The Caring Company Rutland 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.

At our last assessment we rated this key question good. At this assessment the rating has changed to 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 the legal regulation in relation to leadership oversight and governance.

This service scored 50 (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 vision, strategy and culture which was based on equity, equality and human rights, diversity and inclusion. However, there was limited evidence of engagement with people and staff.

The aims, objectives and values of the service were set out in a staff handbook. It was not clear how this had been shared with or discussed with staff to ensure they understood the providers expectations. The provider had set up regular staff meetings and supervisions, but these had not been fully embedded or tested at the time of this assessment.

We received a limited response to our requests for staff feedback about their experiences of working at the service. As a result, we were unable to gather sufficient evidence to comment on staff understanding of the providers direction and culture. However, people we spoke with praised the staff and the service provided.

Not all leaders understood the context in which the provider delivered care, treatment and support. They did not always embody the culture and values of their workforce and organisation. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively.

At the time of our assessment there was no registered manager in post, a new manager had been recruited and was in the process of applying to become registered with the CQC. Team leader roles had also been created along with the recruitment of a qualified nurse.

There had been recent changes to the management team which the provider told us had occurred without an appropriate handover and had resulted in ineffective oversight of issues and priorities for the quality of the service. The provider has taken action to address these shortfalls and to establish a leadership team with the required knowledge and experience. This included improved communication with people and staff through meetings, supervisions and care reviews. However, these systems and processes had not yet been fully embedded or tested.

We received positive feedback from a staff member we spoke with. They told us they felt supported by the management team and could contact them at any time. Another member of staff did not feel communication with leaders had been effective.

The provider told us their leadership team was meeting daily to respond to and monitor risk and to review compliance data.

People may not always feel they could speak up and their voice would be heard.

One staff member we spoke with told us they had confidence in the management team and in speaking up if they had any concerns. However, there were no recorded care reviews, staff supervisions or team meetings to evidence people had been provided with opportunities to speak up.

We received a limited response to our requests for staff feedback about their experiences of working at the service. As a result, we were unable to gather sufficient evidence to comment on staff views within this key question.

The provider had a policy and procedure about freedom to speak up and whistle blowing. This included the provider's obligation to be open and honest if things went wrong (duty of candour).

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 comprehensive policies and procedures about equality and diversity. The policy adopted a zero-tolerance approach to discrimination or harassment regardless of peoples protected characteristics.

Equality and diversity training was available to all staff. However, staff training records did not clarify who had received this training.

We received a limited response to our requests for staff feedback about their experiences of working at the service. As a result, we were unable to gather sufficient evidence to comment on staff views within this key question.

The provider did not have clear responsibilities, roles, systems of accountability and good governance. We could not be assured they always acted on the best information about risk, performance and outcomes, or shared this securely with others when appropriate.

There was an absence of effective systems and processes to ensure safe oversight, monitoring, and continuous improvement. Audits had not been taking place so assess and monitor the quality of the service. There were no mechanisms in place to ensure the voice of people who used service was represented in governance and decision-making structures.

Data management and cyber security systems had not been robust and this had resulted in staff and leaders not having access to important information to monitor and manage risks.

The provider could not demonstrate they communicated with staff around risk in the service, improvements needed or how staff performance was monitored and supported.

This increased the risk of people, some of whom had complex needs, experiencing unsafe or inconsistent care or avoidable harm.

While people consistently told us they were happy with the care and support they received and spoke positively about staff, our assessment identified areas where the service was not always operating in line with regulatory requirements.

The provider told us they had experienced a highly challenging transitional period following the departure of the previous management team and this included the loss of vital operating records essential to the running and oversight of the service. The provider had taken appropriate action to address any unlawful data destruction and to ensure data security. This included seeking support from appropriate external agencies such as the Information Commissioners Office.

The provider had also engaged an external compliance and clinical governance consultancy team to support and re-establish effective governance and risk management systems and processes. We reviewed the risk assessment, governance and audit systems being introduced and saw they were comprehensive and designed to identify risk, drive improvement and to effectively monitor the quality of the service provided. However, at the time of our assessment, these systems had not yet been fully implemented or embedded into day-to-day practice.

The provider told us their leadership team was meeting daily to respond to and monitor risk and to review compliance data

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.

People told us and records showed staff had contacted other agencies such as health care professionals for support and guidance when people’s health deteriorated or required additional support. However, leaders did not have contact details for essential external stakeholders and had not made important healthcare advice and guidance available to staff.

After we raised concerns, the provider took immediate action to establish clearer working partnerships and to ensure staff understood their responsibilities to share information and learning with external agencies where appropriate.

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.

At the time of our assessment the provider could not evidence involving people, relatives or staff in developing the service or making improvements. The provider had taken action to strengthen and improve the leadership team and had begun to take action to ensure people, relatives and staff were consulted and involved.

New quality assurance systems and processes which included seeking comprehensive feedback from people and an increased focus on staff training compliance had been introduced. However, these processes had not yet been fully embedded or tested.