Rapid Improvement Care Agency

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 remained good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 68 (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 shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

Staff were supported by their line managers and supervisors to deliver personal care and support to people living at home in line with the provider’s values and culture. A member of staff told us, “The culture here is excellent because we have such good teamwork and supportive colleagues we are able to make a positive difference to people we support. We put people at the heart of everything we do here at Rapid Improvement.” Systems and processes had been designed in line with this vision and focused on people and meeting their individual needs. The managers routinely used individual and group meetings and training to remind staff about the provider’s underlying core values and principles.

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 and the senior staff team based in the provider’s offices had appropriate expertise and experience, supported staff well and ensured care delivery met professional standards. They promoted inclusivity and openness, ensuring staff felt comfortable raising concerns or seeking advice. The registered managers leadership style was a supportive one that promoted transparency and staff wellbeing. Staff confirmed this approach, noting they always felt able to speak openly with the office based managers and senior staff team and voice their ideas and views. One staff member told us, “The managers are very approachable and easy to contact if you have a problem.” The people receiving care and their relatives also expressed confidence in the office-based managers and senior staff team.

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

People expressed feeling able to raise any concerns they might have about the provider and were confident their views would be taken seriously and acted upon. A relative told us, “There was a hiccup a few years ago when our carer kept leaving early, but the managers in the office sorted this out as quickly as they could when we told them about what was happening.” A member of staff added, “We have lots of opportunities to share our views about how our work is going through regular meetings, supervisions, and more informal chats with our supervisors and managers. They generally listen and respond to concerns or suggestions we make.” There was an accessible complaints and staff whistleblowing procedures in place, which set out clear expectations for how concerns should be reported and dealt with by the provider.

The service valued diversity in their workforce. They had an inclusive and fair culture which had improved equality and equity for people who work for them.

The provider supported staff fairly and promoted an inclusive working environment. Policies reflected equality and diversity principles, and managers ensured staff needs were understood and accommodated. Staff reported feeling valued and treated fairly. A staff member told us, “I do feel respected by my employee.” Staff had opportunities for career progression, were offered flexible work options and the staff teams diverse cultural and religious needs and wishes were taken into account and respected. Staff were also supported through relevant training and supervision to inform their knowledge and understanding of equality, inclusivity and fairness in the workplace.

The service 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.

The office-based managers and senior staff team had established governance systems in place. They regularly undertook a range of quality monitoring tasks including, gathering people’s views about their experiences of receiving a home care service from them and conducting regular spot checks to observe staffs working practices and audits on medicines management and infection control. A member of staff told us, “Managers regularly visit us while we are working to check we are doing a good job and to make sure everything runs smoothly.” They also used an electronic call monitoring [ECM] system to continually check staffs time keeping in relation to their home care call visits.

However, the provider did not ensure these established oversight and scrutiny systems were always effectively operated. The office-based managers and senior staff team did not have formal mechanisms in place to routinely analyse or discuss the outcome of the audits and checks or feedback they had received from people which adversely affected how they identified performance shortfalls.

In addition, the provider had failed to identify and/or address multiple issues we identified at this assessment in relation to medicines record keeping, end of life care and reporting notifiable incidents. Furthermore, the provider did not always routinely analyse the outcome of audits and feedback or develop action plans based on their findings to drive improvement.

We found no evidence that people had been harmed by this gap in staff’s knowledge and skills, but it could place a person at risk of harm. We discussed these oversight and scrutiny issues with the registered manager at the time of our assessment who agreed to operate their established governance systems more effectively, including routinely analysing the outcome of audits they undertook and feedback they received to continuously drive improvement.

The provider notified the CQC without delay in relation to most incidents they had a regulatory requirement to report. However, they had failed to notify us about one safeguarding incident. We discussed this issue with the registered manager at the time of our assessment who had notified us retrospectively about this incident. The registered manager confirmed this incident had been investigated by the relevant agencies and abuse had not been substantiated.

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 shared information and learning with partners they worked closely with. Managers and staff confirmed they worked in close partnership with various external health and social care professionals and bodies who they regularly consulted and welcomed their views and advice. A member of staff said, “We work closely with healthcare professionals and other agencies such as GPs, social workers, and occupational therapists. Their guidance is followed to ensure people receive safe and effective care.”

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system.

Systems were in place to review performance, identify learning opportunities and adapt practice. The provider also demonstrated willingness to innovate and develop their service and systems, including investing in a new electronic care records system.

However, the provider did not routinely analyse and review the outcome of the audits and checks they conducted or feedback they received which meant they missed opportunities to identify performance shortfalls, continuously learn lessons and improve. In addition, when things had gone wrong and lessons needed to be learnt, the provider had not always developed time specific action plans setting out exactly what steps they needed to take to address identified issues and improve.

We discussed this issue with the registered manager at the time of our assessment who agreed to review how they analysed and response to the outcome of audits, checks and feedback, and developed action plans to improve.