ResCare

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

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 service. This key question has been rated 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 the governance at the service.

This service scored 54 (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 did have a clear shared vision and culture which was based on transparency, inclusion, and engagement. However, the absence of a defined strategic approach meant the provider did not always fully understand their responsibilities or the challenges people and their communities faced.

Whilst the culture of the service promoted person-centred care, sufficient scrutiny was not consistently prioritised. The risks identified during the assessment had not been recognised by the provider, and there was limited external engagement and professional curiosity. Despite the existence of a conflict of interest policy, there remained a potential risk of a closed culture, particularly as members of management and staff were related.

A relative told us their family member was well supported and felt safe as they had been using the service regularly for planned respite stays. A person told us they felt comfortable and staff were familiar with their preferences and routines.

Not all leaders understood the context in which care, treatment and support were delivered, nor did they consistently reflect the culture and values of the organisation. Leaders did not always demonstrate the skills, knowledge, experience or credibility required to lead effectively, or consistently act with integrity, openness and honesty.

The provider was also the registered manager, and they were committed and passionate about delivering a quality service. However, they did not always ensure staff were adequately supported to deliver safe and effective care that met people’s needs, managed risks and improved outcomes. Leaders were not fully aware of their responsibilities to investigate, and report concerns to appropriate external bodies to ensure openness and transparency. Although we found no evidence of incidents requiring notification to the local safeguarding authority or CQC, we could not be fully assured, as information was not consistently reviewed to ensure it reflected people’s current needs and risks. The provider acknowledged areas that needed improving and showed a commitment to learn, improve, and act on concerns raised by the inspector.

The provider was liked by relatives and a person using the service and staff and felt they had a good relationship with them. Staff told us the provider and director were supportive and provided information and direction when needed.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. The provider had a whistle blowing policy in place and staff felt supported to raise concerns.

Staff told us the provider was approachable and they knew what to do if they had concerns. One staff member said, Yes I'll speak up ; it's my duty to call out if something isn't right.” Staff felt able to raise issues directly and were confident the provider would take action.

A relative told us the provider had been responsive when they raised any concerns and acted promptly which had a positive outcome for their family member.

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 provider was aware of their duty as an employer, to understand and respect the protected characteristics of staff and to prevent discrimination.

Staff provided positive feedback about their experiences working for the provider. They felt respected and had not experienced discrimination. A staff member told us, “I've got no concerns; I'm treated fairly and equally and valued for what I do.”

The provider did not have clear roles, effective accountability arrangements or robust governance systems in place. Leadership was not sufficient to ensure effective systems for assessing, monitoring and improving the quality and safety of the service.

Although the provider spent time in the service and knew staff and people well, oversight and governance arrangements were not effective in ensuring safe practice. Audit and checking processes were limited, and as a result, concerns identified during the assessment relating to people’s care needs and records, monitoring of restrictive practices, medicines management and governance, had not been recognised or addressed. Systems were not in place for servicing and maintenance to comply with fire safety, water safety and wider health and safety requirements. Medicines governance was not safe, due to the lack of effective systems, monitoring and audits to ensure procedures were followed. Oversight of staff recruitment, training and competency was insufficient, which meant the provider could not be assured staff delivered safe care and support.

Whilst some actions were taken immediately by the provider to improve safety and manage risks, this showed a lack of governance. As a result, care and support were not consistently safe, and people were placed at risk. The provider has been instructed to make improvements in this area.

There was limited evidence to show the service had established connections and professional relationships with external organisations or the wider community.

The provider did not have regular involvement in local community initiatives. People’s care records included details of healthcare professionals, but no evidence of staff working in partnership working to ensure instructions provided were correct.The provider told us they were only supporting people for short respite stays but they missed opportunities to seek advice and make referrals, for instance, use of restrictive practices. The provider took action and they acknowledged they needed work collaboratively to people in their care.

A relative told us the provider and staff communicate well with them and worked in partnership to promote their family member’s safety and wellbeing. Care records reflected some discussions. Strengthening record keeping and partnership working would further improve collaborative working to improve people’s quality of life and promote positive outcomes.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system.

Systems and processes to ensure learning happened when things go wrong were not embedded in practice. Although staff told us they reflected and discussed incidents to enable collective problem solving, these were not always documented.The provider took some to address safety concerns. They also assured us new processes would be introduced and discussed with staff, to reduce the risk of mistakes happening again. The provider also contacted various external partners to request support to make improvements to safety within the environment. They also sent us evidence of the improvements they started to make.