Nationwide Care Services (Northfield)

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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

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 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 provider had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities. The provider told us they were clear about the standards they expected, providing support and guidance when staff had failed to meet the standard. The provider had a vision in place to support their business to grow. There was evidence of regular supervisions available, and appraisals for staff that demonstrated discussions of the values. Audits and spot checks were actioned regularly with care led competency checks. Staff said, every month we have spot checks, and if we need extra support we can ask.

The provider 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.Staff gave positive feedback about the management team and the culture of the service. Staff said they could talk to the office staff and the management team at any point and felt involved and included in the day to day running of the service and any changes that occurred. Staff felt supported and were positive about the management. Staff told us they had team meetings, as well as 1-2-1 support and supervisions, which provided opportunities for discussing any issues with the service and how to make improvements. Relatives were also positive about the management and told us they were confident should they need to raise any concerns action would be taken.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. The service had a whistle blowing policy in place, and staff spoken to felt able to raise concerns and where confident action would be taken. One staff member told us, “Managers are amazing and very nice, they always listen.” The provider had an accessible complaints policy in place. The policy detailed how people could raise concerns if they were not happy with the care or service they received.

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. There were policies and procedures in place to support equality and diversity. Staff had received training and knew how to recognise discrimination within the workforce. Staff told us they were all treated equally and were not discriminated against.

The provider 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 acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate. A robust system to monitor, assess and drive improvements to their service was used. This included medicines management audits, care plans and risk assessment audits, daily notes, and infection control audits. However, during the inspection one audited care plan log identified a safeguarding concern, which was investigated and managed retrospectively.

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. We received no information of concern from partners working with the service. Records showed appropriate partners were involved in people’s care when needed.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research. Within the management structure the Quality Assurance team completed annual audits which followed. CQC key questions of safe, effective, caring and responsive and well-led this included Staff and Client surveys. Following a staff audit, an action plan was in place to address concerns raised by staff, which included an update to care plan software to enabling staff to access people’s current records or care plans and risk assessments. Staff all said that they used the care app and could access people’s needs and risk assessments.