Great Park Homecare

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 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Leaders and staff described a shared vision and culture based on dignity, choice, inclusion and respect. 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.

The provider had an equality, diversity and human rights policy in place at the time of the assessment which set out the aims and objectives of the service. The registered manager also told us how they worked with staff to ensure there was a shared culture within the service. They said, “Staff do their care certificate, which covers our values. We talk about it in supervisions and what do they feel. Some people might say one thing is the most important thing. We share the document with staff at the induction about dignity, choice, respect etc.” Staff also told us about the values of the service. One person told us, “In the induction they talk about values how we present and conduct ourselves.”

Leaders did not always demonstrate the skills, knowledge and oversight required to identify and address risks within the service. They did not always demonstrate the skills, knowledge, experience or credibility required to lead effectively.

Leaders had not identified or addressed all of the concerns mentioned throughout this report prior to our inspection, and further improvement was required. We also found inconsistencies in record-keeping and risk assessments, including those relating to environmental risks and medicines management. This showed leaders needed to further develop their skills and knowledge to provide effective oversight.

Staff spoke positively about the manager and how well supported they were. One person said, “[registered manager] is passionate about [their] job. Listens to us carers…Great manager and asset to the company. Couldn’t wish for a better care manager.”
 

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Staff told us they felt able to raise concerns with the manager, and felt confident these concerns would be heard and actioned. The provider had a policy in place for speaking up.

The provider demonstrated a commitment to promoting equality, diversity and inclusion across their workforce. Staff described an inclusive and diverse working environment and told us there was a positive culture of kindness within the team. One person said, “I would say everyone is caring and everyone is different. If any need to ask a question we will discuss it or phone the office.”

The registered manager told us how they encouraged all staff to develop within the service. The manager said, “During supervision I will ask if they are interested in any other learning. I have one carer who is like this, within her eLearning platform there is a library. I tell her to go through that and look at anything she is interested in learning or giving her more knowledge, she has done that and has shared it with me.” As a result, there were now dementia and oral care champions. Champion roles had been developed in areas including dementia and oral care to support good practice and learning within the service. Staff were also supported to contact the registered manager for support. The manager told us, “If I haven’t heard from somebody I will check in with them. We do have a WhatsApp group but there are restrictions for this i.e. not sharing anything confidential. I would prioritise [staff] workload as well.”
 

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.

At the time of our visit the provider told us they had recently completed a planned transition to a new system for managing care records. However, we found the provider had not ensured all detailed information was transferred over to the new system. This meant some information was not accessible or sufficient to review, including care plans and risk assessments. Leaders acknowledged that systems were still being developed. As a result, leaders had not identified significant concerns relating to medicines management, recruitment practices, staff competency, care planning and risk assessment. This meant risks to people's health, safety and welfare were not always recognised, monitored or mitigated. This meant staff and leaders could not always access complete and accurate information about people's needs, risks and care, limiting the provider's ability to monitor the quality and safety of care being delivered.

The provider’s business continuity plan did not sufficiently detail what emergency preparedness was in place, and we did not find an action plan was in place to ensure this transition was safe and effective, mitigating potential risks which may arise. This meant we were not assured there were robust arrangements for the availability, integrity and confidentiality of data, records, and data management systems. We were not assured information was used effectively to monitor and improve the quality of care.

The provider did not have robust systems in place to monitor and improve the service. Although the provider had some medicines audits and monitoring processes in place, these had not identified key risks such as staff administering medicines to a person who did not have an eMAR in place, and no PRN protocols in place for people using this medicine. The provider did not demonstrate they completed any formal audits on care plans, recruitment files and training for staff. Although the provider told us they completed annual surveys, there was no evidence to demonstrate they sought and acted on feedback from relevant persons and other persons on the services provided in the carrying on of the regulated activity, for the purposes of continually evaluating and improving such services.

The governance and quality assurance systems in place had not been effective in identifying, assessing or mitigating risks to people. Significant concerns relating to care planning, risk assessment, medicines management, recruitment practices and staff competency had not been recognised or addressed prior to inspection. As a result, the provider could not demonstrate effective oversight of the service or assure themselves that people were receiving consistently safe and effective care. This increased the risk that concerns would remain unidentified and people could be exposed to avoidable harm.
 

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 registered manager told us they regularly interacted with healthcare professionals including GPs, district nurses and occupational therapists. This included arranging reassessments, additional support and equipment, which helped people remain safe and independent in their homes. The registered manager told us how they worked with pharmacies to complete medicines reviews for people using the service.
 

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always actively contribute to safe, effective practice and research.

The provider did not demonstrate they completed audits across all areas of care delivery and management to ensure learning areas were identified and used to drive improvement. The provider told us they completed an annual feedback survey with staff and people. However, we found limited evidence that feedback, including concerns, was analysed or used to improve how the service was managed. The registered manager told us care reviews took place, but there was not always documentary evidence of this. This meant we could not be assured that people were routinely involved in reviewing and shaping their care.