1st Central Care 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 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.

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.

The service was in breach of legal regulation in relation to shortfalls in governance and oversight arrangementsand safe recruitment practices.

This service scored 54 (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 did not have a clear shared vision, strategy and culture. They did not always understand the challenges and the needs of people and their communities.

Whilst the service had a set of values recorded in their statement of purpose and in the service user guides, there was no evidence that this was embedded in day to day practice and that staff shared the vision of the service.

We checked the minutes of staff meetings for a period of 3 months prior to the inspection. There were no discussions or points on the agenda that pointed to the services vision, direction or culture. As a result, we are not assured that the provider was embedding these in the running of the service.

Not all leaders understood the context in which the provider delivered care, treatment and support. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively.

Whilst the registered manager and management team had a wealth of experience in clinical care, we found significant gaps in knowledge and experience needed to run a provision and manage regulated activities. The registered manager gave the inspection team assurances that the identified gaps in knowledge were being addressed.

However, we found that leaders were compassionate, we received positive feedback from people using the service regarding the management team. Some of the comments included, “I phoned the manager when we didn’t have a carer, and he came himself.” Another person told us, “Very amicable and sociable, he calls and checks we’re ok, and asks “Can I do anything more for you?”

Staff told us, “Management is approachable and supportive.” Another told us, “The staff are valued by the management I’m happy to be a part of the team.”

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

Staff spoken with told us they felt they could contact the provider at any time if needed. One staff member told us, “The management team are good leaders, supportive, open to discussion and they are always ready to assist the team.”

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.

The provider had a diverse workforce that met people’s care needs. The provider and deputy manager were keen to recruit staff with the attributes and character that would lead to a positive relationship being built with the people they supported.

Staff respected people’s specific religious, communication and cultural needs.

The provider did not have clear responsibilities, roles, systems of accountability and good governance. They did not act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

There were very limited systems and processes in place to monitor the safety and quality of the service, and these were ineffective. For example, we found that the providers own quality assurance policies and procedures were not being followed.

Many checks we expected to find in place were not undertaken.For example, there were no audits of safeguarding concerns and matters looked into. We also found concerns with General Data Protection Regulations (GDPR), there was not an effective or robust system in place to oversee and manage people’s data. The services Record of Processing Activities (ROPA) was incomplete. We also found that the services Business Continuity Plan (BCP) was incomplete. We further found that the service did not complete audits on Electronic Call Monitoring (ECM). Concerns were highlighted when our inspection team conducted an analysis of this data.

These among other areas of concern highlighted in the report demonstrated a lack of suitable, effective and robust systems to keep people safe and ensure effective service provision.

Following our inspection feedback, the provider told us they were now more aware of what they needed to do and would become more familiar with the regulations they needed to legally meet.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people.

The service worked closely with other partners such as hospice provisions; we saw positive evidence of partnership working. This was further highlighted to us by people using the service, comments we received included, “The carers do communicate very well with the palliative carers. We didn’t know that our carers had called on the team to check Mum, they just arrived and assisted. It’s such a relief having this care in place.” Another person told us, “The carers work extremely well with the palliative care nurses, there seems to be excellent communication between them all. It’s really helped us knowing they’ve working together.

The provider did not focus on continuous learning, innovation and improvement across the organisation and local system. They did not encourage creative ways of delivering equality of experience, outcome and quality of life for people.

Insufficient systems and processes had been put into place by the provider to enable them to gain effective oversight to continuously learn, innovate and improve the service.

Where the provider gave us examples of having addressed specific complaint issues with staff, these had not been documented. Feedback was often gained from informal conversations which did not always promote identifying themes or lead to driving improvements.