Ideal Care Services - Kent

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 changed to 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.

This service scored 36 (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 did not have effective systems in place to mitigate the risk of a closed culture within the service. A closed culture means a poor culture that can lead to harm, which can include human rights breaches such as abuse.

The provider had not prioritised safe, high quality and compassionate care. For example, ineffective oversight of care calls and poor monitoring of care plans meant that concerns about the quality and consistency of care were not always identified or acted upon. This increased the risk that poor practice became embedded within the service and negatively affected people’s safety, dignity, wellbeing and experience of 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 to lead effectively.

The provider had gathered feedback from staff; however, this had not been sufficiently analysed to identify themes, areas for improvement, or clear action points. As a result, opportunities to use staff feedback to drive service improvement had been missed.

The provider did not have the necessary knowledge and experience to ensure risks were effectively assessed and managed. Risks associated with people’s health needs, including epilepsy and diabetes, had not been fully assessed or appropriately mitigated, increasing the risk of avoidable harm.

People did not always feel they could speak up and that their voice would be heard. People and their relatives were not consistently given to opportunity and support to ensure their voices were heard. When people raised concerns, they did not always feel this was dealt with appropriately or in a way that met their needs and preference. One person told us that the provider had threatened to hand back their care package, which caused them concern that they would lose the regular carers they relied upon.

However, staff told us they felt they could raise concerns with the provider. One staff member told us, ‘I think they are ok as a provider. If something bothering me could approach them to raise this.’ However, daily notes demonstrated concerns raised by people were not always escalated.

The provider did not always work towards an inclusive and fair culture by improving equality and equity for people who worked for them. Leaders had not taken effective action to continually review and improve the culture of the organisation in relation to equality, diversity and inclusion.

Team meeting agendas did not routinely provide opportunities to discuss equality, diversity and inclusion or hear the experiences and views of staff. This limited opportunities for leaders to identify barriers, understand staff experiences and take appropriate action to promote an inclusive and supportive workplace culture.

However, staff we spoke with told us they would raise concerns to the provider if they felt they needed to.

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 demonstrated a lack of knowledge, and did not implement any quality frameworks for best practices.

The provider did not have robust systems in place to monitor and improve the service. The provider did not complete any formal audits, for example, reviewing of care plans and daily notes. Care plans and risk assessments lacked key guidance and information to inform staff how to support people safely. This limited the provider’s ability to identify gaps in care, take timely action and drive continuous improvement, increasing the risk of unsafe or inconsistent care.

The provider had not ensured staff were suitably trained and competent to meet people’s needs. The provider did not have sufficient assurance that staff were competent to provide safe and effective care, increasing the risk of inconsistent care and avoidable harm.

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

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 if people’s health needs changed.

Some processes were in place for referrals to be made to other health care professionals and staff supported people to make appointments with their GP if needed at support them in attending appointments.

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. They did not actively contribute to safe, effective practice and research.

The provider did not have effective quality improvement processes in place to demonstrate continuous improvement. Leaders lacked a clear understanding of how to identify, implement and sustain improvements, and there was no effective approach to measuring the impact of changes made.

Whilst the provider carried out spot checks, these did not highlight the concerns we identified during the inspection. The spot checks were not consistently analysed, embedded or evaluated to support sustained improvement across the service.