Extra Care Service

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 good. At this assessment the rating has remained good.

This service scored 75 (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. The provider summarised its values through the acronym SERVICE, which stands for Service, Effective, Responsive, Visionary, Inclusive, Compassionate and Empowering, and sets out the standards expected of staff. These values focused on delivering safe, person-centred and inclusive care, responding promptly to people’s needs, promoting innovation, treating people with compassion, and empowering individuals to make decisions about their own care. The management team told us they followed this values-based vision and ensured it was shared and understood across the staff team. The management team told us they reinforced these expectations through supervision and team discussions, helping staff embed the values in their practice. The service also used a “policy of the month” approach, sharing key policies with staff to encourage ongoing learning and reflection, for example, recent monthly learning had focused on nutrition and hydration.

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.

Staff told us they felt managers were visible within the service and provided meaningful support. Staff described the management team as approachable and responsive. One staff member told us, “[The registered manager] reassures us we can speak to them. They are always around and come in regularly. They ask us how everything is. We are really lucky, we have so much support. It’s the best place I’ve ever worked.” People using the service and their relatives shared these positive views. They told us they knew the management team well and felt confident approaching them.

The registered manager understood their responsibilities and felt supported by the provider. The registered manager told us, “I get support, the nominated individual has been with Thurrock for 26 years, [the nominated individual] is so supportive of me and the service.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. The management team told us they operated an open‑door policy and encouraged staff to come to them with any concerns, and staff confirmed this approach. One staff member said, “They [management] are very supportive, it's one of the most supportive environments I've ever come across working in care. I can't sing their praises enough. I can go into the office and raise a concern and they just listen and act. They don’t ignore u, they take our concerns seriously and they always act on these concerns.”

Staff had regular opportunities to share information or raise issues through staff meetings and supervision. Staff told us supervisions were meaningful, two‑way conversations where they felt able to speak openly. One staff member said, “Supervisions are really supportive. They always ask us if we have any concerns and how we are doing, not just in regard to work, but our personal lives too. They ask if they can help with anything, again personal or at work.”

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 told us they were treated fairly, and both the management team and staff demonstrated an understanding of the Equality Act, supported by relevant training. Staff described the manager and provider as supportive, with one person telling us, “They let us move and adjust work around our lives. They understand and that’s what makes our team work so well. I feel very lucky to work there, I have no intentions of leaving.”

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, however, they failed to submit required statutory notifications to the CQC. Providers are legally required to notify the CQC of certain changes, events and incidents. We found that some reportable events had not been reported. The management team acknowledged this and confirmed notifications would be submitted in future.

The service had a range of audits and governance systems in place to support effective oversight and ensure the quality and safety of the service. These included regular medicine, infection control and health and safety audits. The service also completed routine analysis of incidents and accidents to identify patterns or emerging risks and to ensure appropriate actions were taken to prevent reoccurrence.

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 service worked collaboratively with other professionals and ensured people had access to the services they needed. Feedback from external partners was positive. One professional told us, “It’s a well‑managed service. Staff are proactive for best outcomes for the clients they support.” The service also encouraged and supported people to access the community and make use of communal areas. People were supported to work towards personal goals, such as socialising with others and visiting the on‑site café.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. During our assessment, we found the management team were receptive to feedback and recognised this as an opportunity to strengthen the service. We also observed positive practices, such as the use of peer audits carried out by staff from another service within the same organisation. This approach helped identify areas for development and had already resulted in actions being taken to enhance the quality and safety of the service.