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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

We identified 1 breach of the legal regulations. The oversight of the service needed improvements. Audits completed failed to identify all the concerns identified within this assessment, and where concerns had been identified they were not always actioned in a timely way. Notifications had not been submitted. There was a positive culture at the service and feedback from staff and people was very positive in relation to the management of the service. Staff felt well supported and people and relatives complimented the responsiveness of the management team.

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.

Staff told us there was a positive culture within the service. Staff were clear about the aims and objectives of the service. They told us they aimed to delivered person centred care with the best outcomes for people, and they were delivering this. One staff member told us, “It’s so nice to work for a company that as their ethos.” Staff and leaders demonstrated a positive, compassionate, listening culture that promoted trust and understanding between them and people using the service.

The service aimed to give people consistently good care and staff worked together to try and achieve this.

The concerns we identified regarding failure to submit statutory notifications were discussed with the management team who started to address the issues during the assessment. Managers and staff were passionate about delivering quality care and support and promote a positive culture. Their approach aimed to achieve good outcomes for people. Staff unanimously told us they fell well supported by the management team. They also told us that they felt listened to and able to provide feedback. One staff member told us, “[Name of registered manager] is lovely, they are all lovely, I wouldn’t have a problem in going to any of them if I had an issue, they are all very supportive. Another staff member told us, “[Name of registered manager] is approachable, [Name of manager] has also been really good, they have really taken time to get to know the clients, they are very helpful."

Providers are required to act in an open and transparent way when people come to harm and to notify CQC of significant events without delay. The provider had failed to notify CQC of significant events that happened in the service. This included allegations of abuse. Providers must also notify CQC of any changes to their statement of purpose. During the assessment we identified they were providing a supported living service. The provider had failed to submit a statutory notification and change their statement of purpose to ensure we were informed of the kinds of services provided. At the time of the assessment this was a breach of legal regulations that was rectified during the assessment. The provider took immediate action and started to submit notifications. The service had a management structure in place with defined roles and responsibilities. The registered manager visited people regularly and sought feedback from people and staff.

Staff felt confident to speak up and that they would be listened to. Staff told us there was an open culture where they were able to raise any concerns. They were aware of the whistleblowing procedure and knew how to report any concerns externally if required.

There was a whistleblowing policy in place and staff knew how to access this.

Staff told us the registered manager was supported and treated staff fairly. One staff member told us, “[Name of registered manager] Is approachable and fair.” The registered manager told us they promoted equality, diversity, and inclusion by providing language training for staff, flexible shift arrangements to accommodate religious observances (e.g., Ramadan, Easter, Diwali), equal pay for equal positions across all staff and a system enabling staff to record notes via voice input.

The service promoted fair and equitable treatment of staff. Training and development opportunities were available to everyone. Staff told us that if they were to identify they needed specific training, the management team would facilitate this.

The concerns we identified regarding the system in place to monitor the quality and safety of the service were discussed with the management team who started to address the issues during the assessment. Staff provided positive feedback about the management of the service and found them supportive.

There was a system in place to monitor the quality and safety of the service. The system was not fully effective in identifying concerns, and where concerns had been identified they were not always actioned in a timely way. For example, the medicines audit did not identify where PRN protocols were not in place, the training audit had not identified competency assessments were required, and shortfalls identified during an external audit that was completed in December 2023 had not all been addressed at the time of our assessment. This included missing information from staff files. There was not a robust system in place to ensure oversight of records relating to the care and treatment of people using the service contained up to date information and guidance. We found shortfalls in the application of the MCA, and risk management, however these were not all identified in the audit. We also found some documents were outside of their review date, whilst others were not dated, signed and detailed no evidence of any review. We found no evidence that people had been harmed however, systems and processes were not operated effectively to assess, monitor and improve the quality and safety of the service.

People and their families told us they received effective care and that their needs were met. They told us the service supported them to have joined-up care by liaising with other professionals as required.

Staff and the management team told us they worked in partnership with other organisations such as healthcare professionals and commissioners to support the care provision. Records showed evidence of this joined up work.

One professional working with the service told us that since some initial issues, communication has now improved. The service asks for advice and guidance and the staff are compassionate and caring.

The provider worked in partnership with other key stakeholders. This included the local authorities who commissioned packages of care with the provider, as well as other healthcare professionals.

The concerns we identified regarding the systems in place to learn and improve the quality of the service were discussed with the management team who started to address the issues during the assessment. Staff told us the service learned from incidents and any learning was shared amongst the wider team. One staff member told us that in a daily handover they used the time to discuss any incidents and how things could improve.

We found improvements were needed to ensure there were effective systems in place to learn and improve the quality of the service. Shortfalls identified during an external audit that was completed in December 2023 had not all been addressed at the time of our assessment.