoken with did not feel listened to or their views valued. Some staff were frustrated with changes in management and high agency use.

The service did not have a positive culture and people did not always receive person-centred care. The management team told us they had responded to the concerns raised by the local authority, staff, and relatives. They were committed to learning and improvement of the service. The management had identified areas for improvement and action plans were in place. However, we identified some areas that had not been fully identified and required improvement. For example, infection control. Partners told us they could see improvements being made by the management team, but staff were still not embedding them into practice. This placed people of risk. Following our assessment we made three referrals to the local safeguarding authority due to concerns found during our visit.