Care 4 U - 466 Melton Road

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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

Effective governance, and the systems and processes in place ensured the service was well-led. People, their relatives, and staff views were continually sought to ensure the service met their expectations. The service worked in partnership with other professionals and organisations to ensure people continued to receive care that was in line with changing practice. Where improvement was needed managers ensured this was implemented promptly. Minor shortfalls identified at our previous assessment had been addressed. Throughout the assessment process managers and staff were open and transparent with us.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The management team had instilled a positive culture at the service and were open and transparent during the whole assessment process. Their mission statement, 'exploring the essence of value and vision' they added, underpinned their approach and culture. A service wide strategy to 'enrich lives with compassionate support, promote comfort, safety, and meaningful connections' was the service's core vision and purpose. Staff told us the registered manager had an open-door policy to ensure they could freely approach them and raise any concerns. We received positive feedback from everyone we spoke with, and all stated they would recommend the service to receive care from, or work for. We were assured through general discussion with managers they wanted to provide a safe service and deliver good quality person-centred care to people. During this assessment we found no evidence of a closed culture.

Processes were in place to enable the service's vision and culture to be delivered. Managers supported and communicated effectively with people and those most important to them throughout their care journey. Staff had received training in equality and diversity. Regular feedback was gathered from people, relatives and staff and regular spot checks of staff practice and competence were routinely undertaken.

Managers were knowledgeable and experienced. People, relatives and staff spoke highly of them. A relative said, "They [managers and staff] really listen to [Name] and are very accommodating. When we first used the service, the manager sat and completed a care plan that was very comprehensive." All office staff and carers we spoke with told us managers were very supportive and always available to them. They are here everyday and can be contacted over weekends and out of office hours."

The registered manager understood the duty of candour and was open and transparent, sharing with us when things had gone wrong. Apologies were issued to people following any shortfall in the expected standard of the service, and they acknowledged and acted where things needed to improve.

Staff told us they understood and would use policies to support them to speak up if they needed to raise formal concerns. However, they were all confident if they had any concerns they could openly report these to managers without fear of reprisal. One staff member said, "They would listen to me and do something about if I raised an issue." Managers said they had every confidence that if anyone across the workforce had issues or concerns they would be reported to them report them, and they would treat them seriously, and confidentially wherever possible.

Thorough and detailed policies and procedures to support staff to speak up and raise concerns were in place. Staff had been provided with access to up to date policies to matters relating to safeguarding and whistleblowing concerns. There were effective management systems in place to oversee these and respond promptly to any concerns.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Staff knew their roles and responsibilities and how to deliver high quality care to people. All discussions we held with staff confirmed they were committed to their roles and felt of each other they aspired to be the same. Staff were enabled by managers, by their own ethos and commitment, to deliver care to people in a compassionate and dignified manner. Managers understood the importance of monitoring staff conduct and how they delivered care through performance management including, spot checks, appraisals and supervisions. Managers told us they had oversight of the day to day running of the service. They encouraged staff to come to them when they needed to with an open door policy approach. One manager told us, "We [mangers and senior staff] will always deliver care ourselves if the need arises which demonstrates to staff that we are just as committed. This sets the right example to all."

The provider had robust governance and management arrangements. Quality monitoring processes in place were thorough and effective which included structured planned reviews of care or more frequent reviews if required. Feedback was sought from people, relatives and staff through formal spot checks, satisfaction surveys, reviews of care and any information shared informally. This enabled issues to be identified at the earliest opportunity and to be acted upon promptly. Relevant information with external organisations, including CQC, were shared in a timely and secure way. A clear staffing structure was in place throughout the organisation. All staff had their own roles and responsibilities which managers had oversight of. Systems were in place to manage performance across the organisation. Feedback received from local authority commissioners confirmed the service was complying with their requirements to commission care from the service, and any actions identified completed swiftly.

People and their relatives identified needs were achieved by good partnership working with other health professionals. A relative told us, “When [Name] developed red marks and bed sores, the carers contacted the district nurses and they have a special cream that they apply and the carers have managed to keep those areas from breaking down further and things have improved.“

We were satisfied the service was collaborating well with other agencies. The registered manager provided us with a recent local authority monitoring report which demonstrated the compliance the service achieved with their requirements. Minor shortfalls identified had either been addressed, or were in the process of being addressed, at the time of the assessment.

Through general discussions with managers, and feedback we received throughout the assessment, we were assured managers worked in collaboration and partnership with other agencies. This meant people continued to receive safe care ensuring their individual needs we met.

Managers gathered feedback from staff and sought their views during individual supervisions and appraisals, and collectively in regular team meetings. Staff told us they were listened to and valued.

The management team worked with staff to identify areas that may need improvement. They ensured they were adhering to current guidance and best practice by carrying out spot checks. When training was refreshed they ensured any changes to policies and guidance were reflected in their training.