Minster Homecare

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.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

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

This service scored 57 (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.

Directors had recently invested in a full new management team. Directors told us this had improved the morale and culture throughout the staff team and that work to rebuild the culture of the service was ongoing. The provider told us a staff survey would be carried out shortly to monitor the work being carried out around the culture of the service.

The new manager had introduced daily ‘huddles’ with staff to ensure good communication and staff involvement and engagement with the service. There was an open-door policy and the directors were present in the service.The provider was in the process of embedding a positive culture through clear communication systems, daily huddles, and staff supervision sessions. These sessions supported staff well-being, and ensured that staff had opportunities to discuss challenges and celebrate achievements.

Oversight from the directors had not always identified issues in a swift, timely and effective manner. The directors had now implemented a new management team and feedback about their skills, knowledge and credibility to lead effectively was positive. Various positive changes had already been implemented, but these needed to be developed, continued, maintained, and reviewed by the directors. Leaders needed time to embed positive changes. Professionals described the new manager as a “caring and compassionate practitioner” and told us, “I have no reason to doubt [new manager’s] suitability to work with clients and deliver safe and high-quality care.” The new manager had submitted an application to CQC to become the registered manager.

People were able to speak up but did not always feel their voice would be heard. The provider had in place multiple ways people and staff could provide feedback, including via surveys, an open-door policy, meetings, supervisions and reviews. However, we received mixed feedback from people about whether their feedback was listened and acted upon. Comments included, “We do complain if things are not right, but I get the feeling the office don't listen”, and “We constantly bring things up but nothing changes.” However, we were also told, “Any issues are resolved in a professional manner”, “When I email it’s always picked up and actioned”, and “Any concerns I phone them, and they sort it out in an instant – it is amazing.” The new management team had implemented changes and were confident feedback would improve when they next carried out a survey. Staff had already noted improvements and told us, “The manager is approachable, and staff are encouraged to raise any concerns or suggestions.”

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. Under the new management team, we found no evidence of discrimination. Staff told us morale was good, and they felt included. Feedback included, “The new manager is really helpful and involved, it is great since she has been here”, and “The Management is approachable. Whenever l make any suggestions, the office acts upon them."

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. There were some significant gaps in audits at both manager and provider level, resulting in issues not being identified. The provider implemented a new management team and throughout the assessment process identified these gaps and were responsive to feedback. The new manager implemented multiple audits and improved the quality assurance processes. These systems needed to become sustained and embedded, and the provider needed to ensure effective oversight at all levels within the service.

The provider spoke about recent improvements with their partnership working and duty to collaborate with other services. However, information provided by other professionals was not always robustly or clearly incorporated into people’s support plans and risk assessments. The new manager was taking steps to pro-actively communicate with professionals to ensure accurate information was obtained about people’s needs, including monitoring needs such as food and fluid intake, and support plans were in the process of being reviewed. These positive changes needed to be completed, sustained and embedded within the culture of the service.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not always actively contribute to safe, effective practice and research.

Accidents and incidents were generally dealt with appropriately, and lessons learnt were identified and shared with staff in meetings, supervisions and reflective practice sessions. The directors were committed to providing a good quality service, however, the limited quality assurance systems in place had hindered this and prevented the continual improvement of the service. During the assessment and immediately following the assessment, the provider and new management team implemented a comprehensive action plan and held weekly meetings to drive the completion of this plan.