A & A Services West Midlands

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• 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

Our rating for this key question has improved and well led is now rated as good. The providers vision centered around equality, however there was no monitoring system in place to check the effectiveness of this strategy. Governance arrangements were in place however, these were not consistently effective. There were systems in place for learning, however the detail was not widely shared. Partnership working was undertaken by the management team and systems were in place to ensure staff had the freedom to speak up.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Leaders told us the service’s ethos was driven by equality and diversity, ensuring people received tailored support to meet their individual needs. They gave examples of how this policy was central to how staff supported people with meeting their care needs. Staff confirmed they understood individual needs and they shared the providers views around equality and diversity. Staff spoke about people being treated equally and having their culture respected.

An equality and diversity policy formed the basis for a shared direction and culture within the service. However, there were no processes for monitoring and reviewing their compliance with this policy. This meant there was a risk that any non-compliance with the policy would not be identified and acted upon promptly.

Leaders told us they had regular meetings with the management team and staff could speak with them at any time. Staff told us they felt leaders were inclusive and gave the example of regular monthly meetings where they could talk things through with the management team.

Recruitment processes for leaders did not follow safe recruitment practice. Processes did not show how leadership competency was assessed and what support and development was available to the management team.

Leaders told us they had an open door policy in place and spent time speaking with staff about their experience of working at the service. Staff told us they felt comfortable to raise any concerns with the management team and felt any concerns would be addressed.

The systems in place to enable staff to raise concerns about the service did not include a documented process or outcome, this was informal and verbally managed.

Leaders told us they had systems in place to ensure people and staff were supported with their protected characteristics and their ethos was one of supporting equality and diversity. Staff told us, they felt leaders treated them equally and felt included in the service.

There was an equality and diversity policy in place which set out how the provider supported equality of opportunity, fostered inclusion, celebrated difference and prevented discrimination. The policy set out the actions the provider would take to embed this practice for staff through training, recruitment and monitoring.

Leaders told us they had put in place a range of systems to manage risks and improve the quality of the service. However, they told us the care plan audit only checked there was one in place, not the accuracy of the care plan and whether this described for staff how to meet people’s needs. Staff were aware of their role and responsibilities for keeping people safe and confirmed checks were in place to ensure peoples safety, such as regular spot checks from managers during peoples care calls

Processes were in place to manage risks and check on the quality of the service however these were not fully effective. For example, medicines audits did not pick up the concerns we identified about the medicines administration policy guidance and recording systems. Care plan audits did not identify where information was missing from care plans. The recruitment file audits had not identified where the providers recruitment policy was not meeting all of the expectations for safe recruitment.

Relatives were unable to share any experiences of supporting people through partnership working with other agencies, however they felt the provider shared information where this was required. One relative told us, “If we need anything they are helpful, they have contact with social services.”

Leaders told us they worked in partnership with other agencies. They gave examples of working with local commissioners, individual social workers and the wider community including working with hospitals and charity-based organisations. For example, they built community links through their work as a charity and supported local dementia services. Staff told us they worked in partnership with other agencies, but were unable to share examples of how people were supported.

Partners did not have contractual arrangements in place to commission support for people to receive care. However, one local partner told us they were working with the provider to make improvements and they felt the provider collaborated well with other services and disciplines.

The provider had processes in place to work with the wider community. For example, they offered a food parcel service to people locally.

Leaders told us all staff had been retrained and achieved the care certificate. Improvements had been made to how the service was managed and to the governance arrangements following learning from previous inspection activity. Staff told us the management team had made changes since the last inspection. One staff member told us, “They want to get it right before growing the service.” However, staff told us they were not aware of learning when things went wrong in the service.

Systems were in place to enable the provider to learn and improve. Quality checks with people and their relatives were used to identify areas for improvement. However, some processes were not fully effective in identifying areas for improvement. Audits were not consistent in identifying where things were not working as they should for example with recruitment. Where learning was identified through systems this was not shared widely with staff to make changes to practice.