Secure Care UK Limited

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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

At our last assessment we rated this key question requires improvement. The service was in breach of legal regulation in relation to good governance. The service has made improvements and is no longer in breach of regulations. At this assessment the rating has changed to 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.

We scored the service as 3. The evidence showed a good standard. The service 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.

Leaders were passionate about restraint reduction and avoidance. Reports shared with external stakeholders showed senior leaders had a vision to promote high quality patient care within their service and a clear strategy for how this would grow and develop. Staff reflected the service’s vision and values in how they interacted with patients and within their teams.

Senior leaders were strongly aware of the challenges the service faced and worked with staff to overcome these. Staff undertook additional shifts to support operational pressures while recruitment was in progress. Some staff reported they were not pressured by managers to do this but felt it was their duty to support vulnerable patients.

We scored the service as 3. The evidence showed a good standard. The service 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.

Leaders ensured staff were accountable for their behaviours and actions. Records for capability and performance management showed leaders took appropriate action to address poor staff conduct when this occurred.

Staff in team leader roles were supported to develop with a competency framework. These were in line with the service’s values, strategy and vision. Additionally, there were diploma programmes for staff development and extra roles such as safeguarding support officer, learning disability champions and dementia friends.

Leaders had a good understanding of the services they managed. They could explain clearly how teams worked together to provide high quality care. At the time of the inspection, there was no registered manager, and the applicant had recently left the service. However, senior leaders increased their frequency of visits to the Keynsham location to a weekly basis and were actively recruiting a new area manager, who would be expected to undertake this role.

However, some staff reported a lack of support from team leaders where they did not have regular team meetings to share learning or feedback. Senior leaders were aware some staff continued to be impacted by low morale as a result of capability and performance management processes within the service. As senior leaders were unable to discuss the outcomes of this with staff due to confidentiality concerns, there was a wider strategy for rebuilding trust and confidence.

We scored the service as 3. The evidence showed a good standard. The service fostered a positive culture where staff felt they could speak up and their voice would be heard.

Staff and leaders acted with openness, honesty and transparency. The service accessed a central Freedom to Speak Up (FTSU) Guardian who covered all locations under the provider. There was a dedicated phone line and email address to support the whistleblowing process and this was advertised in staff coffee room noticeboards, on internal websites and with external stakeholders. In 2025, there was 1 FTSU disclosure which led to enhanced support with local teams to ensure the individual was being supported.

We scored the service as 3. The evidence showed a good standard. The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

Staff records showed the service supported staff with flexible working arrangements and reasonable adjustments when this was needed. Leaders shared examples of supporting staff with short and long term health conditions to return to work or continue working by arranging workplace equipment, re-arranging teams to support reduced manual handling and reduced exposure to risk during recovery.

Senior leaders undertook equality monitoring of staff such as gender and ethnicity. Most staff preferred to not share their ethnicity which meant the service was not able to use this information to ensure staff diversity was representative of the patient group.

We scored the service as 2. The evidence showed some shortfalls. Leaders did not always act on the best information about risk and performance or share this with others when appropriate. However, the service had clear responsibilities, roles and systems of accountability for good governance.

The service had effective systems for good governance, but there were some areas which could be improved with enhanced leadership oversight. The service’s records registers showed most policies, documents and audits had been reviewed annually. The service used a traffic light system to identify and prioritise which records needed updating first. There were 2 red rated actions which had been identified for review since February 2025 and October 2024 and an additional 6 amber actions identified for review since May 2025. Although there was no impact on service delivery at this time, continued lapses of review of organisational documents could result in late implementation of change and improvements, impacting on quality of care.

Records showed leaders understood the potential and actual impacts of risk and developed reasonable action plans for improvement. The risk register reflected risks shared by leaders and staff. The greatest risks were related to staff recruitment and retention challenges, performance and productivity. However, sometimes action plans were not timely for the lower risk concerns. For example, faulty defibrillator units were identified as a risk in November 2024, and an action plan had not been developed to resolve this until February 2025. Although staff had identified the fault was due to missing software updates, the repairs for the units requiring servicing did not occur until July 2025. Leaders said this was due to logistical challenges for arranging loan equipment.

