Global Caring Gloucester

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 changed to 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 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Whilst the provider shared their vision and strategy to ensure that the foundation of their domiciliary care service in Gloucestershire remained strong and sustainable moving forward; we were not fully assured about the culture of the service. During our assessment of the service, we requested feedback from staff about the views of the service and the support they received via telephone and email. Whilst the feedback from staff via email was positive, we noted their responses were similar and subsequently, we received some concerns which indicated staff had not been able to freely share their views. Therefore, we were not fully assured about the content of the feedback from staff, or the culture of the service.

The provider had leaders at all levels who understood their role and the context in which they delivered care and provided support to people in their own homes.

The provider had a stable management team. The registered manager and senior leadership team had oversight of the service and worked collaboratively together. People were generally positive about the management team and their approach. One relative said, “The management is responsive and always available when I call them. They go over and above. I honestly have no complaints. Another person said, “It is a well-managed service.”

A business contingency plan was in place which had identified potential risks to the service and provided guidance on how managers and staff should operate in an emergency or a disruption to the service to reduce impact on people and to ensure business continuity.

The provider mainly fostered a culture where most people felt they could speak up and their voice would be heard. Most people praised the management of the service and said they felt listened to and the registered manager worked with them to find a solution to their concerns, although we found some people’s experiences prior to the assessment did not fully reflect this view. However, the registered manager was open and willing to take on our feedback throughout the assessment and address our concerns. The provider and registered manager were passionate about the service and keen to ensure people received good quality care and support.

The provider stated they valued the 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’s policies supported an equable culture, and the results of a recent staff survey showed staff felt confident and satisfied in their role. The provider said they had an open-door policy and gave staff opportunities to raise concerns with them through team meetings and supervisions. However, we were not assured that we had received an accurate representation of staff’s views about equality within the service.

The provider had clear responsibilities, roles, systems of accountability and good governance. The service had made improvements and is no longer in breach of regulations relating to the governance of the service. The registered manager had implemented various governance systems to monitor the quality of care being provided and drive improvement. For example, the registered manager operated systems to audit the care being delivered to people, their medicines and accidents and incidents. In addition, systems to track mandatory and specialized training for staff, along with supervision enhanced the registered manager's oversight of the staff team's skills.

Meetings with management and staff took place to address concerns and to exchange information. We saw evidence of staff meeting minutes reminding staff about good practices to prevent people being exposed to harm such as good nutrition and hydration, confidentiality and professional boundaries. These systems were used to ensure people’s support needs were being met by staff who were competent and trained in their role. Managers acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

However, we were aware that the provider had been experiencing operational issues in the management and input of the electronic call monitoring system (a system which tracks staff care visits to ensure they arrive on time and stay for the required duration which leads to payment for the visits from the local authority). This meant the provider and local authority were unable to assess the reliability of data being sent to them and whether the service was meeting their commissioned hours. The provider was working collaboratively with the local authority to address these shortfalls of the management of their electronic call monitoring system.

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. We found improved records of communication and referrals to key health care professionals. The service jointly worked with partners to help drive quality of people’s care and their personal well-being. The registered manager stated they had formed a good working relationship with health and social care partners and valued their input and recommendations. The registered manager was aware of their responsibilities to escalate concerns to the relevant professionals and notify CQC of significant incidents or events.

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. Systems had been put into place to report accidents, incidents and near misses. The reports were reviewed by the registered manager to understand the incidents and to act as required and share any learning. Any changes to people’s support requirements were shared with staff through individual and staff meetings and the provider’s internal communication systems.