Aden House Care Home

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

At our last inspection we rated this key question inadequate. At this assessment, the provider had made some improvements, and this key question is now rated requires improvement. However, we identified a continued breach of regulation in relation to good governance. Whilst improvements had been made at the service since the last inspection, not enough improvement had been made in some areas and the provider remained in breach of regulations relating to staffing, person centred care and governance. Quality assurance systems and processes were in place but oversight of these was inconsistent, and they were not always effective in identifying and addressing areas for improvement. There continued to be no registered manager in place at the service and the manager who was newly appointed is no longer employed. However, staff demonstrated good teamwork and promoted a positive culture. Leaders supported an open culture and staff felt supported by them. The provider worked successfully in partnership with other key stakeholders. For example, the local authority.

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.

Most staff felt leaders at the service listened to and supported them. Staff felt they worked well as a team and promoted a positive culture. Feedback included, “Communication [with managers] is good we have regular meetings,” “Managers are always visible, always here, their doors are open” and “I think the culture here is good. These are our residents, and we are still here to support them.” However, the newly appointed manager had a very poor understanding of what was meant by staff culture. They were also unable to describe what they felt the culture within the service was like. Other leaders in the service showed increased knowledge regarding this.

Person-centred care was not in place for some people and improvements were required. However, staff meetings were held regularly. Meetings were held with people and feedback obtained via surveys. There was a newsletter in place to share information. The values were outlined on signs within the service and the staff recognition scheme related to the values of the service.

Staff told us leaders had continued to update staff regarding improvements that were being made at the service. Feedback included, “[The Deputy Manager] has been committed to improving the service.” Staff mostly felt unable to comment on the capabilities of the newly appointed manager. When speaking to the manager we found their knowledge was, at times, limited. For example, they did not know what the company vision and values were. We also found a number of deficiencies within the service indicating that staff and leaders were not consistently promoting equality and inclusive care.

There was limited consistency in the management of the service. At the time of assessment, the service had a newly appointed manager. The manager is no longer employed. The service has been without a registered manager for a prolonged length of time. The provider has a contingency in place until a new manager can be recruited. The wider provider level leadership team continue to support the service.

Staff told us they felt able to speak up about any issues and they would be listened to.

Systems and processes in place supported people to speak up. There was an open-door policy in place, where staff could approach the leadership team with any concerns is they wished. There was also opportunity for staff to share ideas in team meetings, supervisions, and daily flash meetings.

Diversity in the workforce was evident. Staff told us they were supported with flexible working arrangements and did not raise any concerns regarding unfair treatment. Leaders at the service spoke about recognition within their services of events that supported equality and diversity. For example, pride week. Leaders made adjustments for staff when needed to enable their employment.

Appropriate policies were in place to support staff. Staff received training in equality and diversity.

The manager had some awareness of the quality assurance processes and procedures, but their oversight was limited. They were not robustly implementing checks and identifying areas requiring improvement. Provider level leaders told us about a new quality team that would be in place to support quality assurance. Staff told us they got feedback when checks had been completed, for example, monitoring of the lunch time experience.

Quality assurance systems and processes were not always implemented effectively and consistently. There was a lack of managerial oversight to support robust monitoring and service improvement. For example, the resident of the day initiative was not being robustly applied, and care plan checks were not consistent. Internal processes had failed to adequately address issues relating to person-centred care and staffing found during the assessment. However, some elements of the quality assurance systems had been successfully embedded and had supported aspects of service improvement. For example, accident and incident management, safeguarding and medicines management. A leader at the service told us about a new electronic management system which they said going forward would provide strong systems of assurance.

People told us appropriate professionals were involved in their care when required.

Leaders and staff were open and transparent. They collaborated with all relevant external stakeholders.

The Local Authority had been working with the service since the inspection last year. Feedback included, “The provider has been very engaged throughout this process and always submits an action plan prior to the meeting to update on progress."

Systems and processes were in place to support partnership working with a number of agencies. The provider was working in partnership with the local authority’s enhanced monitoring programme to support improvement at the service.

Staff told us they could make suggestions for service improvement, and this would be considered by the manager and wider leadership team. Some people and relatives were involved in making suggestions, which were acted upon. However, this was not consistent for all people. Therefore, improvements needed for some people were missed.

Leaders did not consistently drive improvement, innovation and learning across the service. There were some areas still requiring improvement that had not been addressed. Identifying and implementing ways to improve was, at times, inconsistent. Outcomes and impact of improvements were not always effectively monitored and evaluated. The leadership team worked openly with us during this assessment and acknowledged there were still areas requiring improvement within the service. They started to take action to address some of the points raised during the assessment without delay.