Absolute Care at Home Limited Head Office

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 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. The provider was in breach of legal regulation in relation to the governance of the service.

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.

The Service User Guide outlines the aims and objectives of the organisation and what people can expect from the service. Support packages were developed with the inclusion of people and their families. The staff handbook clearly details the organisations responsibilities in supporting the work force. Policies and procedures along with staff training were provided to guide staff in equality, diversity and human rights, helping to promote good standards of care. However, this had only been completed by 50% of the team. Whilst staff felt they were valued as a member of the team opportunities to help promote learning and improvement needed implementing and embedding.

During our inspection we were assisted by the manager who had been in registered with CQC since 2021 however had worked for the provider for many years, as had many of the staff team. Staff felt senior staff were supportive of them on both a personal and professional level and were compassionate to their individual needs. One staff member said, “Office staff are more like family and friends. You can speak to them about anything.” Another spoke about an incident, where senior staff had fully supported them. They said, “Its well run and they help you if you have any problems.” When asked about the culture within the service staff felt this was ‘open’ and ‘supportive’ and there was not a ‘blame’ culture if mistakes were made. One staff member said, “If anyone has a problem, they know they can go to the office and then it will be dealt with.” Management systems needed to be improved to evidence better oversight and effectiveness of processes in place.

Staff were provided with a handbook, which outlined relevant policies and procedures and what was expected of staff working for the service. Information outlined the whistleblowing procedure and guided staff on what they should do if they needed to report information or concerns. Staff told us they felt able to raise any issues or concerns, including poor practice. One staff member said, “I would report it. I’ve had to do it once. I wrote a statement and then they [managers] dealt with it.” Staff were confident senior staff would listen to them and were fair. Comments included, “Management are all approachable” and “They will always make the time for you to go in and see you.” Other processes to seek the views of staff were not formally embedded, such as feedback surveys, regular team meetings and individual supervisions.

Managers recognised and valued diversity in their workforce. The staff handbook outlined expectations of staff as well as their employment rights including support around staff well-being and flexible working arrangements. Information included the ‘equality, diversity, and inclusion policy’ which promoted equal opportunities for staff and how their protected characteristics will be considered and respected.

Robust audits and checks were not in place to clearly evidence effective oversight of the service, helping to identify areas of improvement including those shortfalls found during this assessment. This included areas such as workforce planning, safe administration of prescribed medicines, accurate and complete care plans and risk assessments and robust recruitment, training, and development of staff. We were told regular management meetings were held between the registered manager and director. However, these were not recorded to evidence or inform the development of a business improvement plan. Policies and procedures were in place however these were not always followed in practice. In addition, incidents had not always been reported to CQC, as required. The management team had clear delegated roles and responsibilities. We were told, following recent concerns, it was recognised improved monitoring was required. A member of the care team had been appointed to take on a new quality monitoring role and senior managers were looking to implement further checks involving people and staff to help improve quality and safety. It is essential to have a robust governance system. These need to be implemented and embedded to identify concerns and improve quality and safety. Without such systems we could not be assured the provider was able to identify and make the improvements needed within the service.

The service understood their responsibility to work in partnership with other agencies ensuring appropriate referrals were made to external health and social care professionals where this was required for people.

The registered manager acknowledged robust systems were not in place to effectively monitor and identify areas of improvement and learning, including those shortfalls found during this assessment. Managers were responsive to our findings and were exploring systems to support and drive improvement.