The Recruitment Partnership Also known as Total Care UK

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 assessment for this registered service. This key question has been rated Requires Improvement. This meant governance systems were not always effective, and records were not always up to date and accurate. Leaders lacked clear oversight, which limited learning to improve care.

The service was in breach of legal regulation in relation to governance of the service.

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.

Improvements were needed to ensure the provider’s systems supported delivery of care in line with their shared vision for the service. Leaders promoted a positive culture based on equality, diversity and inclusion within the service.

The registered manager promoted a positive, supportive culture focused on good quality, person-centred care. This vision was shared by the provider and understood by staff, who treated people with respect. People and relatives gave positive feedback, and regular staff knew people well and delivered care in line with their preferences. However, the lack of formal audits and inaccurate care plans meant the service was not fully effective in learning and improving. These gaps limited the provider’s ability to embed good practice and consistently deliver care in line with its vision.

The provider had an equality and diversity policy in place, which was accessible to staff and ensured staff were trained to understand the importance of providing care in line with people’s diverse needs.

Leaders were visible, approachable and supportive and ensured staff carried out their role as required. However, improvements were needed to ensure leaders had a clear oversight of the service provided.

The registered manager carried out spot checks and provided feedback and training where needed, which demonstrated commitment to staff development. However, governance systems to monitor and improve the service were not consistently in place. This meant there was a lack of oversight of the service, which limited the registered manager’s and provider’s ability to identify and act on risks, learn lessons, and drive improvement.

The registered manager carried out regular spot checks to ensure staff provided care as required. Records showed these checks were completed consistently. Where gaps in staff knowledge were identified, feedback was given to staff and action was taken to provide additional training and support.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff understood how to speak up and told us they were able to raise concerns easily and approached the registered manager if they had any concerns. Staff understood how to follow the provider’s whistleblowing policy, which was accessible to them. One staff member said, “I would report any concerns I had to [registered manager’s name] or [provider’s name]. I do know I can whistle blow if I felt I wasn’t listened to and know how to do this.”

The registered manager promoted an environment where staff felt able to speak up. The registered manager told us, “I have an open-door policy, and I am always available for staff. It is important for me to be approachable for staff if they have concerns.”

The registered manager held team meetings, which provided an opportunity for staff to raise practice related issues and discuss ways to improve as a staff team. This demonstrated open communication as staff were encouraged to share ideas and raise practice-related issues.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The registered manager promoted a culture of openness, diversity and inclusion. Staff told us they felt able to approach the registered manager with any concerns and were encouraged to recognise and respect people’s diverse needs.

The provider encouraged recruitment of a diverse workforce and respected the individual needs of all staff. Staff told us they felt treated in a fair and equal way by the management team and all colleagues they work with. One staff member said, “The managers are absolutely brilliant, they are supportive and respond to me in a nice way.”

The provider had clear responsibilities, roles and systems of accountability; however, some improvements were needed to ensure the systems in place were consistently effective in identifying areas of improvement required.

Improvements were needed to ensure the provider had effective and robust governance systems in place. Some audits were not recorded, which meant there was no evidence to demonstrate actions taken to drive improvements or to analyse trends and themes. For example, there were no recorded audits for care plans, incidents, or repositioning. Although the registered manager told us they reviewed care plans and care logs to ensure people were receiving care, these checks were not documented. Medication audits had been completed but these contained incorrect information about people’s medicines and had not identified the concerns we raised at the inspection. This demonstrated that governance systems were not effective in identifying and addressing risks, as audits were either missing or inaccurate and did not highlight the issues we found during the inspection.

Records were not always up to date. While people told us they were happy with the care provided and regular staff knew their needs well, the lack of accurate and current documentation created a potential risk for new or unfamiliar staff delivering incorrect care. For example, one care plan stated a person required a repositioning regime but did not specify the frequency or include a task for staff to complete. Prescribed creams which were no longer in use had not been removed from care plans; care plans did not always contain personalised information about people’s preferences in how they received support. This meant there was a risk of people receiving inappropriate and inconsistent care.

The lack of robust governance systems and accurate records increased the risk of inconsistent care, particularly when unfamiliar staff were providing support. It also limited the service’s ability to evidence monitoring and continuous improvement.

The registered manager had notified us of events which had occurred at the service and were open and honest when things went wrong, responding and acting on feedback provided to improve the service for people. The registered manager and provider were receptive to the feedback provided during and following the inspection and took action to implement plans to ensure the required improvements were made.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

The registered manager had developed good working relationships with a range of professionals to ensure people received consistent care and their needs were reviewed when needed. This included health and social care professionals to ensure people’s care needs were discussed to provide joined up care.

Improvements were needed to ensure systems were in place to focus on continuous learning, innovation and improvement across the organisation.

The provider was unable to demonstrate a strong focus on continuous learning due to the absence of effective audits and checks. Systems to identify patterns, learn from incidents, and implement improvements were limited. This reduced the provider’s ability to show a proactive approach to learning and improvement across all areas of care delivery.