Eunha Healthcare 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 was in breach of legal regulation in relation to 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 not have a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement.

Staff and leaders shared a common goal of ensuring people received good care. The provider had organisational strategy, policies and procedures in place to support organisational culture. However, there was very minimal evidence of input and feedback from people and staff gathered to enable their participation and meaningful engagement in the development of the organisational culture.

Ineffective audits and inaccurate care plans meant the service was not fully effective in learning and improving. These gaps limited the provider’s ability to embed good practice and consistently deliver care in line with its vision.

The provider had an equality and diversity policy in place.

Leaders had some knowledge and understanding of issues and priorities within the service and there was evidence some issues and poor practice had been addressed since the last inspection.

More office staff had been employed since the last inspection, and roles had been more clearly assigned. These roles and the new business structure required further embedding.

Leaders were visible, approachable and supportive. However, improvements were needed to ensure leaders had a clear oversight of the service provided.

The leadership team carried out spot checks and provided feedback and training where needed, which demonstrated commitment to staff development. However, governance systems to monitor and improve the service were not consistently in place. This meant there was a lack of oversight of the service, which limited the registered manager’s and provider’s ability to identify and act on risks, learn lessons, and fully drive improvements.

The provider did not always foster a positive culture where people felt they could speak up and their voice would be heard.

Staff understood the term ‘freedom to speak up’, and how to do this. We saw evidence of staff being encouraged to give feedback to the provider in team meetings. However, we also saw evidence that some concerns had been raised by staff on more than one occasion, or impacted multiple staff, and the provider had not always taken timely action to resolve staff concerns or issues.

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 valued their diverse team of staff. The staff we spoke with during the inspection told us they were treated fairly and equitably. One staff member said, “Absolutely treated fairly and equitably.” Another staff member advised they were treated fairly and would not have returned to their employment with the provider following a career break if they felt this was not the case.

The care manager advised there had been some issues within the local area where some staff members who were working under the provider’s sponsor licence were subjected to racism from people who used the service. The care manager said, “Staff experience quite a lot of racism, and can be treated as servants by the service users. I am trying my hardest to empower the staff, to teach them they are not servants, and they don’t have to accept it." The care manager told us how they had served notice on a package of care, where the person and their family continuously failed to respect the staff member’s race, to actively reduce the amount of racism the staff experienced.

We saw evidence of a reasonable adjustment being implemented for a staff member with a long-term health condition.

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

Improvements were needed to ensure the provider followed their newly implemented governance processes. The systems had failed to identify the concerns we found during this inspection. This demonstrated that governance systems were not effective in identifying and addressing risks.

Records were not always up to date. While people told us they were happy with the care provided and regular staff knew their needs well, the lack of accurate and current documentation created a potential risk for new or unfamiliar staff delivering incorrect care. Prescribed creams were not always added to people’s medicine records to show staff clearly what needed to be applied and care plans did not always contain personalised information about people’s preferences in how they received support. This meant there was a risk of people receiving inappropriate and inconsistent care.

The lack of robust governance systems and accurate records increased the risk of inconsistent care, particularly when unfamiliar staff were providing support. It also limited the service’s ability to evidence monitoring and continuous improvement.

Additionally the provider had failed to identify conflicting information relating to people’s consent and MCA documentation. This meant the provider could not be assured they were working in line with the principles of the MCA.

We also identified some incidents where the registered manager had failed to submit statutory notifications to ourselves. This was raised during the inspection, and these were submitted retrospectively.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

The service worked in partnership with local health professionals, such as Occupational Therapists, District Nurses and GP’s.

We saw evidence people received timely medical intervention when required, and the provider submitted emails to us to demonstrate them involving specific stakeholders for a person with complex needs.

Feedback from partners was positive, with 1 stating, “I have had a few clients supported by Eunha which I have had to review as part of the Proportionate project. [Care Manager] and [Training Manager] have been really accepting of my recommendations and advise when it has involved new ways of working for carers, or clients they have worked with for a long period of time and accepted positive changes for all. [Care Manager] was excellent at communicating concerns with me and the social worker involved, in regard to a complex client before accepting their care package and we managed to work through concerns effectively.”

Since the last inspection, the provider had made some improvements to the service. The last inspection found there were limited governance systems in place. We found new systems had been developed and implemented, however, these were not yet fully embedded, and as a result, had not identified the issues we found during this inspection.

Another improvement noted was an increase in office staff and the leadership team. This had allowed specific roles and tasks to be assigned, and a new business structure to be designed. Again, this still required some further development and embedding for it to be fully functional and to operate effectively.

The appointment of the care manager had seen oversight at the service begin to improve, and they had co-designed a variety of trackers and spreadsheets to ensure detailed records could start being kept.

During the inspection, we found leaders, particularly the care manager, to be receptive to issues raised, and responsive in making immediate changes to records where required. All leaders assured us they had taken our feedback seriously and showed a collective and positive approach to continuing to drive improvements across the service.