Astell Care Centre

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

The provider had a good range of systems and processes in place to check the quality of the service being provided. However, we found during the assessment, staff had not always used these effectively and overscored on occasions. The management team acknowledged our findings and had started to address this with staf, including reviewing procedures. Staff were supported by the management team and the new provider. The culture of the service was positive. Staff were able to speak up when they needed to. Partnership working was good, and comments indicated the service had improved since our last inspection.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The registered manager encouraged good practice and sought feedback from staff on ways to improve the service and people/staff experiences. The providers website stated, 'Our philosophy at Crown Care is to provide a safe, happy and homely environment for our elderly residents to enjoy a full active life and be well cared for'. One staff member said, "Our values are on the company website and in our handbook." The management team had a clear direction and action plans in place to help them meet these goals. This helped staff to understand the services values and the direction they were going with changes to the service and the quality of care provided.

Processes were in place to ensure people and staff knew the provider’s shared values and culture. Information was available on the providers website and staff handbooks clearly set out the ambitions for the service and expected behaviours and culture of the staff team. Policies and procedures were in place to address equality, diversity and human rights.

The service had a capable, compassionate and inclusive leadership team. The registered manager had worked at the service for many years with previous providers. The registered manager told us they had been fully supported in the takeover by the new provider. They said, "The regional manager visits often, and she has been a real support." The staff team, including management, were open and honest throughout the assessment. Staff told us they were supported and told us they were clear on their roles. Staff told us the registered manager was very capable and skilled in her role.

Processes were in place to support a compassionate and inclusive style of leadership. Good recruitment processes were in place to ensure staff employed were capable and kind-hearted in their roles. Competencies of staff were completed to ensure staff remained skilled and suitable. Contingency plans were in place to ensure the service continued to operate should an emergency occur.

People and staff told us they were able to speak up if something was wrong. They were confident that any concerns raised would be dealt with effectively.

The registered manager had an open-door policy and people, relatives and staff were able to discuss any concerns they had. The provider had whistleblowing and safeguarding policies in place to support staff. Safeguarding was a topic of conversation in team meetings and one to one support sessions to ensure staff felt easily able to raise concerns.

Staff felt fairly treated and there was a good diverse group of staff working at the service. The provider had an inclusive workforce and respected their differences and human rights. The registered manager had adjusted working arrangements for some staff due to health or other commitments.

Processes were in place so that staff could raise any adjustments required in their roles to allow them to complete their roles safely. The provider had a bullying and harassment policy in place and staff knew they could raise concerns with management if they needed to.

Staff clearly understood their roles and also worked as a team. One staff member said, "We all work as a team to support each other and the residents."

Processes were in place to help maintain a quality governance system and maintain sustainability, but they were not always accurate, and did not always ensure errors and omissions were monitored. Audits and checks took place regularly, however, we found that audit outcomes and scores did not always accurately reflect the service. This included medicines management processes. We raised this with the registered manager who was going to review this with staff to ensure they were scored accurately. Notifications of incidents were sent to CQC in line with legal requirements. Actions plans were in place to address any shortfalls the provider had found, this included plans to refurbish many parts of the building and update garden areas after taking over the service at the end of 2023.

People enjoyed going out into the local community, including to the shops or for fresh air. Staff organised a range of activities, including visits to a range of outside venues. One staff member told us, "Residents do get a chance to get out and visit places away from the home. Its really good. Some choose not to go, but that is their choice. I am sure we do more than a lot of places."

Staff liaised with a range of professionals to share good practice and work in partnership with each other. One staff member said, "We work in collaboration with GP's, OT's, physiotherapist, care managers, dentist, opticians and other professionals who provide support and advice where and when needed." Weekly visits from the local GP occurred. We were told by staff, that the working relationship was good.

Healthcare professionals visiting the service said they had a good working relationship with the staff. One social worker said, "They (staff) liaised with the ward. There is a massive difference now. (They) are calmer. They are sitting looking through a paper now and were agitated a lot but seems settled now." One healthcare professional was concerned about staffing levels on two units. We had already raised this with the management team and it had been addressed.

Processes were in place to ensure partnership working and community engagement was occurring. Referrals to healthcare professionals were monitored by the management team via audits and checks taking place. Diaries and shift handover records were in place to monitor any contact with external support and ensure people attended appointments. Activity staff constantly looked for new ways to engage people with the local community, including church services at the home and engagement with schools to organise visits for people.

Staff had opportunities to learn from additional training and development opportunities within the service. The registered manager told us they were going to communicate with staff how the services staffing dependency tool worked so they had a better understanding. This was going to be completed as part of a staff meeting.

Regular meetings took place to share learning with staff and improve the service. Surveys with people, relatives and staff had taken place, in order to gather views and improve the service. Since the new provider took over the service, a full review of care plans was taking place and the introduction of an electronic system was planned for the future. The provider had conducted a comprehensive assessment in January 2024 to establish an action plan for improvement and they were working on this.