Gain 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 Requires improvement. At this assessment the rating has remained 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. We found two breaches of the regulations in relation to good governance. Governance systems and audits were not always effective in identifying or addressing areas for improvement and the provider did not always notify CQC of reportable events. A notification is information about important events which the provider is required to send us by law.

This service scored 61 (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 equity , equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities. The management team valued their workforce, and staff told us they felt supported and appreciated. A staff member commented, “There is a strong emphasis on a positive culture, clear leadership vision effective communication, improvement initiatives and a focus on delivering high-quality services.”

The provider had inclusive team leaders who managed the daily running of the service and had the skills and experience needed. There had been a safeguarding investigation conducted on behalf of the local safeguarding team. The provider had not recognised CQC should have been notified of this incident and investigation. The provider had however, taken the appropriate actions to respond to the investigation and confirmed in future any contact with local safeguarding authorities would be notified as required.

A whistleblowing policy was in place and staff confirmed they were encouraged to speak up. Staff told us the service fostered a positive culture where they felt they could speak up and their voice would be heard. One staff member said, “Yes, we do have staff meetings, and we are listened to in most instances.”

The provider valued diversity in their workforce and an equality policy was in place. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them. Systems were in place to support staff such as a lone working policy, and flexible working arrangements. Staff told us they felt valued and supported. One staff member told us, “They [management] are supportive and are listening.”

There was a range of checks and audits to monitor the quality and safety of the service and to help drive improvements. These included checks on risks to people, care plan reviews, spot checks and medicines. However, these systems were not always effective. Audits failed to identify our concerns relating to safeguarding and risks to people’s care and support.

The provider did not always notify CQC of reportable events. A notification is information about important events which the provider is required to send us by law. For example, any incident that involves the police should be reported to CQC in a notification. Records confirmed multiple incidents where the police were involved. However, no notifications were submitted.

These are breaches of Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 17 Good governance and the Care Quality Commission (Registration) Regulations 2009: Regulation 18 .

The service understood their duty to collaborate and work in partnership, so services worked seamlessly for people. However, the collaboration with the local authority was not always effective and relationships were strained. Commissioners of services told us they were currently not commissioning services with the provider and that communication with the provider was not always good, deadlines were often missed, and action plans were not always completed. The local authority was holding meetings with the provider to address these issues.

Learning from accidents and incidents was used to improve the service . We saw learning was identified, shared with staff and care plans were updated to reflect this learning. However, this was not always effective. Repeated incidents continued to be recorded in spite of multiple interventions.