Hearts of Care Agency

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 Inadequate. At this assessment the rating has changed to 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 made sufficient progress since the last inspection to leave special measures. However, leadership and direction remained inconsistent, with continued reliance on external consultants. The provider’s shared vision, strategy and culture were not yet clear because its focus had been on addressing the previous inspection shortfalls.

The continued absence of a registered manager presented a risk to effective oversight, visible leadership and the delivery of high-quality care. Management knowledge and experience varied, and the service did not have a registered manager. The service relied heavily on external consultants for oversight, while internal managers had varying levels of sector knowledge and experience. This resulted in unclear responsibility and accountability, increasing risks to effective oversight and visible leadership.

During inspection feedback to the provider, we discussed the regulatory risks associated with the registered manager vacancy, including potential enforcement action. The nominated individual said previous attempts to recruit and register a manager had not resulted in an appointment. Since the last inspection, they had completed management qualifications and were considering submitting a further application to become the registered manager.

The service was owned and managed by members of the same family. Staff described managers as approachable and raised no workplace concerns. However, arrangements were not robust and did not clearly show how staff could independently escalate concerns if they involved the management team. This created a risk that staff might not feel able to speak up or trust that concerns would be reviewed objectively. The provider acknowledged this shortfall and said they would take action to establish clear, independent escalation arrangements for staff.

The provider promoted fairness and inclusion across the workforce and valued staff members’ diverse backgrounds and experiences.

Managers fostered a respectful working environment where individual differences were recognised and appreciated. Staff had completed training in equality and diversity.

The provider had made progress in strengthening governance, management and sustainability. However, responsibilities and accountability remained unclear, and internal processes needed further development to evidence meaningful analysis, regulatory understanding and improved outcomes for people rather than a tick-box approach.

Without a registered manager, there was insufficient assurance of consistent oversight, visible leadership and sustained delivery of high-quality care.

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 management team and staff had established partnership working with various organisations and external stakeholders to provide positive outcomes for people. They knew who to contact if people required additional support from other healthcare professionals such as GPs, district nurses and hospice staff.

The provider did not consistently promote continuous learning, innovation and improvement across the service or wider local system. Opportunities to develop creative approaches to improve people’s experiences, outcomes and quality of life were limited.

Although the provider had introduced systems since the previous inspection, reflective practice and learning from incidents, audits, complaints, feedback and partner engagement were not yet embedded. This limited continuous improvement and effective quality oversight.