Archived: Florence Care and Consultancy Service 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 service 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 no evidence that people using the service had been harmed however, we identified a breach of the legal regulations in relation to this key question because the provider did not have established quality monitoring systems in place.

This represented a breach of regulation 17 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can find more details of our concerns in the evidence category findings below.

This service scored 62 (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.

Staff were supported by the registered manager to deliver consistently safe, person-centred care to the people they supported in line with the provider’s vision and values for the service. Staff worked-well together to try and achieve this. Systems and processes had been designed in line with the providers vision and values and focused on meeting individually assessed needs and wishes.

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 office-based registered manager remained responsible for the day-to-day running of this home care agency. This meant the service continued to be consistently managed. The feedback we received from people receiving a home care service, and staff about how the agency was managed was positive.

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

The registered manager encouraged an open and transparent culture where people receiving home care, their relatives, external health and social care professionals and live-in care staff who worked for the agency were all encouraged to speak up without fear and share their views about the agency. The registered manager used a range of methods to gather people’s views about the quality of service provided including, regular telephone contact with the people using the service and staff.

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.

Staff were well supported by the registered manager who treated them equally and fairly. The registered manager understood the importance of having a fair and inclusive workplace for all staff to work in. Staff were provided support through relevant training to inform their knowledge and understanding of equality, inclusivity and fairness in the workplace.

The service 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 service did not have any established governance systems in place to continuously monitor the quality and safety of the home care service they provided. This was because the provider had failed to pick up and/or take appropriate action to address several new issues we identified throughout this inspection. This included issues we found in relation to the way they managed risk, staff training and support, providing information and end of life care planning. For example, staff competency to manage medicines safely was not being routinely assessed nor were their medicines practices observed at regular enough intervals, contrary to recognised best practice and the providers own medicines and training policies. Furthermore, the service did not use electronic call monitoring [ECM] to help them monitor staff working hours. Nor had the provider developed any improvement plan that showed us they knew how to identify and routinely analyse issues and take appropriate and timely action to address them and learn lessons to continuously improve.

However the registered manager did understand their responsibilities in relation to their regulatory requirements around notifiable incidents. Our records indicated they notified the CQC in a timely manner about any incidents and events they were legally required to.

The service did not always have a proactive and positive culture of safety based on openness and honesty. They did not always listen to concerns about safety and did not always investigate and report safety events. Lessons were not always learnt to continually identify and embed good practice.

The registered manager did not have a proactive culture of routinely identifying and learning lessons when things had gone wrong to continuously improve. For example, the provider did not have systems in place to regularly conduct audits and checks on the quality and safety of the service they provided and to analyse their performance.

The service did not always focus on continuous learning, innovation and improvement across the organisation and local system.

The service did not always have a proactive culture of continuous learning and improvement. This was because opportunities to continuously learn lessons and improve the service were still being missed, especially when things had gone wrong. The registered manager did not always recognise the importance of learning lessons and continuous improvement to ensure people using the service received good quality safe care and support. The provider did not routinely conduct audits and checks on the quality and safety of the service they provided or analyse their performance to learn lessons when things had gone wrong and continuously improve.