Archived: Maxi Health Care 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. At our last assessment we rated this key question Good. At this assessment the rating has changed to Inadequate. This meant there were widespread and significant shortfalls in leadership. Leaders and the culture they created did not assure the delivery of high-quality care. The service was in breach of legal regulations in relation to good governance and failure to notify CQC of notifiable incidents.

This service scored 32 (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 shared vision, strategy and culture based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. The provider did not have effective systems in place to mitigate the risk of a closed culture within the service. A closed culture means a poor culture that can lead to harm, which can include human rights breaches such as abuse. The provider had not prioritised safe, high quality and compassionate care. Effective systems were not in place to review the care people received, for example people’s care plans were very poor and lacked important information.

The provider did not demonstrate they had the experience, capability and integrity to ensure care and support could be delivered safely and that risks were well managed. Leaders did not have the skills, knowledge, experience and credibility to lead effectively, and they did not do so with integrity or openness The provider was not always open with us, for example, during the assessment they failed to disclose the full number of people they supported. The provider had not ensured the service was able to continue as normal in their absence. For example, during the assessment the provider was not always available to support with the assessment leading to delays gathering the information we needed to ensure people’s safety. We spoke with other members of the leadership team to gather the information we needed; however, this was not always provided in a timely way when the documentation should have already been in their possession.

The provider had not ensured they created a culture where staff and leaders acted with openness and transparency. The provider had not acted with transparency. For example, the provider withheld information that they supported over 27 people in the Bath and Somerset region from this registered location in Kent. We could not be assured staff would be supported to raise concerns internally or externally to other organisations.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

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. The provider failed to ensure effective audits were in place across all aspects of the service. The provider had an external consultant who carried out reviews, however they failed to identify the significant concerns we found during the assessment. The provider failed to ensure care and support plans were reflective of people’s current needs and that they were regularly reviewed to reflect any changes to people’s care and support needs. The provider did not understand their regulatory responsibility regarding submitting statutory notifications to the Care Quality Commission. For example, we identified incidents that met the requirement for a notification to be submitted to CQC, the provider had not submitted any notifications to CQC.

The provider did not understand their duty to collaborate and work in partnership, so services work seamlessly for people. They did not share information and learning with partners or collaborate for improvement. The provider was not honest with their partners regarding the people they supported. For example, the provider and staff were carrying out complex clinical tasks during care visits that people’s funding authorities were not aware of and therefore they funding authority were unable to assure themselves if they had the skills to carry out this task safely. The provider also informed the funding authority that staff had received the relevant training in relation to people’s complex health needs, such as suctioning training, however we found that staff had not completed this training, which left people at significant risk of harm.

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. They did not actively contribute to safe, effective practice and research. The provider failed to recognise the improvements that were needed to ensure documentation, such as care plans, were reflective of people's currents needs. Staff were not supported to prioritise time to develop their skills around improvement and innovation. For example, there were a number of gaps within staffs training that were necessary for them to carry out their role and support people safely.