Nurture Care Services

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. This is the first inspection for this newly registered service. This key question has been rated Good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

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 service had a shared vision, strategy and culture based on the principles of person-centred care, promoting independence and respecting people’s human rights. Staff were very positive about the management team and complimented them for how supportive they were. The nominated individual said, “Culture is very important. We aim to be open and not have a closed culture. It’s important we all work together, work safely and avoid bad practice as a team.”

The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty. The registered manager was supported in the day-to-day management of the service by the nominated individual. People spoke positively about the service and the management team. They told us they were treated with respect. Staff were also positive about the management team and told us they were compassionate and cared for the staff and people they supported. A staff member said, “I can talk to [registered manager] about anything. They are very approachable and helpful.”

The service fostered a positive culture where people felt they could speak up and their voice would be heard. Staff said they were able to speak with the registered manager to discuss any concerns. Staff felt they would be listened to respected. A staff member said, “It is a very open service. There is 2-way communication and we can speak up in meetings and they will listen.” People told us they could contact the service at any time to speak with managers. They said they knew how to make complaints and felt there was a positive culture in the service. The registered manager told us they would speak with people or relatives and listen to concerns they raised. There was a policy for whistleblowing. This meant there were processes for staff to follow should they wish to speak with external agencies such as the local authority, the CQC or the police if, for example, concerns were not addressed by the provider.

The management team valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who work for them. Staff felt they were treated fairly by managers, and worked well with them as a team. Staff completed training in equality and diversity and had an understanding of what it meant. Recruitment and disciplinary processes were in place and ensured there was no disadvantage based on staff's specific protected equality characteristics. The provider had processes to ensure an inclusive workplace where staff were treated and supported as individuals. A staff member said, “The managers are very fair and very respectful of the staff.”

The management team had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They act on the best information about risk, performance and outcomes, and share this securely with others when appropriate. There were systems to monitor the quality of the service people received, which helped to identify if any improvements could be made. These included observations of staff competency, audits and team meetings. The registered manager worked with the nominated individual to complete quarterly and monthly care audits. These included checking the quality of care plans and making sure staff records and training were up to date. Safety processes were also checked so they could be assured people remained safe. The registered manager also supported people. Therefore, they could also check staff records such as handover sheets, daily notes and medicine records. We saw that documents were up to date and there was a clear goal towards identifying key areas such as staff training, communication, technology use and satisfaction of people using the service. However, audits had not identified the concerns we found in relation to people's capacity assessments but we were assured that the management team had systems to learn from mistakes and improve the service.

The registered manager understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement. The service worked well with people and professionals. The service was small, and the managers were able to network and contact external organisations, such as the local authority, for advice and guidance within the health and social care sector. Professionals we contacted provided positive feedback about the service.

The management team focused on continuous learning, innovation and improvement across the organisation and local system. They promoted an equality of experience, outcome and quality of life for people. The management team and staff confirmed there was a continued focus on improving the care and support provided. Staff told us they attended team meetings with the management team to discuss various matters such as training, care standards, communication and policies. A service improvement plan had been developed by the provider to help drive continuous improvements, which was based on CQC’s key questions safe, effective, responsive, well-led and caring. For example, establishing improved communication protocols between the provider, staff, people and relatives and professionals. Other actions included continuous involvement of people in the service to ensure their consent and views are sought and acted upon. The provider also planned to invest in new technology to help monitor the safety of people in the service should it expand and support more people.