Elm Case Management 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 previously unrated service. This key question has been rated 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 68 (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.

The registered manager and her management team had a vision and desired culture to share with the service’s staff team. The staff team had a good culture and worked together to deliver the best outcomes possible for people using the service.

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.

The service’s registered manager was also the provider and so there had been consistent leadership over the course of the last 3 years, since the service was registered by the CQC. They understood the context in which the service delivered care, treatment and support. The service leaders were visible within the service and led by example to their staff team, demonstrating inclusive behaviours.

Staff we spoke with were positive about the support given by the service’s management and by the registered manager. The service employed 15 staff and was small enough to operate in a more informal manner. The impact of the management approach was demonstrated by the very low staff turnover since the service was registered.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

The service fostered a positive culture where people, their relatives and staff could speak up and their voice would be heard. Staff were receiving supervision, and meetings with people and staff were taking place. People, and relatives, were confident if they raised concerns to the service these would be effectively addressed by the leaders of the service.

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.

Staff told us they worked well as a team and did what they could to help each other. Staff members told us how service leaders knew them personally and were committed to be being flexible so that the staff member could work effectively around their other commitments outside of work.

Staff were of different ages, backgrounds, gender, sexual orientation and experience which demonstrated equality, diversity and inclusion in practice at the service.

The provider did not always have good governance. They did not always act on the best information about risk, performance and outcomes delivered by their governance processes.

Staff and relatives were positive about the quality of the service. However, the governance arrangements had not identified the issues found at this assessment, including the lack of detail to reflect the whole person in both care planning and risk assessment, and a heavy reliance on training provided by health professionals rather than formalised training led and arranged by the provider."

Oversight and governance of the service was taking place. The registered manager and the management team had awareness of the quality of the service and were accountable for ensuring the present quality was maintained and continued to improve.

The audit system was based within the IT system and for example, would identify if there were any issues with the arrival and departure times of staff at people’s homes.

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 stakeholders and services to support people. Other stakeholders such as the commissioning local authority and health services had full confidence in the management of the service.

The service worked effectively with health and social care professionals involved in each person’s care. There was a relationship of trust and confidence between the service and their GP surgeries.

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.

The service was well led and was improving further. The registered manager supported a learning culture in the service, so the service met the needs of the people using the service and continued to innovate and improve further. However, there was no formal feedback system to gather the views of people, relatives, staff and professionals. Instead, the service told us they took note of informal feedback from all these stakeholders. The registered manager said they would identify a means of collecting formal feedback, from which they could then identify further improvement actions.