Chiron Care (UK) 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 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 1 legal regulation in relation to good governance.

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 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. Staff told us the provider embraced the diversity of everyone, empowered people to be independent, to live fulfilling lives, prevent hospital admissions and develop skills so people could live meaningful lives. The provider had an equality, diversity and human rights policy. The provider told us staff had access to policies.

Not all leaders understood the context in which the provider delivered care, treatment and support. They did not always embody the culture and values of their workforce and organisation. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively, or they did not always do so with integrity, openness and honesty.

Staff gave us positive feedback about the provider. Staff told us leaders led by example, were approachable, visible and they acted promptly to address concerns affecting care quality. We were also told, the registered manager consistently demonstrated integrity and, “His leadership is supportive and steady, offering clear guidance and rational, measured input to the team.”

The provider and registered manager demonstrated positive interpersonal qualities but lacked the systems, oversight and consistency required to ensure safe, well‑led care.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. The provider had a whistleblowing and freedom to speak up policy and a complaints and compliments policy. Staff told us they are encouraged to speak up and felt confident raising concerns. Comments included, “I believe in speaking up and doing the right thing, even when it may be difficult” and “The manager and team leader always encourages both residents and staff to express their opinion and help each other to take the company high”.

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. For example, staff told us the service allowed them to have time off for religious observances and they were supported with flexibility to balance their studies alongside their role at 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 provider and their team were responsive and supportive throughout the inspection. However, our inspection identified the provider did not have established systems and processes in place to support their service. The liability insurance certificate and the certificate of registration were not on display in the registered office. The provider rectified this during the site visit. The provider held some records relating to the service in an unregistered office. The provider informed us these records had since been moved to the registered office. The provider did not have systems in place to assess, monitor and improve the quality and safety of the services provided in the carrying on of the regulated activity. The provider and registered manager told us they did not have “a systematic form of audit but will be putting audits in place” and they had previously agreed an auditing framework whereby they had “started some of it but not yet implemented. Therefore, there was no robust oversight of the service.

We identified there were gaps and inconsistent information within the recruitment records. The provider did not have robust systems in place to identify when training became overdue. PRN medicines were not always administered in line with PRN protocols, and the effectiveness of PRN medicines was not recorded. MARs audits had not always been actioned. There were inconsistencies identified within the care records, they were not always up to date and did not always align to people’s current needs. Not all fire extinguishers had been serviced, and risk assessments were not completed for emollient creams which posed a significant fire risk. Care notes did not evidence consent was obtained from people. The principles of the Mental Capacity Act 2005 were not followed.

The provider informed us they have initiated their reviews in the areas CQC observed did not meet the standards expected of the service. The provider also informed us “I would like to assure you every feedback coming out of the inspection has been taken on board and, has either been addressed or plans in place to address them urgently.” However, our inspection identified the provider did not have effective oversight of the service nor full understanding of their regulatory responsibilities. The provider did not have established effective systems to enable them to ensure compliance with their legal obligations and the regulations.

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 registered manager told us they worked with various professionals including the GP and pharmacist. A professional told us when they visited the service with another professional, they did not have any concerns about the service and we were told, “in fact we were both very impressed at the levels of person centred, flexible care.” A professional also told us, “The service works well with professionals and responds to recommendations.” Professionals also told us they felt the service was led well and managed by the provider and there were no concerns about the leadership. A professional told us staff were prepared for the review meetings and provided the information requested.

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 provider told us they were putting in systems and audits in place to monitor the service. The provider was responsive when areas for improvement were identified. A member of staff told they received debriefs and feedback following incidents and any learning or changes to practice are shared with the team.