Great Care Health Services

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.

The service was in breach of legal regulation in relation to good governance.

This service scored 57 (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 always have a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not always understand the challenges and the needs of people.

There were instances in which the provider did not always work closely with others to maintain a shared direction and support continuous learning and improvement. For example, because there was little evidence care plans and safety events were effectively reviewed and safety events appropriately reported to external stakeholders, opportunities for the provider to engage with others and strengthen service culture and direction was often missed. A lack of regular staff meetings was a further example in which opportunities to share information and improve standards of care were missed by the provider. This meant people were at risk from a lack of provider contact to support engagement and learning.

Staff reported the provider was supportive. There was a complaints and equality and diversity policy in place. Staff received training in both these areas and most told us they were able to speak to leaders should they have concerns.

Leaders did not always demonstrate the skills and knowledge to lead aspects of the service effectively.

The provider had failed to identify and / or effectively address the concerns we have detailed within sections of this report, which included incident management and care records not always providing information which accurately reflected and mitigated people’s needs and risks, along with a lack of regular staff meetings. This meant at the time of this assessment, the service was not always managed effectively, and there was an increased risk to people using the service.

There were areas in which leaders demonstrated effective leadership. For example, people, relatives and staff were confident the provider would effectively deal with concerns, and staff felt well-supported.
 

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

Staff told us they felt able to speak up and raise concerns when needed. People and relatives also knew how to raise concerns and felt confident doing so.

The service had a whistleblowing policy in place, and staff had an awareness of it. Staff told us they felt confident they could raise concerns, should they have any, and the provider would take it seriously, with a staff member saying, “There’s no issue raising concerns; the manager listens.”

People and relatives told us people received safe care from staff, and they were confident any issues would be taken seriously and acted upon by the provider.

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 described a positive and supportive environment where individuals were treated fairly and with respect. A staff member told us, “The manager is really good and supportive.”

Staff had completed equality and diversity training, which supported their understanding of inclusive practice and helped reduce the risk of discrimination, bullying or harassment.

The provider told us they recognised the contribution staff provided to the service, and that they support them where they can, such as providing them with reasonable adjustments in their roles to support a positive work-life balance.

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.

Effective systems and processes were not always in place to ensure safety events were always analysed and acted upon and ensure care records contained accurate person-centred detail. Systems failed to highlight the concerns we found relating to consent and staff receiving training relevant to people’s needs. This meant governance systems were not always effective and exposed people to the risk of receiving poor care.

There were examples where effective systems were in place. For example, systems to ensure people transitioned safely into the service, and some satisfaction telephone calls and visits took place.

The provider did not always understand their duty to collaborate and work in partnership in order that services could support people.

The provider did not demonstrate they understood their role and responsibility in ensuring they maintained appropriate communication with external partners. Safety events were not reported to external partners, such as CQC, where the provider was required to do so. This meant there was a lack of collaborative working in some areas.

Staff supported people to integrate within their local communities and the provider communicated with people’s relevant professionals on occasions.

The provider did not always focus on continuous learning and improvement across the service.

The provider had not identified and effectively acted in areas of the service which required improvement. For example, the concerns we have identified during our inspection and detailed throughout this report. Furthermore, the provider did not always have a good awareness and understanding of audit processes and how these can be used to effectively identify concerns and mitigate risks to achieve continuous learning and improvement. This meant there were missed opportunities to learn and make improvements to the overall quality and safety of the service.