CareCaliRaya Ltd T/A Apollo Care South Liverpool

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.

The provider was in breach of legal regulation in relation to governance.

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 culture of the service was warm, open and transparent. The provider demonstrated a passion for providing good quality care. However, the accuracy and completeness of care plans and risk assessment did not always evidence this.

The provider acknowledged some areas of the service required improvement and further development. They responded positively to CQC feedback demonstrating a clear commitment to ensuring the culture and delivery of care met regulatory requirements.

The provider had an inclusive leader, but they did not always understand the context in which they delivered care, treatment and support. Improvement in the management and leadership of the service were required.

Adequate quality assurance systems had not been implemented to ensure people’s care mitigated risks to their health, safety and wellbeing. Shortfalls were identified in areas such as care planning, assessing risk, staff training and medicines management. This did not demonstrate the provider fully understood the regulatory context in which they delivered care, treatment and support.

The provider and registered manager demonstrated a caring and compassionate approach to people’s care and the people they cared for. Leaders and staff were knowledgeable about people’s day to day needs and spoke warmly about the people they cared for with genuine affection. Staff told us they felt supported by the registered manager and office staff. Comments included, “[Registered manager] has always been supportive” and “[Operations lead] is really helpful, any issues I feel I am listened to, and I feel valued."

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Staff had access to a whistleblowing policy, and all staff told us the registered manager and office staff were approachable, and they could share concerns openly. Comments included, “I will report concerns to the office, and it does get addressed” and “I do feel I am able to speak up."

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 employed staff from overseas, and different cultures, faiths and backgrounds were represented within the staffing team. Difference was respected and celebrated and no one told us they felt excluded.

The provider did not implement effective governance systems. They did not act on the best information about risk, performance and outcomes.

Auditing processes were not effective. Systems and processes did not enable the provider to identify where quality and/or safety were being compromised to ensure they could respond appropriately and without delay. We identified shortfalls in assessment, care planning, risk management, medicines, staff training and governance. The provider had not identified all shortfalls as part of their auditing processes as demonstrated by the following examples.

Medicines audits were not effective. Audits were either absent or did not identify and address all concerns found with medicines management. For example, overdue competency assessments, lack of information within medication support plans and medicines missing from the medication administration records.

Effective auditing systems were not in place for staff training. We identified missing and overdue training. For example, medication training and competency assessments for catheter care and medicines management. These shortfalls had not been identified through the providers’ own monitoring systems.

The system in place for auditing care notes to identify and gain assurance care delivered was in line with care plan was either not completed or ineffective. For example, the audit for 1 person identified gaps in skin integrity checks and calls taking place later than planned, but no outcome of what action had been taken to improve care quality was recorded.

The absence of effective audits increased the risk to people as there was no manager oversight or assurance that care was being delivered in line with people’s needs. Opportunities to identify concerns were missed, as evidenced by our findings.

Overall, leaders were open and transparent, and we saw evidence they collaborated with relevant external stakeholders to promote the health, safety and wellbeing of the people.

We received positive feedback from stakeholders who worked with the provider. Comments included, “On occasions a package of care is shared between [ Community health provider] and Apollo, both services ensure any updates on patient/families are communicated as required. Apollo coordinators update us via email or phone when there are significant changes in patients’ condition or any other issues."

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not always actively contribute to safe, effective practice and research.

Systems in place to ensure learning from accidents and incidents were not effective. The registered manager did not have oversight of all incidents in the service and auditing processes relating to care notes were not effective at identifying these concerns.

Auditing systems were not implemented effectively to drive improvements and promote continuous learning. However, the registered manager and provider were receptive to our feedback. They worked hard to address concerns to improve the quality and safety of the service in a timely manner and have demonstrated they have completed a thorough action plan to drive improvement in the areas of key concern.