Desire Care - Burton

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 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 of the service.

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.

The provider had a vision and aimed to promote a positive culture; however, this was not always consistently embedded in practice. As a result, elements such as transparency, equality, inclusion and engagement were still developing, and leaders did not always have a full understanding of, or consistently respond to, the needs and challenges of people and their communities.

The provider’s systems were not always robust enough to ensure accurate and timely updates were made to people’s documentation for staff to follow.

Leaders were visible, approachable and supportive, and helped ensure staff understood and carried out their roles. However, improvements were needed to strengthen leaders’ oversight and understanding of the service being delivered.

Some new systems had been put in place following the previous inspection. However, these still needed improving through the identification of risks and actions to address these to consistently drive improvements in people’s care.

Additional audits and spot checks supported management around staff competencies and supervisions enabled staff to raise any areas for additional support. Staff would then receive additional training if this was identified, however, this had not always been embedded in practice.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

People, relatives and staff spoke positively about the culture of openness within the service. They told us they felt able to raise concerns, were confident they would be listened to, and that appropriate action would be taken in response. One person told us, “My concerns were taken seriously and addressed.”

A staff member told us how leaders encouraged staff to speak up, “By being approachable, listening, and encouraging open communication.”

We found staff were given the opportunity to speak up in staff meetings.

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

Staff we contacted told us they generally felt positive about the way they were supported in their roles by management. A staff member told us, “I feel appreciated when managers acknowledge good work or give positive feedback.” Another staff member commented, “I generally feel treated fairly, and the office supports my professional development. I was recently encouraged to enrol in [a training course] to further my skills.”

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

The lack of robust governance systems and accurate records increased the risk of inconsistent care, particularly when unfamiliar staff were providing support to people. It also limited the provider’s ability to evidence monitoring and continuous improvement. Some audits identified areas of improvement and actions were taken; however, as errors continued, learning was not always embedded and therefore systems were not always effective.

People’s care documentation was not updated in a timely manner, and systems in place to address this were not robust in resolving this in a timely manner. This meant there was a risk to people as there was a lack of specific support plans where risk was identified and care plans to support staff around specific health conditions.

People had not been impacted by this at the time of our inspection and told us they were satisfied with their care. One person told us, “I’m very happy with the care I get.” Another person told us, “It’s the longest company I have been with, so must be good.”

The provider demonstrated an understanding of the importance of partnership working to support joined-up care. They worked collaboratively with a range of health and social care professionals to help ensure people’s needs were consistently reviewed and met.

The provider had developed positive working relationships with external professionals, supporting coordinated care. Records showed relevant information was shared and concerns about people’s health were responded to. However, people’s health needs were not always consistently reflected in care plans, meaning guidance for staff was not always in place to support agreed actions and outcomes.

Staff told us they worked in partnership with a range of health and social care professionals and this supported people to get the appropriate care when needed. Staff told us they were kept updated about changes in people’s needs. One staff member commented, “Working closely with externalprofessionals helps ensure people receive joined up care and the right support at the right time.”

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not always actively contribute to safe, effective practice and research.

Auditing and monitoring systems were not robust enough to identify trends, learn from incidents, or drive improvement, limiting a proactive approach across the service.

Governance arrangements did not provide clear oversight, and we were not assured audits were effective in supporting learning, improvement and innovation.

The provider implemented an action plan following the inspection visit and feedback and was responsive to issues raised when we highlighted them. However, many of the areas of concern were raised at the previous inspection and therefore learning had not been embedded.

People could provide feedback through regular questionnaires, which were analysed and actioned. Most responses were positive, and where concerns were identified, appropriate steps were taken, including reviewing care and updating staff.