CRM Healthcare Solutions 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.

The service was in breach of legal regulation in relation to governance at the service.

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 have a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They understood the challenges and the needs of people and their communities.

The provider had strong values in terms of the quality of care and service they wanted people to experience, which staff understood and they delivered care to a very high standard. People and their relatives told us they had a very positive experience of the care provided. However, the culture between staff and leaders needed further work. Staff did not always feel able to raise concerns to leaders and felt there would be negative consequences if they did. Staff told us, “Colleagues are afraid to speak openly because they worry this could affect their visa, immigration status, or ability to work in the UK at all. This has created an environment where people feel they cannot be honest or ask for help when they need it, and where genuine concerns are never properly addressed.”

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.

Leaders were knowledgeable and experienced in health and social care. They had a good understanding of the people they provided care for. The registered manager and other leaders would regularly deliver care to people when there were staff shortages or unexpected emergencies. Relatives all told us they had a positive relationship with leaders. One relative said, “We have a strong relationship with management, they are a family run business who are dedicated and really made for the job in my opinion. Nothing is a chore to them. They will do their utmost to support me and my relative”.

People did not always feel they could speak up and that their voice would be heard.The provider is family run and employed several members of their own family within the company; some staff told us this made it hard for them to speak up and raise concerns. The provider had a whistleblowing policy in place, but it lacked detail around how and where concerns about the management team or the organisation could be raised. One staff member told us, “Staff accounts are dismissed without proper investigation, and there are frequent reminders about losing employment and sponsorship. This creates fear rather than encouraging openness and learning.”

The provider did not always value diversity in their workforce. They did not always work towards an inclusive and fair culture by improving equality and equity for people who worked for them.

Staff did not feel they were treated in a fair and equitable way by the provider. Staff told us some staff were given preferential treatment due to being related to the providers of the service. Staff told us that rotas were published with very short notice and annual leave requests had to be submitted 8 weeks in advance, with little flexibility. This made life outside of work difficult and impacted their well-being.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes.

There was an over reliance on electronic care systems to monitor performance, oversight and manage risk. The provider had failed to establish effective governance systems beyond alerts generated by the electronic care system and had not recognised the limitations around these in terms of quality improvement and a person-centred approach. The provider failed to identify concerns we found during the assessment; for example, issues around poor or missing risk assessments, inconsistency and variance in the quality of care plans and medicines management concerns.

The provider acknowledged that improvements were needed to demonstrate good governance and was keen to get this right.

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 provider was open to learning and improving the service based on feedback and learning from partner agencies. The registered manager told us how they had worked with the local authority and had taken action based on their feedback. The provider wherever possible, was present when other health professionals visited people in their own home, to ensure an effective handover of information.

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.

The provider was committed to driving improvements and providing people with the best experience of care they could. They took learning from complaints to implement changes in practice to reduce the change of the same issues happening again.