Rance Healthcare 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.

This is the first assessment for this newly registered service. This key question has been rated 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 71 (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 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.

The registered manager and nominated individual knew the person well and spoke respectfully about them and their experiences. They shared examples with us of how they and their staff team had supported people beyond their agreed packages of care. Staff spoke positively about the management team and felt equipped and supported to provide care that positively impacted people’s lives. One staff member shared how the culture of the service had a positive impact on the person they supported. They told us, “With [person], we do change over and discuss about behaviours, share things that work, new jargon, we share how we manage. The management team do frequent spot checks. Through this I can see we can change people's experiences.”

The provider 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.

Feedback about the management team was complementary. A social care professional spoke positively about the registered manager and the nominated individual telling us, “We are really impressed with Rance. [Person’s] needs were so complex, other providers have not been able to support them, some have given notice, they have struggled to meet their needs. With Rance we have no concerns.”

Staff feedback was similar with 1 staff member telling us, “I would confidently say it is well managed. Ideas are always welcomed, regular staff meetings, I feel involved as staff. Compared with other companies, it feels well managed.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

There were systems in place to support staff to speak up and share any concerns or feedback about the service. Staff told us they were confident to share their views and felt they would be listened to and taken seriously. One staff member said, “[Field care supervisor] always asks me in my supervision the same question, are there any improvements we can make? We are given the platform. We are honest and free.”

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.

Staff told us their diverse needs were recognised by the registered manager. They told us they were treated fairly and any requirements they had around their religion or faith were valued and respected. One staff member told us, “When it was Eid I requested leave, my rota was changed.” Another staff member said, “They let me have time off on Sundays so I can go to church. They are supportive.”

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.

Although there were systems in place to monitor the quality of care people received, audits carried out in relation to Mental Capacity Act (MCA) assessments and medicines were not always effective in identifying concerns. Checks carried out on medicines records had not identified errors in ‘as required’ instructions, and mental capacity assessments did not always contain sufficient information about the decision being made. Following the inspection, the nominated individual shared the actions they intended to take to ensure the required improvements were made. We will check this at the next inspection.

Despite the above concerns, there were established systems in place to monitor the person’s experience of care and also checks carried out to ensure staff carried out their roles safely and in line with the person’s care plans.

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 management team worked in partnership with external agencies to support the person’s access to services that supported their health and wellbeing. This included local community services as well as healthcare professionals such as community nursing teams and GPs. As part of our assessment, we asked the local authority for feedback about the provider, they told us they were not aware of any concerns relating to this service.

The provider 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 contributed to safe, effective practice and research.

The registered manager and nominated individual were receptive to our feedback and told us they would take action without delay to improve the areas where concerns were identified. There was a culture of learning which was reflected within both the management and staff teams. Staff told us they were regularly asked for their input and suggestions about how things could be improved, through both team meetings and 1 to 1 supervisions.

The management team actively sought feedback from people and their families so they could improve people’s experience of care. The registered manager told us, “We want our support to make a difference to people. We support 1 person and we’ve seen the improvement in their home and their quality of life. What we do has an impact on people.”