Cheshire & Manchester

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 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 has changed to 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

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.

There were policies and procedures in place and these were accessible for all staff. Staff were aware of their services values and beliefs.

The provider had a clear vision, strategy, and culture, focused on fairness, inclusion, human rights, and understanding the needs of people and their communities. People were at the heart of all support provided.

The provider had inclusive team leaders who managed the daily running of the supported living services and had the skills and experience needed. However, the registered manager and provider did not demonstrate they were aware of the demands on the team leaders. Meetings between the team leaders and the provider were tasks and targets based and did not allow for shared discussion. We shared this feedback with the provider who informed us they were reviewing the structure of these meetings, and an example of the new structure was shared. Staff worked hard to protect people's human rights, treating everyone with dignity and respect. They supported family life by helping people to visit their relatives and ensured there were no restrictions which prevented people seeing their families whenever they wanted.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. There was consistent engagement with relatives of people who used the service. One relative told us, “I know whom to contact regarding any issues and feel any issues would be dealt with promptly and to my satisfaction. Fortunately, we have had no concerns at all so have had no need to contact anybody.” Referrals to advocacy services had been made for people who did not have family to support them with decision making. Staff members demonstrated they could speak up if they needed to. One staff member said, “I have raised a concern in the past, I was listened to, and action was taken.” Another member of staff informed us, “I wouldn’t hesitate in raising any concerns.”

Staff were passionate about the support they provided to people and their role. Comments included, “I absolutely love it here” and “I love this job.” The provider explained reward and recognition systems were in place, however not all staff told us they felt valued. One staff member told us, “I don’t feel valued by AFG.” Some staff reported they were required to like and comment on posts on the provider's internal social network platform. This platform was used by the provider to allow for sharing of information. Some staff told us this was set as a measurable target. They expressed concerns about facing consequences if this target was not met. This was raised with the provider who told us, they were reviewing this target with the view of removing it.

The provider could not actively demonstrate how they learnt lessons following any accidents and incidents. The analysis of incidents did not demonstrate ways to mitigate future risks. Team leaders were knowledgeable and had clear systems in place for quality assurance, however, the provider lacked oversight of the quality of support being provided to people as they were not always present in people’s homes. Some staff told us they did not know who the registered manager was. We shared this feedback with the registered manager.

Team meetings focused on performance and targets rather than the quality of the support. This was discussed with the provider who informed us they had acknowledged this and demonstrated their new ways of leading meetings. This was more focused on team leader wellbeing, any lessons learnt and general discussions of how the supported living services were running.

Care plan and risk assessment reviews took place. When a person’s need had changed, their care plans had been updated. Staff ensured people could continue to live their lives the way they wished by ensuring reviews were completed frequently and provided weekly timetables of activities which were flexible to meet the needs of the people receiving care and support.

People were supported by staff to access health and social care services to ensure their needs could be met. Where a person requested support to access community services this was encouraged and staff ensured they could provide this support safely. People received a high standard of care based on their needs, this enabled them to remain independent and to be actively involved in new situations and experiences within their family and wider community.

The provider did not always monitor the training staff had undertaken and therefore were not aware some staff members training had expired. This was discussed with the provider and assurance was provided where staff did not have the necessary training or competency assessed they would ensure they did not lone work until they had completed all relevant training. Staff told us the training they had received was mainly online training, some staff told us they did not like this method and would learn and benefit from more face-to-face training.