Fosse Healthcare - Lincoln

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 that service leadership, management and governance assured high quality, person centred care; supported learning and innovation; and promoted an open, fair culture. While the registered manager understood there were still aspects of care to improve, we found the service was consistently managed and well-led. Leaders and the culture they created promoted quality, person centred care and approaches. We found there was good leadership in place and we received positive feedback about the registered manager. The manager and provider had clear auditing systems and reviewed the effectiveness and quality of care regularly. There were further improvements to be made in relation to communication and scheduling of care visit times to ensure consistent, quality care. The provider had plans in place for any areas that still needed to be improved and were aware of and working towards any concerns we found. There was a good learning culture in place, with opportunities for staff to raise concerns or gain additional support. Staff told us they felt there was no discrimination and staff were treated equally.

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.

Most staff were not aware of the values and vision for the service. However, they felt the culture was positive and open and their personal values in relation to a desire to provide good quality care aligned with the providers. One staff member told us, “[The aims are] to deliver a high standard of care to [people]. To keep them safe from harm and abuse. To minimise the risks to their wellbeing. To ensure [people] live a longer, happier and healthier life.”

The registered manager was aware of how to reduce the risk of a closed culture and worked hard with the staff and external professionals to prevent it. They promoted an open culture and sharing of information. While staff were unable to recall the vision and values, the training and information shared encouraged the values in practice.

Staff told us they were happy with the support from leaders and felt they listened and role modelled good practice. They said leaders were approachable and this promoted a positive culture. One staff member told us, “I am happy with all the staff that I work with and all the office and management team I always feel very supported.” Another staff member said, “The [managers] have always said if you are struggling or drained ring us at the office and you have our work number and we will happily help you and talk to you.”

We found there was good leadership in place and we received positive feedback about the registered manager. Managers had the knowledge and capability to lead the staff team and deliver a quality service.

Staff told us they felt empowered to speak up with concerns or suggestions for improving the service. One staff member said, “The management are very approachable anytime and I can raise a concern and they usually come back to you quickly.” Another staff member told us, “I always feel like I can speak up when we have staff meetings. I am always so open and honest and If I have any ideas about like making [care visits] easier, [management] says they can have a look at that and get back to you.”

The provider and registered manager encouraged staff to speak up. They did this through use of 1:1 supervision, team meetings, complaints processes, surveys, suggestions and informal discussion. There was an open culture of information sharing and responding to concerns.

Staff were happy with the way they were treated and feel there was no discrimination and they were treated fairly and equally. One staff member told us, “We can now claim for extra time. There is definitely a fair rate of pay, no differences in pay across genders.”

The provider and registered manager continually reviewed the impact of policies and processes to ensure equality and inclusion was promoted. The culture in the service encouraged diversity and understanding amongst staff and people. They sought feedback from staff about how they felt through the use of surveys and supervision. They ensured there is no discrimination in relation to fair pay and treatment. They supported staff who were from other countries and cultures, to adapt and learn about differences for the people they supported and each other. The provider had implemented policies that meant there was no tolerance of bullying, harassment or discrimination should it occur.

Staff and leaders understood their roles and responsibilities and there was a clear line of accountability. They worked on continuously improving plans in place and kept up to date on the latest statutory requirements and best practice, which they shared with the teams. Staff told us they were supported to develop in their roles and lessons learnt and updates were given to them. One staff member told us, “The bigger managers and directors send out regular emails giving updates on the company and what they stand for and their plans.”

The registered manager and provider had clear auditing systems and reviewed the effectiveness and quality of care regularly. They had plans in place for emergency contingencies and for any areas that still needed to be improved and were aware of and working towards any concerns we found in relation to the consistency of care visit times.

People felt the management did not always learn from their feedback and complaints. They felt nothing changed to improve the quality of care or timings of care visits. One person told us, “[The registered manager] came to see me to let me know what was going on, then it just changes again." Another person told us, “I wouldn’t necessarily recommend them to anyone but then I wouldn’t say definitely don’t use them either.”

Staff and leaders told us how they worked together with other teams, people and external professionals to ensure care was person centred. They sought advice both formally through referrals and meetings as well as informally through discussion where needed. They told us how they worked intensely with people, the local authority and external professionals regarding the care for a person with particularly complex needs. They made suggestions of new ways of working that resulted in positive outcomes for the person.

Professionals gave positive feedback about collaborative working, the improvements and changes that have been made. One professional told us, “[We] have a good working relationship with Fosse, with all the individuals in branch including the registered manager, deputy manager and quality assurance manager. This appears to be resulting in effective communication. Phone calls are pleasant, personable, useful and efficient. The team are proactive with querying packages to ensure a thorough understanding of the needs of a client and Fosse are proactive in providing [us] with updates as part of the process.” A professional also said, “New and robust systems have been implemented to ensure issues are addressed efficiently and sustainably. Enhanced training programmes, including the innovative training house initiative, have been effective in addressing recurring themes and improving staff readiness.”

The registered manager held regular reviews of people’s care and reviews of the service with the local authority. They worked with them openly around improvements identified and implemented and the outcome and impact of these changes.

Staff were supported to learn from events and encouraged to develop their skills and knowledge. One staff member told us, “Some of [the training] is by [video meetings] like the medicines training. Moving and Handling training was face to face in branch. We do refreshers on the training and have a go on all equipment. The training with Fosse is the best I have ever received in care, I have learnt things that I have never heard of before so that was good.” Another staff member said, “I am glad they did the kitchen as they weren't giving training to people from other countries and young people.”

There was a good learning culture in place, with opportunities for staff to raise concerns or gain additional support. The provider was open about learning from incidents or complaints or changes to best practice. Staff had development plans and completed their care certificate and/or NVQ qualifications once commencing employment. The registered manager was keen to use new learning to improve the way things were done. For example, implementing kitchen/cooking training and updating software to better plan care visits times with a view to improving the consistency.