Care 24-7 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.

At our last assessment we rated this key question good. At this assessment the rating has changed to 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.

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 transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

There were shared directions and culture, which was embedded throughout the service, including in discussions in supervision with staff. There was a clear shared vision, set of values, which were regularly reinforced through supervision and ongoing discussions with staff.

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.

Leaders did not always demonstrate capability to ensure organisational risks were well managed. People consistently voiced their concerns that staff did not always know their needs due to lack of staff consistency, this was echoed by staff and professionals. Leaders did not identify this as a pattern of concern or provide evidence actions had been taken to address this feedback. Therefore, it was unclear whether they were not aware of issues which may have impacted the quality of people’s care.

People did not always feel they could speak up and that their voice would be heard.

Staff we spoke with told us they felt able to raise concerns to leaders in the service. However, there was mixed feedback as to whether concerns would be managed effectively by leaders. Staff were aware of whistleblowing policies.

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.

There was a diverse workforce in place. One professional told us, "The care team is diverse in it's make up." The service supported equality, diversity and inclusion by celebrating cultural events with people and staff, such as Eid.

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.

Governance processes were not always effective in identifying and addressing concerns relating to the quality and safety of care. During the assessment we found gaps and inconsistencies in care records, including missing information relating to the management of specific health needs escalation arrangements and risks. Oversight of safeguarding concerns was not always sufficiently detailed to demonstrate actions taken to protect people and monitor actions. PRN medicines and quality assurance documentation were not always or sufficiently detailed to support effective oversight. The providers auditing processes had not identified these issues, limiting the readers ability to assure themselves that records were accurate, current and reflective of people’s needs. Following the assessment, the provider told us they planned to strengthen governance arrangements and improve the effectiveness of quality assurance systems.

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.

There was evidence the provider worked in partnership with relevant services, for example, the dementia team, reablement services. One professional told us, "Care24/7 work very well with other services and I have never had any kind of negative experience of any of the carers or leadership team."

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not always actively contribute to safe, effective practice and research.

There were systems in place to support learning in the service. For example, learning during team meetings, and analysis of trends, however, it was not always clear from oversight documentation what actions had taken place. Therefore, systems were not robust in identifying overall themes and trends. However, the service showed some examples of innovation, for example, use of the "flourish" framework which aims to improve dementia care.