Collaborative Care 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 registered 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.

We identified a breach of regulation in relation to the governance of the service.

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 did not have a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement.

The service had core values in place, which included choice. However, the service was not always working in line with these values, as people did not have full choice and control over their lives. This meant people’s rights were not always upheld.

However, staff felt there was a positive culture at the service. The service worked in line with their other core values. For example, people were respected, and we saw examples of where people were given opportunities including promoting access to education.

Not all leaders understood the context in which the provider delivered care, treatment and support. For example, leaders were not always alert to any examples of poor culture that may affect the quality of people’s care. At the time of the inspection, we were told of restrictions placed upon people and observed people did not have full access to their own home. This meant the leaders were not encouraging an inclusive approach to people’s needs in line with Right Support, Right Care, Right Culture.

However, leaders had completed a wide range of training and staff spoke positively about leaders’ approach and knowledge. For example, a staff member told us, “They have the knowledge and experience to manage care safely, support staff and maintain high standards whilst promoting a positive, values-driven culture. They are also approachable, organised and communicate effectively.” Leaders were knowledgeable about other relevant legislation.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Staff understood what it meant to have freedom to speak up and felt able to raise any concerns. Staff were aware of the term ‘Freedom to speak up’. There was a policy which outlined procedures, including CQC’s contact details if staff did not feel able to raise concerns with the care provider directly. This promoted an open and positive culture.

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. All staff told us they felt the service promoted a fair culture. For example, one staff member told us, “The service has policies that are available to every staff to read, and management are always there to help with any inquiries. The service always ask staff what preferred shifts they would like to do and tried to accommodate whenever possible.” There was a policy which supported workforce equality, diversity and inclusion, including information about reasonable adjustments.

Areas of risk had not been assessed using a holistic approach, and control measures had not been fully explored. For example, the restrictions of a locked staff room had not been fully considered. This meant a person was being restricted within their own home.

The provider had not always followed the legal requirements of the Mental Capacity Act when making decisions on behalf of people who lacked capacity. This meant some decisions which had been made may not have been in people’s best interest.

Managers and staff were not working in line with the Right Support, Right Care, Right Culture guidance and they could not assure themselves that this guidance was embedded into the organisations knowledge and values. This meant people were at risk of not having their human rights upheld.

However, there were clear roles and responsibilities within the service. Audits took place regularly which were effective. Policies were in place which were detailed and outlined relevant procedures.

In response to the concerns regarding restrictive practices and consent, the provider took swift and appropriate action. This included enrolling staff and leaders onto relevant training, ceasing any unlawful restrictions, and liaising with a person’s social worker to ensure appropriate documents were in place in line with legislation.

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 service worked well with other healthcare services. For example, the service regularly liaised with the mental health team, the GP, social workers and the learning disability team. One partner told us, “CollaborativeCareServices appear to be a great service and have supported [person] well. They ensure that [person] is involved in aspects of careand ensure [person] engages in activities [they] enjoy. They communicate well with the [multi-disciplinary team] and any concerns they have, they will raise these with the [team] and ask for guidance.” A relative also felt the service worked well with other healthcare partners.

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 service worked with people and relatives to improve the service. The manager told us, “We are in constant communication with [person’s relative]. I also update her weekly, email or calls, or if there is anything significant happening like appointments. [Relative] can also give us feedback, as she visits the placement every weekend.”

We saw audits where actions were recorded following these to improve learning. In response to our feedback from this inspection, leaders promptly told us the actions they would take to improve the service. This demonstrated leaders focussed on continuous learning and improvement.