Orbital 4 Support 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.

At our last assessment we rated this key question good. At this assessment the rating has changed to 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 good governance.

This service scored 50 (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. They did not always understand the challenges and the needs of people and their communities.

The provider and registered manager expressed a commitment to supporting people to live quality lives in the community and told us they aimed to ensure each person was at the centre of their support. However, gaps in their knowledge and understanding of current regulation and legislation meant this was not consistently achieved in practice. There was limited evidence that people were meaningfully involved in making decisions or shaping their care and support in line with their wishes. This did not support an open, inclusive culture where change is driven through the involvement of people receiving care.

The service had inclusive leaders, and both the provider and registered manager told us they were committed to doing their best in their roles and supporting people to lead enriched lives. People and their relatives told us they liked the registered manager, and we observed positive social interactions and good rapport between the registered manager and people receiving care. However, we identified gaps in the knowledge of both the provider and registered manager regarding current best practice, and weaknesses in governance systems affected their oversight of the service. Documentation across the service was not concise or well‑organised, making it difficult for leaders to demonstrate what was working well.The provider and registered manager had not recognised or acknowledged how gaps in their knowledge had limited the opportunities for people to be involved in the assessment and delivery of their care and support.

The provider told us they fostered a positive culture in which they enabled people, their relatives and staff to feedback about the care and support being delivered. However, it was not documented where conversations had taken place, or if actions had been taken in response to people’s feedback. The current systems and processes did not effectively demonstrate oversight and management of concerns being raised. A whistleblowing policy was in place, and staff we spoke with felt confident about raising concerns.

The provider valued diversity within the workforce, and staff we spoke with were positive about their experiences of working for them. Staff told us they were treated fairly, and policies were in place to support equality. However, there was no clear policy or procedure regarding potential conflicts of interest. Some staff worked alongside direct relatives, both in terms of employment and shift patterns. Without clear oversight, this could lead to conflicts of interest if concerns were raised, although we did not see evidence of this during the inspection. We discussed with the registered manager the need for greater clarity about where potential conflicts of interest may arise in the workplace.

The provider did not always have clear responsibilities, roles, systems of accountability or effective governance arrangements. They did not consistently act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

Procedures for responding to incidents and concerns, and for managing risk, were not clearly defined. As a result, when risks were identified, there was limited information about what actions had been taken to reduce them. Some actions the provider told us had occurred did not address the immediate risks, and neither the provider nor the registered manager had recognised this until it was highlighted during the inspection.

Systems intended to ensure people were supported by safe and effective staff were not always reliable. This included oversight of staff training, competencies and ongoing development.

Documentation relating to meetings, reviews and the management of concerns was not effectively organised, leading to a lack of cohesion and inconsistency in the information available for review and action. There was no clear plan in place to improve the quality and safety of the service.

The provider had not identified the concerns we found during the inspection. This was a breach of Regulation 17 (Good Governance) of the Health and Social Care Act 2008.

The provider did not always demonstrate an understanding of their duty to collaborate and work in partnership to ensure services operated seamlessly for people. They did not consistently share information or learning with partner organisations, nor did they routinely collaborate to support improvement. The registered manager had limited opportunities to network with external organisations, which reduced their ability to share information, learn from external partners and contribute to more joined‑up approaches to care. Some professionals raised concerns about a reluctance to communicate and implement professional recommendations.

The provider did not always demonstrate a focus on continuous learning, innovation or improvement across the organisation. They did not consistently encourage creative approaches to delivering equality of experience, outcomes or quality of life for people. Although the provider told us they were committed to developing the service, and senior leaders met regularly to discuss learning and future development plans, there was no documented evidence of these meetings. There were also no effective processes in place to provide sufficient oversight of the service. As a result, shortfalls were not consistently identified, and there was no clear evidence that continuous improvement was being driven forward.