- Homecare service
TrustBridge Care
Report from 25 April 2024 assessment
Contents
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
Whilst processes were in place to check on the quality and safety of services, we found some of these were not fully effective. We discussed these areas with leaders who took action to make the required improvements as part of our assessment. Most, but not all people found leaders achieved improvements. Leaders communicated well with their staff teams on any updates relevant to them. Staff told us their leaders were supportive and they felt valued for the work they did. Staff felt the principles of equality, diversity and inclusion were supported by leaders. Leaders received training specific to their jobs roles to help develop them as competent leaders. Staff told us they felt able to raise any concerns directly with leaders as well as with outside organisations such as CQC and the local authority. The service worked in partnership with other health and social care professionals who told us they found leaders approachable.
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 told us they regularly updated staff with any developments in the service. Leaders told us they looked for staff with values, such as compassion in care, when recruiting. Staff told us their managers were supportive. Staff told us they had been supported to develop their skills and knowledge and for some staff this had enabled them to move into other roles within the service. Staff felt listened to and told us they were happy working for the service. They told us they felt the service was well-led.
Processes were in place to support the shared direction and culture of the service. For example, team meetings were held, and any updates were communicated to staff using an electronic messaging system.
Capable, compassionate and inclusive leaders
Leaders told us they looked for compassionate staff when they recruited. Leaders said they valued and thanked staff for their contributions and passed on any praise received. Leaders provided examples of the support they provided to staff including out of hours management support. They also made personal gestures of appreciation such as remembering staff birthdays. Leaders told us they were part of networks that shared good practice and skills relevant to care to keep themselves up to date and capable. Staff told us they found their leaders approachable and open. One staff member told us their leaders would ask staff how they were and how they were finding the work. They said leaders respected their feelings. Staff told us they had supervision meetings where they could give feedback. They told us leaders would give out ‘employee of the month’ recognition awards. Staff said compliments from people were shared with them and messages praising their contributions and achievements were shared. Staff told us this helped them feel valued.
A variety of processes were used to support leaders’ skills and capability. For example, policies were in place to ensure the service was run in line with good practice and a range of quality assurance processes were in place to help check on the safety and quality of care. Leaders, including team leaders had completed specific training to help them understand their role. For example, understanding the key functions of supervision, responsibilities when on call and team leader roles and responsibilities.
Freedom to speak up
Leaders told us staff reported any concerns to them and they had a variety of ways to do so. Leaders said the training staff had completed provided information on how staff can contact outside organisations, such as the Care Quality Commission and the local authority if they felt concerns needed to be raised outside of TrustBridge Care. All staff we spoke with told us they would feel confident to raise any concerns they had with their leaders. Staff were aware of outside organisations, such as the Care Quality Commission and the local authority who they could also speak with under the provider’s whistleblowing policy. Whistleblowing is a law that protects staff from being treated unfairly by their employer if they have raised genuine concerns about a person’s care.
The provider had a whistleblowing policy in place. Whistleblowing is a process that protects staff from being treated unfairly by their employer if they have raised genuine concerns about a person’s care.
Workforce equality, diversity and inclusion
Leaders told us they welcomed a culturally diverse workforce, and they took steps to support overseas staff to understand local cultures and the expectations of people receiving care. For example, support was given to staff to understand traditional British foods and the types of domestic appliances used in people’s homes. Staff told us they were given work hours that suited their availability, and they appreciated this flexibility. Staff gave examples of how leaders had helped plan work around religious and cultural celebrations to ensure staff could take the time to celebrate these with their families and communities. Staff felt their workplace was fair and promoted the values of equality and diversity.
Training such as equality and diversity training was provided to help ensure fairness and inclusion in the workplace.
Governance, management and sustainability
Leaders had a variety of systems to help them maintain governance and oversight of the service. We discussed with leaders where we had found some improvements were required as part of our assessment. Leaders took swift action during our assessment to make the required improvements. Staff told us they had their competency to administer medicines checked and other checks were completed on how they carried out their duties. For example, staff told us managers would complete unannounced checks on their uniform, use of personal protective equipment, how they followed a person’s care plan and checked whether the person was happy with their care.
Whilst processes were in place to check on the quality and safety of services, we found some of these were not fully effective. For example, audits of medicines had not identified that records for the administration of time critical medicines were not in line with the prescribers’ instructions. Whilst policies and procedures had been reviewed, we found some were not always updated to reflect current guidance. Not all incidents had been assessed as to whether they should be reported to the Care Quality Commission as required. The provider took action during our assessment to improve these processes and submitted the relevant statutory notifications as required. Other processes worked effectively to support the good governance of the service. For example, team meetings showed the management team had oversight of amongst other things, complaints, hospital referrals and staff supervisions.
Partnerships and communities
Most people told us leaders were approachable. However, 1 relative told us they had not always found them approachable or felt listened to. They told us they had been told things that then did not always materialise. On the whole, people felt leaders were keen to try and improve services wherever possible.
Leaders told us they had good working relationships with other health and social care professionals, such as District Nurses, GP’s and local authority social workers. Staff spoke with us about how they made referrals for people to access other healthcare services when needed. For example, such as the GP or District Nurse.
Some partners felt the service had on occasions provided additional services before agreeing these with commissioners. Additionally, partners said on occasion they had needed to follow up requests for information, however, they appreciated how busy the care team could be. On the whole, partners felt the service were open to learn and implemented good practice and understood the importance of working in partnership with professionals to benefit people’s care outcomes. Partners told us they found the leaders of the service approachable and friendly. Partners found consistent leadership had enabled partnership work to develop well. They felt the service was open to learn about any new techniques or equipment that may improve people’s care. Partners fed back that leaders had responded to queries regarding lessons learned from incidents, complaints and safeguarding. Partners shared the view the service was well-led.
Care plans and people’s records evidenced the involvement of other health and social care professionals as and when needed.
Learning, improvement and innovation
Leaders provided examples of how they responded to situations to make improvements. They said they looked to learn lessons from any incidents reported to them. Staff told us they felt leaders would listen to them and would take action to improve any issues they were made aware of. Staff told us they were asked for their views in meetings and in supervision meetings.
Processes such as electronic care planning and messaging helped to show the provider used innovative ways to deliver the service. Information designed to help staff deliver good care was provided to staff through regular newsletters. For example, we saw a recent newsletter had provided staff with how to make good quality care records and how to provide effective personal care. Quality assurance and lessons learnt reporting helped to show actions were taken to improve services. For example, when staff had reported a fault with equipment used by a person this was reported to the appropriate provider so it could be repaired safely.