Enable Care And Support Limited

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. This is the first assessment for this newly registered 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 oversight and governance at the service.

This service scored 62 (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, the registered manager and the staff had a shared vision, strategy and culture where they valued and promoted people's individuality, protected their rights and enabled them to develop and flourish. The registered manager and the staff team demonstrated a shared responsibility for achieving this. 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 staff team and the registered manager used regular daily communication to share and discuss any matters going on in the service. People told us they were happy with the staff team and their support.Any changes were discussed together with staff and other relevant parties to make those changes. The registered manager praised their staff team for positive engagement and added, “[Staff] are enthusiastic, energetic, keen to work and like to work as long as possible. I think [staff are] diligent and compassionate in what they do so I have no doubt in the care they provide. Staff have good sense of humour.”The registered manager and other senior staff worked with staff to ensure equality and diversity were promoted, and the causes of any workforce inequality were identified, and action was taken to address these.

The registered manager and the staff understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation.The registered manager and staff worked together to promote people’s wellbeing, safety, and security. The registered manager was motivated to lead the staff team with integrity, openness and honesty so that people received the care they needed. They said, “[Staff] will communicate openly to sort things out. They come together to do things. [Staff] are very proactive. We could not run the business without [the staff] and that’s why they are so valuable, that’s why we want to hold onto them.”Staff were positive about their jobs and working the registered manager and other senior staff. Staff felt the registered manager supported them to ensure people were supported appropriately and staff were supported to do their jobs. They said, “I think the [registered] manager does a really good job, they know all the residents and help if there are any problems” and “Managers are always willing to talk and reach out.”The registered manager and other senior staff were available to talk to staff, and they visited the services to check on standards of care. The staff teams were motivated to provide care and support to people as their needs and health were changing. The staff were happy for people being able to achieve positive changes in their lives. Staff felt listened to, supported and told us the registered manager was approachable. Staff worked together well and were positive about the leadership in the service.

The registered manager and the provider fostered a positive culture where people and staff would feel they could speak up and their voice would be heard. The staff told us they knew how to, and felt confident, speaking up and sharing any concerns with the registered manager.They were confident the registered manager would respond appropriately.The registered manager told us the process when concerns or issues are raised, and they would work together accordingly with staff, professionals, people and families to review and address these. People and relatives were able to contact the registered manager, other senior staff or the staff team to raise their issues. The provider was pro-active in finding solutions.The registered manager added, “Our staff are really important to us and we understand what they need, and if there any problems, they can escalate it and they do when needed.”All staff said they felt supported by the managers, particularly the registered manager. They said managers were approachable and they felt listened to. Staff said the registered manager visited the services and would attend some of the team meetings. They said if they had a problem or concern, they would contact them and if needed they would come to the service to offer support and guidance. There was an on-call system in place for staff should they need help and advice and staff confirmed this. Staff said an on-call manager was always available at the end of the phone for support and advice. In addition to these more formal avenues of support staff felt the phone group was an important tool for sharing information and seeking advice or clarification.

The registered manager valued diversity in their workforce. They ensured there was an inclusive and fair culture at the service by considering equality and equity for staff who worked at the service. The registered manager and other senior staff worked alongside staff overseeing the service so they could understand any issues staff encountered. The registered manager continuously communicated with staff about the service or any other matters to ensure staff were included and valued. This approach also encouraged an inclusive and equal workforce and mutual respect amongst the team. Staff described the registered manager as being available and visible to them. Staff said they had not experienced or witnessed any discrimination or inequality.Staff felt they were treated equally, and hard work was recognised and appreciated by managers. Staff said they had not experienced any form of discrimination, and this applied equally to the people they supported. Staff added they felt people were treated as equal citizens in the local community, as well.Staff felt positive about the service and were confident to raise any concerns and ideas that could support the service. They felt supported, treated fairly and looked after by the registered manager and other senior staff.The working environment was inclusive, and staff’s wellbeing was considered. This ensured the service had a positive culture which supported better outcomes for people. Staff were able to share ideas and were able to contribute to the service.

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 securely with others when appropriate. The registered manager and the provider did not always have effective governance systems to identify issues we found during this assessment and that are described throughout the report. The registered manager had not always monitored all required recruitment checks to ensure staff were suitable to work with people. We identified some gaps in oversight of the training which posed a risk of inconsistencies in staff’s learning, compliance, and skill development. Where we found issues with medicine management, this was not always identified during quality assurance checks. For example, oversight of medicine administration, PRN protocols and reviews of those, and related risk records to ensure people received correct medicine. Some of the records regarding risk and care management needed reviewing to ensure accuracy. Some information in care and support records had inaccurate details about people’s specific needs. For example, one person’s care plan noted they had a catheter in place to manage themselves however the staff were supporting the person with it. Some people’s records such as evacuation reports had other people’s details. The registered manager had different quality assurance tools to oversee the service and its quality such as different audits and staff spot checks to review different aspects of care and support provided. However, improvements were needed to ensure effective audits of records and practices were carried out and to ensure people remained safe.Provider’s system did not always ensure incidents were reported to CQC. For example, we did not receive notification for one outcome of the court of protection and some allegations.The provider carried out surveys for people, relatives and staff in December 2024. It noted what went well and what needed improving. It was not always clear if areas noted to review and improve were actioned to demonstrate provider listened to the feedback. The registered manager said they were due to carry out the survey again this year.

Other governance processes were effective and helped to hold staff to account, keep people safe, protect people's rights and provide good quality care and support. Staff had staff team meetings to discuss any items arising from running of the service and feedback received was shared with the staff team to help running of the service. The registered manager had an open-door policy and told us they would welcome any feedback to support the service.

The registered manager and the staff understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They would share information and learning with partners and collaborated for improvement to ensure they achieved positive outcomes for people. Where necessary, external health and social care professionals would be or had been contacted for further support and advice or kept up to date with developments.There was a process to report, record and refer people for further support as and when needed to support people’s health and wellbeing.A few professionals responded to us with feedback about the service and were complimentary of the support. They said, “I have always been impressed by the care and kindness shown to the person I am working with, whenever I have visited. The person they support clearly feels very safe with his staff team and has built positive relationships with them. The staff always speak very highly of the person they support” and “Communication from management is open and transparent, and they have been proactive in engaging with external professionals to ensure best outcomes for [people]. [The registered manager] and [staff team] have responded thoughtfully to previous challenges, embedding reflective practice and continuous learning into their approach. The service ethos reflects integrity, professionalism, and a clear commitment to person-centred care.”

The provider focused on learning, innovation and improvement across the organisation.The staff and the registered manager proactively worked with people and their relatives, and professionals where needed, to achieve goals and outcomes that would have positive effects on the people and their quality of life.The staff and the registered manager demonstrated a positive, listening culture that promoted continuous learning and supported improvements. The registered manager would involve and consult other organisations to support the service and people using it. They explained how they reviewed and incorporated new methodology of CQC to support their review of the service and people’s experiences.Staff confirmed they attended team meetings every two weeks or once a month, staff working night shifts said they could join a team meeting online. Staff said team meetings were really useful as they got to raise concerns, discuss practicalities, ensure consistent working practices and share ideas. Staff also spoke about handovers and informal meetings where they discussed daily issues and updates on care as the team leaders were always on hand.The registered manager and senior staff communicated with the staff team to ensure all of them were aware of any issues, important information related to the service, actions to take and to pass on any feedback.Whilst we did identify a few shortfalls during this assessment, the registered manager was responsive to our findings and acted on key areas of improvement.