Caremark Doncaster, Bassetlaw and West Lindsey

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 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 newly registered 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 75 (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. A service improvement was in place which mapped CQC’s quality statements to indicators and the quality monitoring processes for the service. The purpose of the of the organisation and expectations of good quality care were communicated clearly with the staff 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. The management were all experienced care professionals and understood how to ensure the delivery of good quality care services. The provider had grown the service steadily and had increased staffing capacity in line with an increase in care requirements for people. A member of staff told us, “I feel like part of a great team I have learned so much and feel confident I am making a difference in people lives. I am proud to work for Caremark Doncaster, Bassetlaw and West Lindsey.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. The provider had a whistle-blowing policy and processes in place to support staff to speak up. There were multiple ways for members of staff to report concerns which included anonymous reporting mechanisms.

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 and they recognised they have had to overcome some barriers around cultural differences and local accents and the different foods prepared and eaten locally. The management team have found creative ways to support the staff team to adapt and work together so people received good quality care. For example, a mini kitchen was set up where cooking lessons were provided and staff were taught how to cook local meals and dishes. Video information was also provided via the provider’s communication app. This has improved people’s satisfaction of meals prepared and improved the knowledge and skills of the staff team.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care and support for people. They acted on the best information about risk, performance and outcomes and shared this securely with others when appropriate. The management team regularly reviewed care plans, risk assessments and care documentation. There was a comprehensive systematic approach to governance which included audits, unannounced spot checks on the quality of care, supervision sessions for staff and reviews of documentation. The registered manager and the management team understood the service and were aware of which areas met quality standards and which areas needed support and continuous improvement.

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 provider had good links with local communities and community groups. They had sponsored and funded a community luncheon club which helped to reduce social isolation for older people.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research. The registered manager used learning from feedback and outcomes from audits and checks to make improvements to the quality and safety of the care and support provided to people. They attended local meetings and networks to continually improve their knowledge and practice in relation to how the service was delivered to people. Key themes from the feedback CQC received from people were shared with the provider so it could be used as part of their learning processes to support continuous service improvement.