Everkind Healthcare Limited

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 always have a clear, consistently shared vision and culture that was fully understood and embedded across the service. Leaders had defined values in providing person centred and respectful care and staff we spoke with described these values. One staff member told us, “We are person centred and respect our clients, ensuring safeguarding as well.”

However, we received mixed feedback from people and relatives. Some told us that changes in care staff, inconsistent approaches and a lack of compassion from individual staff members had reduced their confidence in the service. This meant that the provider’s stated values were not consistently reflected in people’s experience.

The provider had capable and accessible leaders who understood the service and promoted person-centred values. Leadership responsibilities were clearly defined across the registered manager, care coordinator and administrative functions. Leaders remained involved in the day-to-day running of the service, completed spot checks and provided care when temporary staff were unavailable.

People, relatives and staff generally described leaders as approachable, supportive and responsive. One relative told us, “[The registered manager] is very obliging, you can reach them very easily and whatever you ask them, they try to help.”

Leaders responded when concerns about care were raised, including changing staffing arrangements where necessary. They acknowledged limitations in the oversight of care documentation and were receptive to feedback about areas requiring improvement. Although governance and quality-assurance shortfalls were identified elsewhere in this assessment, leaders demonstrated that they were accessible, engaged in the service and willing to respond to feedback and identified risks.

The provider fostered a positive culture where staff felt able to speak up and were confident their concerns would be heard. Staff said they could approach leaders directly and use supervision, team meetings and day-to-day communication to raise concerns, seek advice or discuss practice.

The provider’s whistleblowing and safeguarding procedures gave staff guidance about how to escalate concerns, including where they could not be resolved internally. Staff expressed confidence that leaders would respond appropriately. One staff member told us, “I am confident managers would investigate any concerns.”

The provider promoted an inclusive and fair working culture that valued diversity and supported staff wellbeing.

Recruitment processes included health declarations and consideration of reasonable adjustments to support staff in their roles. Staff completed equality and diversity training, and the provider’s policies promoted equal opportunities and set expectations that staff should be treated fairly, respectfully and with dignity.

Staff described receiving regular supervision, training and support from leaders. They also had access to annual leave and breaks between visits, helping to support their wellbeing and enable them to carry out their roles effectively.

The provider had governance arrangements in place. However, these were not consistently effective in assessing, monitoring and improving the quality and safety of the service.

Medicines audits had been completed but had not identified that body maps for prescribed topical creams were not completed. Although regular staff understood how the creams should be applied, leaders could not demonstrate that written guidance was sufficiently clear for temporary staff who were unfamiliar with the person. This meant medicines audits did not provide effective assurance that staff had complete and accurate information to administer topical medicines safely.

The provider did not have a system or process for routinely comparing daily care records against the monitoring requirements set out in people’s care plans. This meant leaders could not consistently assure themselves that required care and monitoring had been completed, or identify and address omissions promptly.

Staff had completed safeguarding training and received supervision and competency-related support. However, the provider did not have an effective system for checking whether safeguarding knowledge had been understood, retained and applied in practice. One staff member could not explain when confidentiality should be overridden to protect a person, while another demonstrated limited knowledge of how to recognise safeguarding concerns. This meant leaders could not be assured that all staff had the knowledge required to recognise abuse, take immediate protective action and escalate concerns appropriately.

Collectively, these findings showed that governance systems did not provide leaders with sufficiently reliable oversight of whether care was being delivered in accordance with people’s assessed needs, medicines guidance and expected staff practice. As a result, shortfalls were not always identified promptly, and the provider could not consistently demonstrate that risks were effectively monitored or that improvements were sustained.

The provider acknowledged the areas requiring development and took action in response. This included introducing bowel-monitoring prompts, adding visual body-map guidance and reinforcing safeguarding responsibilities with staff.

The provider understood their responsibility to work collaboratively with external organisations to support coordinated care. Leaders and staff worked with healthcare professionals and other partners, and care records showed that staff sought advice and shared relevant information when people’s needs changed, including in relation to catheter care and medicines.

Care plans reflected the involvement of relatives and relevant healthcare professionals. Leaders also worked with agencies supplying temporary staff and shared concerns with them when a worker’s practice required investigation.

Staff understood when to seek advice from healthcare professionals or contact emergency services. They supported people to attend appointments and followed professional advice. Relatives also described leaders helping to coordinate support when people’s health needs changed. One relative told us, “They have been very helpful in terms of when [person] has had problems, and [the registered manager] has stepped up and tried to sort ambulances for catheters, and this, that and the other.”

The provider did not always demonstrate a consistent approach to learning, improvement and innovation. Systems intended to identify areas for improvement and monitor progress were not always effective, and some of the concerns identified during the assessment had not been recognised or addressed through the provider’s own quality-assurance processes.

The provider had introduced electronic care records and audit trackers to support learning and improvement. However, they could not consistently demonstrate a systematic approach to identifying areas for improvement, agreeing actions and evaluating whether changes had been effective.

The registered manager said an external audit had identified weaknesses in documentation and that an action plan had been developed. However, neither the audit nor the associated action plan could be provided. This meant the provider could not demonstrate what areas for improvement had been identified, what actions had been agreed, who was responsible for completing them or whether those actions had resulted in sustained improvement.

The provider also acknowledged that there had not been consistent office oversight of care documentation and said additional administrative support would be introduced. However, this arrangement was not yet in place at the time of the assessment.