Collaborative Care Solutions

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 good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care. The service was in breach of legal regulation in relation to ensuring effective governance systems were in place and that the CQC were informed of significant events. Improvements were found at this assessment and the service was no longer in breach of these regulations.

This service scored 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Since our last inspection the provider had worked to develop a shared vision, strategy and culture based on equality, diversity and inclusion, engagement, and understanding challenges and the needs of people. These processes of developing the induction package for staff, enhancing training and personalising the support people received needed continued development to ensure this was sustained and embedded into practice. The management team told us that bringing the staff team together each morning to try and develop the ethos of the organisation had been positive and helped them in sharing the changes being made. Staff told us they felt the organisation was striving to be the best they could. One staff member told us, “We try to support service users how we would want ourselves or a relative to be supported. We are striving for this now with the changes that are happening.”

Improvements had been made to the leadership of the service since our last inspection and the management team understood the context in which they delivered care, treatment and support. Since our inspection of the service the manager has registered with CQC. They told us they felt they were supported well by the provider.

People knew the managers and told us they were regular visitors to the different settings. They told us they found the manager, provider and other members of the management team to be approachable andsupportive. We observed the management team being greeted warmly by people and conversations we heard with people demonstrated they knew them well.

Staff told us there had been positive changes in the management team and they felt supported in their roles. One staff member told us, “There is a big difference since new management came, I get all the support I need at all times, they are just a phone call away and they will pop into the service to support us. We’ve got on call now as well for weekends, nighttime and bank holidays.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. People, staff and relatives all told us they felt they could share any concerns and speak up if they felt something needed to be addressed. Meetings were held regularly with people who were given the opportunity to raise anything they were unhappy with. In addition, a representative was on the Clinical Governance Committee which discussed the service, policies and practices. This helped to ensure that the voice of people receiving support was heard.

Staff told us they felt able to raise any issues or improvements they feel would be useful. One staff member told us, “We can speak without restriction, when something is wrong you must say it. The manager always tells us to come to them if anything is wrong or report it straight to the local authority.”

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 an equality and diversity policy in place which recognised staff’s protected characteristics and ensured appropriate measures were in place to support these. Staff completed equality and diversity training. They told us they felt they were treated fairly by the provider. One staff member told us, “I feel we are all treated fairly.”

The provider was working to fully embed clear responsibilities, roles, systems of accountability and good governance with the service. A range of quality assurance measures and audit checks had been introduced. Whilst these had led to positive improvements in the service, these systems needed to be closely monitored to ensure they were fully effective and highlighted quality issues. This included where shortfalls had been identified during the inspection such as the risk with one person’s medicines records not being changed as required, information regarding risk requiring additional detail and fully implementing best practice guidance. The provider assured us these points would be addressed in a timely manner.

The provider had introduced a system of spot checks where staff performance was assessed through unannounced visits. The checks also involved requesting feedback from people regarding how they felt staff members supported them.

The provider did not always understand their duty to collaborate and work in partnership, so services worked seamlessly for people. They did not always share information and learning with partners or collaborate for improvement. Feedback from partner agencies acknowledged the positive improvements the service had made. However, they also indicated they did not always feel the provider shared information in an open and transparent way. They told us this had led to relationships becoming strained in some instances.

In other instances, we saw evidence of positive working relationships with partner agencies. For example, concerns had been noted regarding one person’s use of a local resource. This had been addressed with the provider and additional support provided to minimise the risks going forward.

Since our last inspection the provider had focused on learning and improvement across the organisation. They were working to develop creative ways of delivering equality of experience, outcome and quality of life for people. The provider had worked to an action plan which they told us had been completed and gave assurances that continual monitoring and action was now embedded within the service. The provider told us they had learnt so much since our last inspection. They told us they now had a far greater emphasis on monitoring the service and assessing the quality of the support people received. The provider had invested in the organisation through a variety of ways including implementing an electronic care planning and recording system and strengthening the management team. Staff told us they felt the changes made had been positive. One staff member told us, “After the last CQC visit the management gave us a major leap by bringing in (electronic records), meetings, supervisions, more interaction from top to bottom. It's completely changed, we have governance meetings now with a resident that can speak on their behalf.”