2M Health & Home 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 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 requires improvement. The provider was previously in breach of the legal regulation in relation to good governance. Improvements were found at this assessment, and the provider was no longer in breach of this regulation. However, at this assessment the rating has remained 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 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 based on transparency, equity, equality and human rights, diversity and inclusion, engagement and understanding the needs and challenges of people and their communities. Staff told us they understood the organisation’s values and aims around personalised care. A staff member told us, “We treat people as individuals and focus on their needs.” However, although staff understood the challenges and the needs of people; the care people received did not always reflect the service’s values and objectives as set out in their statement of purpose. The concerns shared with us around staffing and the impact for people demonstrated people did not always receive personalised care.

The provider had leaders who understood the context in which they delivered care, treatment and support. We received mixed feedback about leaders of the service. Positive comments included, “[Registered manager] has popped in a few times, but I don’t know their name. They know me and I think they are good with me and are doing a great job” and “The manager is [Name]. If I need to, then I speak to them. They take it on board and are contactable on phone, evenings and weekends. When I have asked for something, it is listened to and acted on.” However, some people were not aware of the management of the service or did not have confidence in them. Comments included, “[Registered manager] is amiable and approachable. They listen and are supportive. They sorted out some complaints but, to date, providing regular carers and timely visits is still needing to be achieved” and “I can speak to [Registered manager]; it seems like they listen but then don’t do anything about it”. Staff were positive about the leadership of the service. They told us, “Managers always lead by example, put the service users and team first and actively listen” and “The leadership is very supportive. Training and spot checks are done regularly, and they have a hands-on approach to things, and we can really feel their presence. They are also very motivative to us."

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. The provider sent surveys to people and their relatives to gather their feedback and used this information to make improvements to the service and to people’s individual care. People and relatives told us they felt able to speak up but some were not always confident improvements would happen as a result. They told us, “I’ve complained about late visits and not getting regular staff who know me. It’s made no difference” and “I have spoken with [Name of manager] who asked me if everything was okay. I did raise concerns about staff using equipment and damaging walls, but nothing has changed. I do think they are doing okay though and would speak to managers if I needed to.” The provider had appropriate policies in place, including a Duty of Candour policy to ensure staff acted openly and transparently if people experienced harm in relation to their care or treatment. Staff demonstrated an understanding of how to raise concerns through the appropriate channels.

The service valued diversity within its workforce and worked towards creating an inclusive and fair culture by promoting equality and equity for staff. The provider had policies and procedures in place to support diversity and equality. A staff member told us, “We always strive to work together as team to achieve collective results by communicating, respecting and mutually supporting each other. During supervision we have the opportunity to request reasonable adjustments to accommodate personal social activities.”

The provider mostly had clear responsibilities, roles, systems of accountability and good governance. They mostly used these to manage and deliver good quality, sustainable care, treatment and support. They mostly acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate. We saw there was improved oversight and monitoring of the service, including spot checks, care plan and medicine audits and feedback about care. However, the provider’s quality assurance processes had not identified or resolved all the concerns we found during this inspection. These included issues relating to staffing, outdated evidence to provide assurances staff remained safe to drive as part of their role, call timings and duration, and resolving people’s concerns to their satisfaction. The provider was aware of some of our concerns and had an action plan they were working through to ensure compliance. They told us they would address the concerns we shared as part of this inspection and updated their action plan accordingly.

The provider understood its duty to collaborate and work in partnership so that services operated seamlessly for people. Leaders shared information and learning with partner organisations and worked collaboratively to drive improvement. The leadership team and staff worked effectively with health and social care professionals to meet people’s needs. Staff collaborated with relevant healthcare professionals when people’s health needs changed and made referrals to occupational therapists, community nurses and GPs when required. A relative told us, “Staff work with me to keep me informed of [Name’s] needs. For example, they identified a health concern, alerted me and we got the medical treatment [Name] needed quickly.”

The provider had improved their approach to continuous learning, innovation and improvement across the organisation and local system. Although the service aimed to promote ongoing learning and improvement, we identified several concerns during the inspection, which are highlighted throughout this report. The provider was motivated to learn and improve, but systems to monitor and provide oversight of the service were not always used effectively to identify where improvements were needed. As a result, leaders could not consistently act promptly to .drive and embed improvement. While the provider was aware of some concerns before our inspection, we identified concerns that still required improvement or feedback from people to be considered in improving the service.