Supportive Care Services Ltd

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 inadequate. 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 remained in breach of the legal regulation in relation to good governance of the service.

This service scored 50 (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 not have a clear shared vision, strategy and culture which was based on transparency, equity, diversity and inclusion, and engagement. They did not always understand the challenges and the needs of people in receipt of care from their service.

The registered manager and provider explained their intentions for improving and developing the service. We could see from the staff meeting minutes there was an open discussion to improve the service and staff support; however, there was no detail around what specific related discussions took place or what the staff input was.

While the registered manager and the provider understood the requirement to improve the service, prioritising safe, high quality compassionate care, the strategy to support this development had failed to address some of the issues found at this assessment, which had also been identified at the last 2 assessments.

The registered manager and the provider demonstrated a commitment to developing and promoting diversity within the staff team and the packages of care provided. However, since the last assessment there had been no further progress towards this commitment.

The provider did not have inclusive leaders at all levels who understood the context in which they delivered care, treatment and support. Leaders did not have the skills, knowledge, experience and credibility to lead effectively, with integrity, openness and honesty.

Discussions with the provider and registered manager demonstrated there was a lack of knowledge to make the necessary improvements needed to meet the minimum fundamental standards of care provision for people. The provider had made some improvements with their recruitment process and training for staff. However, there remained further improvements to be made. For example, not all staff who applied to work within the service were treated equally. Some staff had an agreement in place if they completed their training prior signing a contract of employment, they would not to be paid for the time spent completing the training. Staff that completed their training after signing their contact of employment, would be paid for completing their training. This was confirmed by the registered manager. The provider’s contract of employment contradicted what was the current practice regarding payment for attending training.

The provider and registered manager were not aware there was a second Supportive Care Services website accessible to the public on the internet. The website was not reflective of a home care service but rather a care home environment, citing testimonies from people who were not users of the service. There was no rating displayed on this website which is a regulatory requirement to have. We discussed this matter with the provider. They explained work was taking place on constructing a new website and it should not be accessible to the public. The provider took immediate steps to have it taken down.

Leaders were visible within the service to their staff team. There was a stable management and staff team. Relatives spoke highly of the staff and management team.

Staff spoke positively about the registered manager and the provider. They told us they were always accessible to them and on the end of the phone. All staff we spoke with felt they could speak to the management team regarding any concerns or questions they may have, and they would be answered and acted on promptly.

The provider had processes in place where people felt they could speak up and they would be listened to.

People told us they would speak up and felt their voice would be heard. Staff were provided with the relevant policies and procedures detailing what was expected of staff working for the service. Staff told us they felt able to raise any issues or concerns, including poor practice. Staff were confident the provider would listen to them. They advised us the management team were always accessible on the phone.

There was a whistleblowing policy in place for staff to access.

The provider did not always work towards an inclusive and fair culture by improving equality and equity for people who worked for them.

While the provider valued their workforce, there were inequalities between staff when it came to who paid for their training and who did not.

Staff told us they felt listened to by the provider. The provider took steps to ensure staff felt they were heard and were confident to raise any concerns they may have.

The provider ensured they were regularly available to staff. They held regular meetings, providing staff with the opportunity to engage with them.

Staff told us they were happy working within the company and felt they were treated fairly.

The provider did not have clear responsibilities, roles, systems of accountability and good governance. They did not act on the best information about risk, performance and outcomes, or share this with others when appropriate.

Where audits and checks had been completed, these were ineffective and did not provide a good oversight of the service. For example, notwithstanding the reviewing of care plans regularly since their last assessment, we found there were still risk assessments missing for some medical conditions and care plans were not always reflective of people’s current needs. Audits had failed to identify incorrect and missing information about people’s risks and needs.

Medication competency checks carried out on staff by the registered manager had failed to identify boxes were being ticked against activities that were not reflective of administering medication or prompting medication in a person’s own home. For example, staff were ticked as competent for ‘medication trolley unlocked appropriately and keys kept secure by staff member,’ and ‘the medication administration tabard during the medication round (is worn).’ Audits had not identified 1 staff member had not had their competencies re-assessed since 25 June 2024. One spot check on a staff member had been completed on a day the staff member was, according to the provider’s records, not working. The lack of oversight and accuracy of these competency and spot checks impacted their effectiveness as a means of assessing and monitoring staff were competent in their roles.

Audits and checks had not identified some of the staff file audit forms had not been signed off and dated, with the provider’s own process stating, ‘the file must be signed off by the registered manager or another equal role before (the staff member) starting work’. Checks had also failed to identify the job description for a care assistant was not always on Supportive Care Service Ltd letterhead , but rather the name and details of another home care agency. Some checklists for staff files had been signed off by the registered manager before the registered manager worked for the provider.

There were also gaps in the provider’s audits and checks to validate staff references. Some references were returned to the provider on plain paper without any company header or confirmation the staff member had worked for the referee and the details of their time with this employer were correct.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people.

Staff felt there was an open approach between the service and the people they supported.

The provider had systems and processes in place to record contact with health and social care professionals and would make referrals where appropriate.

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.

Since the last assessment the provider had made some improvements; however, there remained areas that had not improved enough. These issues were highlighted to the provider in their last 2 assessments and the learning from those assessments had not always led to improvements in the service. However, the provider had engaged the services of an independent external consultant to support them on their improvement journey. Following our assessment the provider submitted an action plan to the Care Quality Commission (CQC), setting out how they planned to further improve the service.

Staff meetings were held regularly, and minutes were kept of the meetings. These were used to discuss care practice such as medication practice. The meetings gave the provider the opportunity to remind staff about their training and the importance of working together to make sure the service provided good quality care for people.

The staff meetings were also used to discuss training and deadlines when training should be completed.

The provider had processes to gather formal feedback from people and maintained contact with people through home visits or phone calls. People told us the provider was responsive to any concerns and dealt with matters in a timely way.