Farecare Gloucestershire 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 Requires Improvement. At this assessment the rating has remained Requires Improvement.

This meant the service 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 governance at the service and safe recruitment.

This service scored 43 (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 management team did not share with staff a clear vision of how the service was to be managed. They had not implemented a set of values and systems for staff to work towards or ensured all staff worked in a person-centred way. However, staff were positive about the new manager. One staff member told us, “Everything is about teamwork. It's a happy place to work. It's the nicest place I've ever worked. Everyone is welcoming. Since I walked in the door it's just been so nice.” The manager told us, “Things have been difficult for the staff, there have been a lot of changes. But I think everyone is really coming on board now, and we can see things are starting to improve.”

The service 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.Feedback from staff on the management team were positive. One staff member told us, “They are really helpful and provide support. I was worried this wouldn’t carry on when the new manager started.” However, the management team lacked the appropriate skills and knowledge required for their roles. The manager and NI were not familiar with policies and procedures, and they had not had their competencies assessed in areas such as medicines. The service did not have a registered manager at the time of the inspection. Person-centred care and support were not consistently recorded and therefore could not be evidenced as a priority for the service.

People and relatives told us they felt they could speak to staff and the manager about any concerns. Staff told us they could speak to the leadership team if they needed to, however they acknowledged due to office staff having familial or friendship connections, they were not always assured of impartiality. We found the manager and senior team were not aware of their policy on Whistleblowing or of their responsibilities under best practice guidelines and regulations. The manager was not aware of the Public Interest Disclosure Act , which is a UK law that protects workers (including employees) from unfair treatment or dismissal for raising concerns about potential wrongdoing in their workplace.

The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

Staff told us they were happy with how their rotas were managed and they had enough days off, which was evidenced in the call logs. One staff member told us, “[The manager] is really approachable. I give my availability from month to month as I look after grandchildren, I message the office, and they sort this so I can work when it suits me.” Staff told us they were paid for their travel time.

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 manager did not fully understand their role in relation to sending statutory notifications to CQC. The provider did not have clear systems for workforce planning. Training records, development plans and recruitment records had missing information, and this was not identified through the provider’s quality monitoring systems. The manager and NI were not aware of the action plans submitted to CQC following the previous inspection, meaning they were not able to evidence they understood the previous breaches of regulation and were not evidencing how improvements were being made and sustained. The provider did not always have systems in place, and these were not always operated effectively to monitor, assess and improve the quality of service they provided. Accurate, complete and contemporaneous records in respect of each person's risks and the management of the regulated activity were not always maintained. This was a continued breach of the regulation for good governance.

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.

People were supported to stay involved in their communities. Partner agencies gave positive feedback on their contact with the service since the new manager started in post.

The service 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.Relatives told us they had confidence in the staff and new manager. One relative told us, “We were invited to a staff party to speak to the management team … Just to emphasise that the whole team with our family have been absolutely brilliant, I could not ask for a better service. My [relative] considers most of them friends. It is so reassuring to know that [they] are in good hands.” One staff member shared the improvements they had noted, “I was about to leave with the old manager, no gaps between the calls working 6 days a week. Now it is so different and feels like a family, I don't fear coming in to work”. The manager was open and honest with inspectors about the shortfalls we found and was committed to working hard to improve their systems. The manager told us, “I love this company and feel so passionate about the care we provide. We want nothing but the best for people and our staff. I know there’s a lot of work to do, but I’m not going anywhere.” However, we found improvements made from the last inspection had not been sustained and the new manager had not kept up with systems and processes which had previously been in place, for example quality monitoring systems and care plan reviews. The service had been in breach of regulations for 3 consecutive inspections. Despite the positive feedback received from people, staff and relatives, the service was issued a warning notice and put into special measures for continued breaches of regulation.