Care Direct Salford

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. At our last assessment we rated this key question good. At this assessment the rating has remained the same. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care. The provider had a vision and strategy. They had an up-to-date Statement of Purpose which clearly explained the organisations' aims and values. Staff spoke positively about managers and all staff felt supported and able to raise any concerns. People and relatives were complimentary about the registered manager and their impact on the service. People and relatives spoke positively about the care and support provided and felt involved. Staff told us the provider had a whistleblowing and freedom to speak up policy, which they had access to and knew how to report any concerns. The provider had up to date policies and procedures in place relating to equality and diversity, staff support and well-being. The provider and registered manager completed a number of audits and monitoring processes, to assess the safety and effectiveness of the care and support provided. People and relatives felt listened to and were able to raise concerns if they needed to. The staff team had the skills, knowledge and experience to perform their roles, and understood their roles and responsibilities. There was a strong sense of trust between leadership and staff. Governance processes were effective, however oversight of the newly implemented eMARS system needed further scrutiny to avoid any potential errors in medicines management.

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.

Leaders ensured there was a vision and strategy for the service. Leaders told us the emphasis of their vision was ensuring staff members had the appropriate training to become ‘excellent’ care workers. Aims and objectives of the service were shared with staff at their induction and at other opportunities including meetings. The induction programme outlined the statement of purpose, the company values and the vision. Staff told us they felt respected and listened to by their senior team members, especially the registered manager. Others told us they felt ‘happy and supported’ and would recommend working at the service due to the compassionate culture which had been established. Some of the staff we spoke to had worked for the service for lengthy periods of time as they felt valued by leaders. A member of staff told us leaders listened to staff and responded swiftly to requests. They provided an example in which further training in mental health was provided for staff following this need being identified. One relative told us, “Staff are always on time and do their job… [Staff names] are great as they understand [person’s] dementia and make [them] smile. [Person] had a memory assessment recently and knows [staff names]. I don’t think they can really improve. I would 100% recommend because of their consistency of care, reliability of care and communication. All of this is massive to us.”

The registered manager and other leaders had the appropriate experience and skills. Staff told us leaders were visible, approachable and led by example. A staff member said “Senior staff have all been in the field in their past jobs. When they support staff, it is clear they have a wealth of experience.” Another staff member told us the manager had an ‘open door policy’ which allowed staff to share concerns without judgement. Leaders were knowledgeable about the key issues and priorities for the service. They understood the electronic medication administration record (EMAR) system which had been introduced recently needed some additional work. They recognised the importance of continuing to audit the service to identify areas for improvement. Staff told us leaders were aware of the key issues faced by staff; they said they were asked by leaders for their opinions and concerns on a regular basis. Staff told us leaders were alert to any examples of poor culture and addressed any internal issues swiftly. A staff member told us “Issues are always treated with confidentiality and dealt with promptly.” One relative told us, “I ring the supervisor in the office if we need extra calls and they are very accommodating. We did a questionnaire about 6 weeks ago but no feedback yet. They are very reliable, for example, if the carer is 10-15 minutes late, they ring me. I would recommend as they are well run and efficient.” A further relative told us, “The managers are unbelievably approachable, I’ve called at crazy times, out of hours, and they were really helpful. There is very good communication, and we trust them. I have no reason to doubt Care Direct.”

There were processes in place for staff to speak up and a culture to encourage staff to do so. For example, the provider had a whistleblowing and freedom to speak up policy, which staff had access to, and staff knew how to report any concerns. There were mechanisms in place for people and relatives to speak up, who told us the service was well led. One relative said, “I have spoken to the manager as they are always here to help. They are patient and caring. It’s not easy for anyone but they are helping as much as possible.” The registered manager welcomed feedback from people, relatives, staff and other professionals. We observed surveys which demonstrated this. Staff told us they would be confident raising concerns to the registered manager or other senior leaders. They were assured they would be listened to.

There were policies and procedures in place to support non-discriminatory and equitable staff recruitment. Processes were in place to support staff to carry out their roles. The provider ensured there was equality of opportunity when recruiting care workers. Leaders ensured there was additional support for staff members from a different culture or country if they required it. The registered manager told us staff from different cultures were encouraged to talk about their heritage, beliefs, values and culture. Leaders ensured there were effective and proactive ways to engage and involve staff. For example, they completed annual staff surveys. The staff survey from May 2024 was positive and showed staff felt happy, valued and supported working for the provider. For areas which staff identified an improvement was required, leaders responded. Staff had completed equality, diversity and inclusion training. The registered manager maintained a staff support schedule for appraisals and supervisions for the coming 12 months. Staff told us everyone was treated fairly and equitably. A staff member told us “We are one big team who support one another with no biases or discrimination.” Other staff members provided a mixed response as to whether the senior team had allowed them to have flexible working arrangements.

The introduction of the eMARS demonstrated a commitment to investing in the service. However, the management of this change had not been effective. Both the design of the system and the process was impacting negatively on their ability to manage medicines safely. Additional measures had been put in place to ensure systems were safe until this was resolved. Aside from the eMARS there were clear and effective governance, management and accountability arrangements. Leaders completed monthly audits which reviewed health and safety, mandatory training for staff, medications, service user files, leadership and management, recruitment and retention and quality assurance. In October 2024, the service was 96% compliant with the audits completed. Leaders ensured staff were competent within their roles by providing a detailed induction, a period for staff to shadow senior staff, regular supervision, an annual appraisal, training and spot checks. There was evidence of staff meetings taking place throughout 2024. The senior team had also met in November 2024. Agenda items included a review of medication management, audits, assessments and incidents. The registered manager and nominated individual collected data, produced reports and fed data back to staff. For example, a safeguarding analysis report had been completed for the previous year. The analysis reviewed the number of safeguarding incidents reported, provided a summary of such incidents, lessons learned and the timeliness of referrals. Learning from the report was shared in staff meetings. Policies which were reviewed contained the appropriate detail and were up to date. There was a business continuity plan in place which detailed how the provider would continue operations during and following a disruptive event such as natural disasters, pandemics or other emergencies.

Leaders collaborated with relevant stakeholders and agencies including the local authority. For example, the local authority completed an annual review of the service based off information the provider had supplied. Leaders engaged with people to review their experience and ensured continuous improvement were made based on their responses. We saw analysis of a ‘service user’ survey which had been sent out in September 2024. Overall, the survey provided favourable responses to all questions raised. An action plan was developed by the leaders to address the very few negative points raised. Leaders engaged with other professionals including general practitioners, pharmacists, community psychiatric nurses, district nurses, social workers and care commissioning teams. For example, in July 2024 a survey was sent to professionals who regularly supported care provision. Topics included staff competence, how well the service responded to concerns raised and overall impression of the service. Overall, the service performed very well, and an action plan was developed by leaders for points which required improvement. Staff were aware of the importance of sharing information with key organisations when required.

Staff and leaders ensured people using the service and their families were involved in evaluating the service. Staff told us they were encouraged by the senior team to share their thoughts and ideas for improvement and innovation. Staff felt the senior team provided time to listen and there was a strong sense of trust between leadership and staff. The provider had strong external relationships which supported improvement and innovation. For example, the local authority completed monthly data returns which identified any issues and provided action points. The provider had an action plan which was reviewed monthly. The plan was in line with what the registered manager had identified as risks for the service. The plan was clear with designated staff to complete tasks within a timeframe. The provider had recently implemented electronic call monitoring which had made improvements to the service. There was also a move towards digital social care records which included an EMAR which was still in its infancy.