Crestar Healthcare

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

The provider’s governance and quality assurance systems were not sufficiently effective to ensure the delivery of good quality care and support. Medicine audits and checks completed had not enabled them to identify and address concerns we found during this assessment. Where the registered manager took on care packages that were specialised and requiring safety risk measures, this was not always completed to identify and mitigate risks. Information was not always fully gathered and at time assumptions on information were made by the registered manager.

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.

Staff understood the values and vision for the organisation. Staff and management understood the importance of listening to the views of people and their relatives on the service. Staff understood people’s human rights and told us about some ways in which they supported people with their diverse needs. Management and staff understood peoples capacity.

Processes ensured staff had a shared vision and values regarding the care and support delivered. People and their relatives had been provided with clear information on how to raise suggestions and concerns about the service. Management gained feedback regularly, this was to seek people’s views about the service, enabling them to contribute to its development. During reviews with people, care plans were reviewed and any changes were actioned. Care plans and risk assessments had detailed guidance and acknowledgements to people’s diverse needs. This meant guidance on how to effectively communicate with people to meet their needs and understanding.

A system was in place where the management team were accessible 24/7. Staff found the management approachable and felt supported. The registered manager told us they were always available and understood how important it was to be available to staff. The management team understood how to promote safe recruitment practices.

Staff told us they knew about the service’s whistleblowing policy and knew how to raise concerns if they had any. The registered manager had an open-door policy and encouraged staff to speak up.

There was a whistle blowing policy in place. Staff were informed about this as part of their induction. Staff could access the policy electronically if needed.

The registered manager promoted equality, diversity and inclusion, they demonstrated a passion for ensuring staff were treated fairly and provided all opportunities. The provider offered where appropriate flexible working patterns to help with staff’s commitments. Incentives were provided for staff and benefits were encouraged by the provider. Staff were valued and shared positive values matching those of the registered manger, all wanting to improve where required and provide a quality service. We reviewed team meeting notes and this evidenced that staff spoke openly and opportunities for staff to express concern or discuss development were provided during team meetings.

Staff and management we spoke with were clear about their individual roles and responsibilities to providing quality care. The management team had a system in place to oversee staffs training and to ensure they were compliant. This was to ensure staff could meet the needs of the people they support. Some care plans lacked detail , for example, guidelines around responding to risks identified to a person were not clearly detailed for staff to follow. Guidance was not always provided to effectively manage people needs.

The provider’s governance systems were not always effective and had not enabled them to monitor and manage risks to the safety and quality of people’s care. Medicines audits completed had failed to identify significant issues we found, including ineffective assessment and management of risk, recording and administering medicines in line with NICE guidance. A process to monitor timeliness of care calls was in place, we reviewed 2 months of calls for 3 people and identified that calls were consistently late. This was discussed this with the manager who stated that they were taking action to improve. However, the actions they were taking had not yet had an impact on the service provided. Where specialised care packages were in place, these did not always prompt the safety of people and staff. For example, where a care package states they must have the same sex carer due to a history, there was no information to explain the concerns staff may see and guidance on how they must respond safely.

People and relatives told us staff assisted them in arranging support from other healthcare services as needed. People felt staff would gain outside professional help around any health concerns if needed.

Processes were in place to ensure external partners were notified of relevant information. For example, the management team completed CQC notifications, based upon information brought to their attention and had raised safeguarding concerns with the local authority safeguarding team. Systems and processes were in place and ensured consistent effective collaboration with relevant external stakeholders. The registered manager showed the process for when people were referred and the actions, they implemented following receipt of any relevant information from stakeholders to ensure they were meeting care needs of people.

The registered manger told us how they actively keep up to date with changes and this was to improve and develop the service provided.

Systems and processes to support learning and improvement in people’s care were effective. Incidents and accidents were consistently reported and, when reported and investigated, learning from these safety events were consistently identified or shared with staff. We saw staff had enough skills and training to embedded and complete effective learning and standard of care safely. The provider welcomed input from local authorities, and we saw that feedback was listened to. Any actions would be added onto a service improvement plan.