Monaveen (Care Outlook)

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• 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

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

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a shared vision, strategy and culture. The registered manager showed a focused approach in ensuring people received good quality care. The provider had identified there were shortfalls in the culture of some areas of the service, but staff and people told us they could recently start to see a real improvement Senior management and staff understood the diverse needs of the people they supported and the staff they employed. The provider worked with staff to promote a positive culture at the service. Provision of wellbeing initiatives and open communication contributed to positive staff practices. Feedback we received supported this. People and their relatives were asked for opinions and feedback through meetings and surveys, while confirming that leadership and staff were open and honest about the support being provided.

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. The registered manager was knowledgeable about issues and priorities for the quality of care of the service. People, staff and professionals all spoke positively about the approach of the registered manager and other senior staff. They described leaders and the senior team as proactive and approachable. One staff member said, “The manager has an open-door policy, I have a good relationship with them.”

Records showed that consistent and regular supervision and appraisals were undertaken, while staff meetings were held so staff could provide feedback and contribute. Managers and staff understood the diverse needs of the people they supported. One staff member said, “Very caring manager. Nothing is too much trouble, whatever the problem, it will be sorted.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Staff were able to raise concerns directly with the Registered Manager. Staff and leaders acted with openness, honesty and transparency. Staff told us that there was a culture at the service to speak up if they needed to. On person told us, “I wouldn’t hesitate to bring anything up. I would just go into the office and say.”

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. Feedback from staff was positive about the approach of the provider in ensuring an inclusive staff team who valued each other. One staff member said, “We have equalities and diversity training, and the team share information about their cultures.

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

Management systems were not always effective in identifying shortfalls in the quality, safety and the risk management of the service. The provider’s systems had failed to identify concerns identified regarding the review and management of risks to people, including risks of diabetes, risks associated with epilepsy, and with people’s risk of self-neglect. There were no risk assessments or care plans in place to provide guidance for staff in how to do this safely and in the way the people preferred. Actions to mitigate these risks were started to be put in place during the assessment.

The provider did not always demonstrate good oversight of the service. System for monitoring incidents and accidents were not robust. The provider and deputy manager could not be sure how many reportable incidents had occurred in any given period. This meant they were not clear about the level of risk at the service.

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 worked closely with the local authority extra care commissioning team to ensure the effective running of the scheme. Staff worked collaboratively with partners to support care provision. One professional said, “The provider will contact me directly if she has any concerns or needs advice about a residents (specific health) management. Something that has improved greatly.

The provider has worked with the local authority to improve their practice on continuous learning, innovation and improvement across the organisation and local system. In response to their efforts to effectively monitor people’s health needs the provider has created a “Close Watch Board”. This is essentially an on ongoing, continuous list highlighting people whose needs are changing. Weekly and daily meetings are held to discuss any incidents and any referrals that are needed, and these tasks are allocated to staff members to complete.