Sevacare - Kingstanding

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.

The systems in place to monitor the punctuality of carers to calls and how long they were staying had not highlighted some of the concerns we found. Some people and their loved ones were not happy with the time keeping of the carers. We received mixed views on how communicative and responsive the service had been to these issues. We found no evidence anyone had been harmed as a result of carers being late or not staying for the agreed length of the care call. This did, however, reflect a lack of oversight of care call punctuality and attendance times. Systems had also not enabled the management team to identify some staff were not taking the time off and breaks between shifts they needed and were entitled to. Systems to ensure recruitment support and training for staff were robust. Systems to ensure people and their loved ones were involved in the development of care plans and the management of risks for them were robust. Staff spoke positively about the support, supervision and training they received. People and their relatives overall gave positive feedback about the management team. We have asked the provider for an action plan in response to the concerns found at this assessment.

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 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. Equality and diversity were promoted. People were matched whenever possible with carers who could speak their first language. Staff told us they felt comfortable to share their concerns with the management team. Staff told us their professional opinions were taken seriously and acted upon. As the service was large, not everyone knew or had spoken with the registered manager, but people and relatives told us they had spoken with others within the management team.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty. Leaders had not identified problems with the lack of oversight of punctuality and duration of attendance to care calls. They did however take robust steps to address the matter when we highlighted it. People told us they had been able to speak with a manager when they had needed to. People and their loved ones spoke positively about the management team. One relative told us, “The service is very well managed.” Another said, “The manager was very good and sympathetic.” Most staff also spoke positively about the management team. One staff member told us. “The managers are very good.” Members of the management team told us they felt well supported in their roles. The registered manager met with registered managers from other local services to share information and support.

Some staff we spoke with were not familiar with the term ‘whistle blowing’. Although we saw that the policy and procedure was discussed during staff induction. It was not clear that all staff understood their responsibility to speak up if they had concerns about the conduct of other staff members. The registered manager told us there had been no recent examples of staff whistle blowing. We did not find any examples of staff telling us they had reported concerns which had not been listened to or felt unable to share concerns. However, given the size of the staff team, the risk of things going wrong was higher and so greater emphasis on whistleblowing and staff understanding would be an essential part of safe governance. We spoke with the registered manager about this, who shared an email with the full staff team, reminding them of the policy and procedure and offering assurances that it was safe to share any concerns they had. We saw examples of the management team being open and transparent when things had gone wrong, and apologising to the people and loved ones effected.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality. The registered manager told us about examples of treating staff with respect and equity. Leaders took steps to ensure the staff team were representative of the population of people using the service.

Quality assurance systems were in place to monitor the safety and effectiveness of care provided to people. However, systems had not always enabled staff to identify some of the issues we found during our assessment. Systems to monitor care call punctuality and the duration of time carers stayed with people, hadn’t identified some carers were frequently late. Carers also did not always stay as long as they should. Our review of care calls for 1 month showed 36% of care calls were more than 45 minutes late. Discussions with people and their loved ones showed these issues effected some more than others. We shared the specific examples raised by people, with the registered manager. They acted immediately to address these concerns and monitor people effected to ensure they received improved punctuality and carers stayed the length of time they should. We found no evidence anyone’s health was harmed because of late of brief care calls. Systems had not highlighted to the management team some staff were not having the breaks and days off they should. The provider told us a new system would be developed which would enable robust analysis of carer punctuality and how long they were staying. It would monitor all care calls and not a percentage as was being completed prior to our assessment. A temporary plan was made to ensure monitoring was robust until this system was introduced. Systems monitoring the safety of time critical medicine hadn’t identified examples where 1 person hadn’t received their medicine in the prescribed window. Changes were made to the records to make this clearer. The registered manager was unaware of the requirement for staff who had any contact with people with a learning disability or autistic people to have Oliver McGowan compliant training. This effected 1 member of the staff team, they completed the training during our assessment.

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. For example, safeguarding concerns were shared with the local authority safeguarding team and with the CQC. We saw examples of people being supported to access healthcare services such as occupational therapy and the speech and language team, and the service worked alongside the EICT (Early intervention community team) to enable people to be supported at home after a stay in hospital. The service had not developed a single page care summary or hospital passport. In many cases people who may struggle to communicate their needs if admitted to hospital lived with or were supported by relatives who would attend with them. This information is however particularly important for people with a learning disability and autistic people. They can be supported to consider what they feel is most important for hospital staff to know about them in the event of emergency hospital care for example. The registered manager advised that when the new electronic care planning system was introduced, a single page care summary would be part of this.

The provider focused on continuous learning and improvement across the organisation and local system. Feedback from people and their loved ones was sought regularly about the standard of care provided. Staff compliance with ongoing training was very good. Staff told us they were happy with the standard of training and learning provided to them. Systems were in place to analyse and learn from when things had gone wrong.