Share the Care Limited Office

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 inadequate. 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 governance at 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 shared vision, strategy and culture. 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.

At our last inspection we found that there was not a positive culture within the service. At this inspection we found that this had improved. There was a culture of staff and the provider working together to improve the service. Staff told us there was a culture of collaboration, where people and staff were listened to and communicated with, to help promote learning and improvement. People and relatives described staff as “wonderful” and “cheery,” which helped maintain trust and boost morale.

Not all leaders understood the context in which the provider delivered care, treatment and support. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively, or they did not always do so with integrity, openness and honesty.

At our last inspection we found that leaders were not capable, had not identified concerns or implemented improvements. Since our last inspection the provider had worked with a training consultant and a director of Share the Care to implement improvements. Leaders were committed and approachable, but gaps in capability and oversight meant improvements were not embedded. For example, leaders did not identify that there remained issues with recruitment, medicines management and care plans and risk assessments.

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

At our last inspection we found that people were not always supported to speak up. We found issues were logged within daily notes, but these were not reviewed and so opportunities to identify issues were missed. At this inspection we found that daily notes were monitored by leaders to ensure that these opportunities were not missed. Staff we spoke with were confident to raise concerns when required. People and their relatives told us they could share any concerns they had and they were confident they would be addressed.

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.

At our last inspection we found that there were no system and processes in place to proactively engage and involve staff. At this inspection we found this had improved. The service now promoted inclusion for example, by supporting staff with language barriers. Leaders worked one-to-one with staff struggling to complete care notes, improving clarity and confidence. All staff we spoke with told us they felt they were treated fairly and supported to be the best version of themselves.

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 our last inspection, we found widespread and significant concerns, with a lack of oversight from the provider. At this inspection we found that although some improvements had been made, there were still areas of the service where risks to people had not been identified. For example, care plans were not sufficiently detailed to mitigate risks to people and were not always person centred. Audits completed on medicines had not identified that MAR’s and body maps were not in place for medicated creams. Actions from meetings conducted had not been completed, including chasing training certificates from completed training courses, and therefore the training matrix was not up to date when it was shared with us. Recruitment files had not been reviewed to ensure that all gaps in work history had been addressed.

Although the provider took action to address some of the shortfalls identified during this inspection, their governance systems had not been effective in identifying these shortfalls.

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.

At our last inspection, we found that the provider had not worked in partnership with other organisations to ensure people received joined up care. At this inspection, we found this had improved. Staff liaised with health professionals including district nurses and occupational health professionals. When people needed support to do so, staff contacted GPs or made referrals to other professionals to support people to receive joined up care.

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.

At our last inspection we found that there was a lack of learning and improvement. At this inspection, whilst we found improvements had been made in some areas, there were still areas where improvements were needed. For example, although care plans had been re-written parts of them remained not sufficiently detailed or person centred. These omissions placed people at risk and showed that learning was not consistently embedded. Staff told us, “Its been quite stressful. And as stressful as it has been it been a kick up the bum. We are really working hard [to improve things].”