Closer Care Services - Main Office

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 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 provider mostly had a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement.

However, staff meetings, supervisions and spot checks had not been completed robustly for all staff to effectively identify where additional staff support was required. These had not been completed for all staff and followed up once additional support or learning was required. For some staff we spoke with, we found their ability to tell us about their learning from training was limited demonstrating a lack of knowledge and understanding. This meant we could not be assured the current training met the needs of all staff.

People who used the service spoke highly of the management, staff and their support and their openness. Staff spoke positively about working at the service and felt well supported in their roles.

Not all leaders understood the context in which the provider delivered care, treatment and support. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively.

Whilst the registered manager was compassionate, there were not always effective systems in place to ensure people received safe care and treatment.The registered manager was committed to delivering a good service, however, gaps in governance and oversight meant the provider was not always able to identify areas for improvement or fully learn from incidents. This meant people could not always be assured the service was consistently well-led and lessons were used to drive improvements in care quality.

Staff spoke highly of the registered manager, with a staff member stating, "[Name] is the manager, she is a good manager, whenever I have any problem, she is reply me. If I need her help, I can ring, or message or email and she will reply me back and she will sort out the things properly. She is quite flexible as well."

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

People and staff told us they could raise concerns without fear of negative consequences. One staff member told us, “I straight away speak to [registered manager] and we sort out problem easily.”

The registered manager was contactable at all times, and this gave staff the assurance they could raise issues in a timely manner.

A whistleblowing policy was available to support safe and confidential reporting.

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 ensured staff were treated fairly and supported.One staff member explained, “Best thing, they give us the respect, equal rights, nobody is perfect, I am still learning, if we need anything, they very quickly sort.”

The provider did not have clear responsibilities, roles, systems of accountability and good governance.

The provider’s governance systems for auditing the service were not effective in identifying or addressing areas for improvement to ensure people were not placed at risk of receiving unsafe and inappropriate care. Whilst weekly and monthly audits were being completed for each person using the service, this did not feed into an overall service audit to identify themes, trends, patterns and drive service improvement. Some audits had also not identified issues found at this inspection, for example, in respect of the medicine concerns identified.

Systems and processes to ensure staff were appropriately trained and supported needed improvement to make them more effective. Systems and processes to ensure people always received their medicines safely were not effective, as we identified shortfalls with the way the provider was managing people’s medicines, which placed people at risk of unsafe care. There were no effective recruitment checks in place to ensure staff had met the required employment standards before starting their roles.

The provider had a number of policies in place which did not relate to areas of their business, and read as being more applicable to a care home, rather than this service which is a domiciliary care agency. Additionally, where policies were applicable to this service, they were not always followed. For example, the staff training and development policy, which had only just been reviewed and updated prior to the inspection starting, stated, ‘The training is delivered in different ways in line with individuals’ training assessments, which indicate their preferred and most effective ways of learning.’ All training (apart from 1 session) was delivered online, and in English where the majority of the work force did not speak English as their first language. This did not assure us the provider was adhering to their own policy in respect of training and development.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people.

Staff told us they could make referrals to health and social care professionals via the management team. Relatives we spoke with, and the provider confirmed, relevant health and social care professionals were involved with people’s care. A relative told us how they liaised with health professionals for their loved one then updated the staff.

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.

Auditing systems were not used effectively to drive improvements and promote continuous learning. There was no evidence of innovation in records or from discussions with the registered manager, or staff.

However, the provider had identified some shortfalls within the service prior to our inspection, and had just commenced the process to change digital care planning systems. The registered manager received our inspection feedback openly, and demonstrated a strong commitment to make the necessary improvements to the service.