Care Quality Services IOW

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 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 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.

Although the provider had a vision, strategy and culture based on transparency, equity, equality and human rights, diversity and inclusion, engagement, understanding challenges and the needs of people and their communities, feedback from staff indicated this was not their experience of working for the service and could not tell us the provider’s vision or goals for the service. A staff member told us, “They have a lot on their training things where they say all that [shared direction and culture] but I don’t know that it really happens. There is a lot of staff that are unhappy and leaving.”

The management team told us they aimed to provide a person-centred service which promoted people’s rights and independence. The registered manager said these goals were shared with staff during induction and monitored during field supervisions. Other than consistency of staff and call times people and family members were generally satisfied with the care they received.

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. The registered manager was supported by an office based staff team and by an area and regional management structure. Each had a distinctive role within the organisation and understood their individual responsibilities. Discussions showed the local management team knew service users and staff individually. Care staff were mainly positive about the registered manager although raised some concerns with responses from other office-based staff. For example, a staff member described the registered manager as, “Very supportive.” Whilst another said, “The manager is like a mother figure.”

External professionals provided mixed responses about the management team. Many stating they often had to chase information or if a new package could be commenced and a start date.

Staff did not always feel they could speak up and that their voice would be heard. Some staff said they felt unable to raise everything with the management team and told us they had not been listened to when they had raised concerns. The registered manager said they worked to encourage staff to raise concerns and would look at how this could be improved.

The provider did not always work towards an inclusive and fair culture by improving equality and equity for people who worked for them. Some staff raised concerns about support from the management team when they had raised diversity issues. They felt their concerns had not been fully understood and action taken to promote an inclusive and positive working environment. One staff member said, “Leadership needs to be dealing with this to say we don’t accept hate.” Other staff told us they were supported with needs such as being a working parent, and extended leave requests to visit family overseas were supported.

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, or share this securely with others when appropriate. Although the provider had a service improvement plan in place this had not identified all the areas requiring improvement we identified during this inspection.

Further information is detailed in the safe section of this report where we identified areas for improvement in respect of safeguarding, risk management and staffing.

CQC had not been notified of all significant events such as safeguarding concerns. There was a duty of candour policy but this had not been used where required. The registered manager undertook to ensure all notifications were submitted and Duty of Candour procedures were fully followed.

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 management team expressed an open positive attitude to receiving support and understood how and where they could access support.

The service had not always focussed on continuous learning, innovation and improvement across the organisation and local system. They did not always actively contribute to safe, effective practice. There were processes for seeking and reviewing feedback from people, family members and staff, accidents and incidents and complaints. However, this had not ensured that appropriate action was always taken and any learning was implemented leading to overall service improvement.