Myable Care 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 Inadequate

This meant there were widespread and significant shortfalls in leadership. Leaders and the culture they created did not assure the delivery of high-quality care.

The service was in breach of legal regulation in relation to good governance and fit and proper persons.

This service scored 25 (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 shared vision, strategy and culture based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not understand the challenges and the needs of people and their communities.

The provider had not ensured there was an open culture where people and staff could share their concerns to improve the service. The provider told us they had held 2 team meetings via videocall, however there was no minutes of the meetings to demonstrate action taken with feedback.

Staff at all levels did not have a good understanding of equality diversity and human rights. They did not aways prioritise safe, high quality compassionate care because people were left for long periods of time in undignified conditions without the support they needed.

The provider had not ensured that values and strategy had been developed through a structured planning process in collaboration with people who use the service, staff and external partners. For example, there was no clear system in place to ensure people received joined up care.

The provider did not have inclusive leaders at all levels who understood the context in which they delivered care, treatment and support, or who embodied the culture and values of their workforce and organisation. Leaders did not have the skills, knowledge, experience and credibility to lead effectively, and they did not do so with integrity, openness and honesty.

The provider did not have the skills and knowledge to lead the service effectively and drive improvements. The provider told us they were “Not aware” of some of the requirements such as needing to have care plans and risk assessments in place, and ensuring staff were trained and competent to meet peoples needs.

The provider was not knowledgeable about issues with the quality of the service. The provider did not access appropriate support and development for their role. The provider told us they were not part of any forums or groups to keep them up to date with any changes within the sector.

The repositioning charts the provider sent to us were not an accurate representation of the care that was provided to people. For example, one person was in hospital for 10 days, however the provider sent us repositioning charts for this period, which included information such as if the person had passed urine or opened their bowels. The provider shared information which was unreliable.

People did not feel they could speak up and that their voice would be heard.

Staff and leaders did not act with openness, honesty and transparency. Information shared by the provider was not a reflection of the care delivered. Staff had not been given the opportunity to speak up and drive improvements. Formal systems to capture feedback from staff, for example through staff surveys had not been utilised by the provider.

The provider did not value diversity in their workforce. They did not work towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The provider did not have any formal programmes in place to support staff wellbeing. We asked the provider what systems were in place to provide support to staff and the provider explained the grievance process to us. This is not a system to provide support to staff. There was no employee assistance programme in place to provide support to staff.

The provider did not ensure that staff’s health conditions were captured within their application forms. This would allow the provider to be aware of any medical conditions and make any reasonable adjustments as necessary.

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 provider did not have robust systems in place to monitor and improve the service. The provider confirmed they did not complete any formal audits on care plans, recruitment files and training for staff. Care plans and risk assessments lacked key guidance and information to inform staff how to support people safely. The provider had not ensured staff were suitably trained and competent to meet people’s needs.

We requested the provider share call data with us on 4 occasions. The provider failed to share this information with us to enable us to review call time responses. The provider did not have a system to review call times and ensure people received their calls when required and pick up when calls may have been missed or were significantly late.

The provider demonstrated a lack of knowledge, and did not implement any quality frameworks for best practices. For example, in relation to the use of assessment tools and best practice documentation, for example not using the Waterlow tool to assess the risk of skin breakdown for people. The provider demonstrated a lack of understanding of the Mental Capacity Act 2005.

The provider did not understand their duty to collaborate and work in partnership, so services work seamlessly for people. They did not share information and learning with partners or collaborate for improvement.

Although the provider told us they worked closely with other healthcare professionals including the district nurse, physios and occupational therapists, there was no evidence that this happened. Care plans for people did not provide any details of any other stakeholders involved in people’s care. There were no contact details for staff to share concerns with the district nurse for example.

The provider did not focus on continuous learning, innovation and improvement across the organisation and local system. They did not encourage creative ways of delivering equality of experience, outcome and quality of life for people.

There were no quality improvement processes in place to evidence continuous improvement of the service. The provider did not have a good understanding of how to make improvement happen. There was no approach to measuring the impact of change. The provider did not have external links to support them with improving the service. The provider did not embrace opportunities to encourage learning. For example, when one person fell twice in a month, and was known to be at risk of falls, the provider failed to ensure that a robust care plan was implemented and shared with staff. The provider could not demonstrate that staff had been given the opportunity to develop themselves through training.