Smarta 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 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 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.

We found the service was in breach of legal regulations relating to good governance and notifications. The provider’s quality assurance and risk monitoring systems were not effective in identifying and addressing shortfalls. The provider did not maintain accurate and complete records and failed to submit required notifications to CQC.

This service scored 61 (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 establish a clear, shared vision, strategy or culture based on transparency, equality, human rights, diversity, inclusion and engagement. Leaders did not consistently demonstrate an understanding of the challenges faced by people using the service or the needs of the wider community.

Staff were aware of the organisation’s aims and values. The provider told us they introduced these during staff’s induction and discussed them in team meetings. One staff member said, “The core value of Smarta Services is transparency – doing the right thing even when no one is watching. The company’s policies are inclusive and promote equality and diversity at all levels.” Another staff member told us, “Smarta Services promotes a no-blame culture. When something goes wrong, the focus is on learning, improving and preventing recurrence, rather than blaming staff.”

Leaders did not consistently understand the context in which the service delivered care, treatment and support. They did not always demonstrate the skills, knowledge, experience or credibility required to lead effectively, and they did not consistently act with integrity, openness or honesty.

During the assessment, we identified breaches of legal regulations relating to safe care and treatment, good governance (including records) and the failure to submit required notifications to CQC. Leaders had not identified or addressed all of these concerns prior to our inspection, and further improvement was required. We also found inconsistencies in leaders’ understanding of record-keeping and risk assessments, including those relating to environmental risks and medicines management. This showed leaders needed to further develop their skills and knowledge to provide effective oversight.

Overall, staff gave positive feedback about the provider; however, some highlighted areas for improvement. One staff member told us, “Communication is generally good, but there are occasions where updates or changes to care plans are not passed on quickly enough. Improving this would help staff stay fully informed and provide more consistent care. Apart from that, the team is supportive, and management is approachable. If there are concerns, they can be raised and are usually addressed.”

The provider promoted a culture where people and staff felt able to speak up and have their views heard.

The provider sought feedback from people and their relatives through surveys and used this information to inform improvements to the service. The provider told us they encouraged open communication and created opportunities for staff to share their views, including through office visits, staff meetings and training sessions. They said they aimed to create a supportive environment where staff felt comfortable raising concerns and that personal discussions were treated confidentially.

The provider promoted diversity within its workforce and worked to create an inclusive and fair culture. Leaders put policies and procedures in place to support equality, diversity and inclusion and to promote equity for staff.

The provider told us they were committed to upholding human rights through a person-centred, rights-based approach. This included listening to people, respecting dignity in day-to-day care and implementing safe and respectful human resources practices. They told us they worked in line with the Human Rights Act 1998 and the Equality Act 2010 and aimed to provide care and support tailored to the needs of both people using the service and staff.

The provider did not establish clear responsibilities, roles, systems of accountability or effective governance. Leaders did not consistently act on available information about risk, performance and outcomes or share this appropriately when required.

The provider’s quality assurance systems did not identify all the concerns we found during this inspection. These included issues with medicines management, risk assessments, statutory notifications, the Mental Capacity Act (MCA) and record-keeping. Audits were not robust enough to identify or address shortfalls before they impacted people’s care. Records showed the provider did not always submit required notifications to CQC, which is a condition of their registration.

The provider did not consistently maintain robust and accurate records. Care plans did not always provide clear guidance for staff on how to reduce risks to people. As a result, staff did not always have the information they needed to deliver safe care. For example, staff did not consistently assess or review risks for people living with diabetes. While some records contained clear information, most lacked sufficient detail to support safe care. Records also showed staff had not always received training in diabetes. Documentation for some people living with dementia was not sufficiently detailed or person-centred.

Records did not always show how staff supported people who lacked capacity to make decisions. As a result, the provider did not consistently follow correct procedures for gaining and recording consent in line with the MCA.

The provider used an electronic medicines administration record (eMAR) system; however, medicines audits were not effective. Audits did not identify key issues, including the absence of ‘when required’ (PRN) protocols for some people. Systems for monitoring risk and safety were not sufficiently robust to identify and address concerns. As a result, leaders had not identified the shortfalls we found prior to the inspection.

The provider had some policies and procedures in place; however, these were not always appropriate for a domiciliary care service. For example, policies relating to fire safety and catheter care were not adapted to reflect care delivered in people’s own homes, which could lead to confusion and increase risks. The provider did not have all required policies in place, including those relating to training, induction, supervision and appraisal.

The provider worked in partnership with other services to support joined-up care and shared information and learning to promote improvement.

Leaders and staff worked effectively with health and social care professionals to meet people’s needs. Staff liaised with relevant professionals when people’s needs changed and made referrals to occupational therapists, community nurses and GPs when required.

The provider engaged with external forums and professional networks to support learning and improve practice. The provider told us they shared knowledge with others and took part in workshops and training sessions to improve their service and keep up to date with best practice.

The provider did not consistently promote continuous learning, innovation or improvement across the service or wider system. Although the provider aimed to support ongoing learning, we identified several concerns during the inspection, as outlined in this report.

While the provider showed a willingness to improve, ineffective risk management and quality assurance systems meant they did not always identify areas for learning and development. As a result, leaders did not always have oversight of shortfalls and could not consistently take timely action to drive improvement.