Grace Care 24/7 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.

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 the quality monitoring and 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 did not have a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement.

Staff did not undertake an induction programme when recruited to the service. There was no evidence to confirm that the values, ethos or vision of the service was shared with staff.

Staff were not expected to demonstrate an understanding of how the provider wanted the care and support to be delivered. Systems had not been developed to ensure any underlying principles and values of the service were followed through into practice.The registered manager and directors however, supported staff to deliver safe and individual care and support and staff worked well together to provide a consistent service.

Leaders were not in post at all levels that understood the context in which the provider delivered care, treatment and support. They did not share the culture and values of the organisation with the workforce.

Although there was a registered manager in post and they were supported by 2 directors, clear roles and responsibilities within the management team had not been established. Clarity on roles and responsibilities had not been defined to ensure the effective operation of the service. The registered manager and directors recognised this shortfall and confirmed the need to address within an improvement plan shared during the assessment process.

The service was new and was being established and developed. It was starting small and we were advised it would be grown slowly with appropriate management arrangements being put in place during this process.

There was a registered manager in post although they currently worked on a part-time basis. Two directors were readily available and involved in the management of the service at this development time. The management team worked well together and shared a vision and direction for the service. They were honest in their approach and recognised they were number of areas to be developed and established to ensure an effective service.The registered manager and a director were completing a diploma in leadership and management.

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

People told us they felt they were able to raise their views with the registered manager or the directors as they needed to. “I have regular contact with the office staff.” People had access to a complaint’s procedure.

Staff told us they were able to speak to the registered manager or a director whenever they needed to. They felt they were listened to and had their views taken into account. One said, “I telephoned the office and told them about a person’s mobility and how it was getting worse. The manager was told and they came out and did a re-assessment to respond to what I had said.”

The management team tended to work fromfrom home and did not use the office facility to facilitate regular face to face communication with staff. However, it was used on booked occasions to communicate with staff. As the service grows it was envisaged that the office would be used on a regular basis to facilitate the service.
 

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.

Staff told us they were happy working for the service and told us they were valued, treated with respect, and they did not experience any discrimination or harassment. One staff member told us “I do feel valued and supported the manager and owners are very good to us. The manager treats all the staff the same.”

The manager was mindful of staff’s individual backgrounds and individual circumstances and how these impacted on their working and daily lives. They knew the staff well as it was a small team and understood family commitments. Staff were matched to visits that also allowed for family arrangements and needs to be accommodated.

Some adjustments were made to support staff, for example, some staff did not drive, and the management arranged for other staff to drive them to their work visits to ensure they were able to work while they learnt to drive.

The provider did not 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.

The management team had not established any quality review and governance systems. This included a lack of any systematic way of seeking feedback from people their relatives or staff deployed. Spot checks to assess staff while working were not undertaken. The provider therefore could not be assured of the quality of the care and support provided.

The service had a range of policies and procedures however these had not been fully adapted to the service and had not been fully implemented into practice. For example, the recruitment procedure was not being fully followed. Audits on practice had not been completed. This included audits of any care records. The provider could not be assured of the quality of the service or compliance with any quality standards or required legislation.

It was however noted through this assessment and feedback recorded on an independent quality feedback website that people and their relatives were satisfied with the quality of the service provided. During the assessment process the management team also produced an improvement plan that addressed a number of the areas raised during this assessment.

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 were positive about their links with local health and social care teams. They contacted other health professionals for advice and guidance. For example, they worked closely with the district nursing team when caring for people’s fragile skin. The registered manager also explained how close links were formed with the hospice when supporting people who were at the end of their lives.

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.

The lack of clear roles and responsibilities within the management team had not supported a focus on learning improvement or innovation. There was no system to review and improve the quality of the service. The current service provision was small, and the registered manager and directors recognised the need to implement learning and improvement strategies as part of the plan to expand and develop the service.

The management team were positive in response to the findings throughout the assessment process. They all responded positively to the feedback implementing a number of improvements immediately and providing an improvement plan to address the areas and emerging concerns during the assessment process.