Enriching Healthcare Ltd Also known as Heritage Healthcare Bristol

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 service. This key question has been rated requires improvement. We found improvements were needed to the provider’s governance arrangements as these were not identifying shortfalls found during the inspection. The service is in breach of legal regulation in relation to good governance at the service.

This service scored 62 (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 supported staff to undertake training and learning opportunities so they could provide people with the best care possible. The philosophy of the service was to provide people with maximum choice, control and power over the care and support they received. All people and families felt the support from staff was positive.

The registered manager delivered care, treatment and support to people that embodied the culture and values of their workforce and organisation.

The registered manager was at the time of the inspection supported by an office supervisor. Both the registered manager and the office supervisor knew people and staff well. Both were accessible within the service, providing people with care and support if and as needed. Staff felt supported by the registered manager and it was a nice place to work. The registered manager confirmed the ethos of the organisation was to provide high quality care and support to people and to value and support staff so they could provide this. They provided staff with further training and development so they could be skilled to provide the best care possible.

The registered manager had a positive culture where people and staff felt they could speak up and their voice would be heard.

People were supported by staff who had regular team meetings, supervision, observed practice and learning opportunities. Staff felt supported by the registered manager and able to raise any concerns should they have any. Staff told us, “Good agency and very informative” and “Very supportive manager and supervision.” People and relatives felt able to raise concerns with the office if needed.

The registered manager valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The registered manager gave examples of how they supported staff. For example, supporting staff with longer holiday periods if needed and providing information on the local area such as local shops. All staff we spoke with felt supported by the management of the service.

The provider needed to make improvements to their governance arrangements and take action where improvements had already been identified by the service.

Although the provider had a system to review the quality of care plans and the safe administration of medicines, we found these quality assurance systems were not being completed often enough or thoroughly enough to prevent shortfalls being identified during our inspection. For example, we found shortfalls in the documentation of topical creams and medicines and where people needed more information about the risks posed by their flammable emollient. Governance arrangements had also failed to identify where 2 people needed more information about their diabetes and catheter care, and where 1 person needed best interest documentation completing following the outcome of their mental capacity assessment.

The provider had an action plan in place that identified risk assessments were needed for flammable emollients and there were ongoing improvements needed to the management of medicines. The provider, who is also the registered manager, did take action during our inspection to address the shortfalls found to people’s medicines documentation and ensure people’s medicines were allocated to their care visit. They also actioned where 1 person needed further information adding to their topical emollient risk assessment due to individual risks, and to 2 people’s care plans. Although, the registered manager took action during our inspection, improvements were still required to the governance arrangements within the service.

The registered manager 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.

People were supported by the registered manager who liaised with health and social care professionals and commissioners as needed. The registered manager sought feedback from people through care plan reviews and through quality calls. These were an opportunity to ensure people were being supported to get care and support that was suitable to them. People felt supported by staff who were familiar with their individual needs. All people were supported with any individual needs they had. For example, if the person needed support to attend community activities, local shops, community events and places of worship.

The registered manager had a positive culture within the organisation where they provided staff with continuous learning, innovation and improvement following incidents and accidents.

The registered manager undertook reviews of incidents and accidents and referrals were made to any health and social care professional if required. Any learning and actions were documented and were shared with staff so people could experience improvements to the care they received.