Additionally, although the increased risk of staff injury and harm was recognised by staff and leaders, this was not recorded to the service’s risk register. This occurred despite the higher incidence of staff hurt at this location compared to other locations under the provider and the known higher incidence of staff sickness. When incidents of staff injury were reported, these were investigated on an individual basis. This meant leaders could miss opportunities to manage and mitigate emerging and existing trends related to staff injury.

Between July 2024-2025, the service had not submitted any statutory notifications to the Care Quality Commission (CQC). The inspection team raised this concern with senior leaders at the time of the inspection. Senior leaders were aware of their statutory and legal responsibilities to notify relevant organisations when incidents occurred, such as local authority safeguarding teams. However, statutory notifications to the CQC had been reported at provider level nationally instead of at the services location level. Following inspection, senior leaders confirmed the correct reporting processes for future notifications and confirmed they had submitted 5 statutory notifications to us between July 2024-2025.

Leaders were knowledgeable about relevant risks to business continuity. There were specific plans for events such as potential IT failure, which the service had previously experienced. The service maintained backup systems for offline working. Leaders recorded other risks to the service, such as changes in key stakeholder policy, to the risk register. This meant staff and leaders were able to manage expectations on how this impact the service.

We scored the service as 4. The evidence showed an exceptional standard. The service clearly understood and carried out their duty to collaborate and work in partnership, and services worked seamlessly for people. They always share information and learning with partners and collaborate for improvement.

Senior leaders invited stakeholder feedback in the early stages of service improvement and development plans. For example, when updates to the vehicle fleet were planned, the naming of the secure area and adjustment to seat arrangements were changed due to feedback. This meant the service always made improvements that considered the needs of the community they serve.

The service engaged with external stakeholders effectively to manage contract provision. External stakeholders reported that senior leaders at the service were responsive when they raised concerns and worked collaboratively to resolve problems. When there were staffing concerns at the service, leaders initiated informal meetings with external stakeholders to proactively manage the impact to transport journeys together. This led to the service developing additional documents to support the process of booking alternative transport when they were unable to provide this.

The service had a joined-up strategy to meet the needs of vulnerable people in their community. The service gained Veteran Aware accreditation in November 2022 and continued to maintain this through annual reporting, staff training and community engagement. This included collaboration with the local armed forces charity where leaders engaged with field hospitals to explore how to support currently serving members. The service was undertaking a gap analysis to identify enhancements to support referral pathways. In addition to this, the service worked with clinical advisers from NHS services to develop a tailored model of care. This was intended to promote restraint avoidance to improve patient experience of secure transport. However, at the time of inspection, there was no data available to measure the effectiveness of this change.

There were always the correct staff present to manage and resolve complaints or concerns. External stakeholders were assured the service had an open culture and communicated exceptionally well.

We scored the service as 3. The evidence showed a good standard. The service 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 contribute to safe and effective practice.

Staff and leaders were committed to reducing the use of restraint at the service. The service’s Keynsham location was an exemplar site for restraint avoidance and senior leaders shared learning from restraint monitoring audits to share with other services within the organisation and external stakeholders. The service shared and utilised learning from all incidents, whether this demonstrated a good or poor standard.

At the end of 2024, the service upgraded their fleet with the UK’s first fully electric safe area vehicle, at one of their bases. Leaders stated this was a key development for their environmental sustainability strategy. The service continued to meet the voluntary standards for environmental management set by the International Organization for Standardization (ISO). The service saved the equivalent of 50 trees by reducing carbon dioxide output and reducing paper usage in 2024.

The service developed new auditing tools to monitor and improve care. The annual quality audit showed the service had previously flagged poor driving incidents where 2.2% of journeys had minor speed issues. This prompted leaders to develop a driving licence style system to manage poor driving and decreased the proportion of incidents to 1.3% of journeys.