Bosun Care 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 of the provider’s previous registered location, 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 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.

The nominated individual, registered manager and senior managers were compassionate and dedicated to drive improvement across the service. Each supported living household was supported by service managers who provided hands on support and guided staff as needed. The registered manager and deputy manager said they had increased their presence in each home to offer people and staff more guidance and support. A director of quality improvement had been employed to help manage and monitor the quality of the service and oversee any significant incidents. The provider had created an internal multidisciplinary team to help guide and steer staff in implementing individual care strategies for people.

The provider had a number of schemes to support staff well-being and to recognise staff’s hard work. Managers had been nominated for various prestigious business awards in the health and social care sector.

Not all leaders understood the context in which the provider delivered care, treatment and support.

At our last inspection, we recommended the provider considered current guidance on supporting people with a learning disability or autism; however, we found this had not been implemented at this inspection. Whilst leaders embodied the culture and values of their workforce and organisation; they had not fully understood and embedded an inclusive culture in line with Right Support, Right Care, Right Culture and other related national guidance.

The management team we spoke with were passionate about delivering person-centred, quality care and to make improvements across the service; however, they acknowledged more work was needed to evidence sustained and consistent improvement.

The registered manager and management team had completed a wide range of training and had progressed in developing a comprehensive structure to have better oversight of the people who were supported by the service. They were aware of their role and responsibilities and had sought external advice and support as needed.

Staff spoke positively about the management team and their approach. For example, a staff member told us, “Yes, they have a listening ear. If I am unhappy with a manager we can go to a more senior manager. I have not had anything thing happen, but I know they would listen and investigate and have a conversation with us.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Staff said they felt confident in raising any concerns with the management team and felt they would be listened to. A whistleblowing policy and procedures were in place for staff to follow. Meetings were held to enable staff and managers to raise and discuss any concerns and share good practices.

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. Feedback from staff during this assessment indicated they felt supported. Staff told us they could speak to their service manager and felt they were treated equally.

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.

Improvement was needed in the governance and management oversight of the service and record keeping. The senior managers had positive relationships with each supported living household and frequently visited to carry out checks and reviewed the in-service audits. However, we identified the provider’s monitoring systems and processes had not always been effective and required improvement to ensure the registered manager had clear oversight of the quality and safety of people who were supported by the service.

We were not fully assured by the provider’s systems to investigate incidents, implement necessary actions and learnings, and notify the CQC when required.

The registered manager and staff were not working in line with the Right Support, Right Care, Right Culture guidance and other related national guidance for supported living services. The provider had not always ensured people’s care records were reflective of their holistic support needs and the support provided was not always person-centred and based on people’s choices, human rights and preferences. Records of people’s support and care needs were extensive but not always personalised to people’s individual risks. There was limited evidence people had been supported to live a life of their choice, were working towards their personal goals and had been supported to access routine and specialised health checks and annual health and medicine reviews. This meant people were at risk of not having their human rights upheld.

The provider’s oversight and records of staff training, recruitment, support and development needed to improve to demonstrate people were supported by qualified, competent staff who had been recruited safely.

Records relating to the planning and delivery of people’s care and the management of the service were not always contemporaneous and detailed. The provider has not ensured safe medicines managements systems were in place.

The provider informed us they are planning to review and update their policies and enhance their digital care management system for improved governance reporting and oversight of the service. Following our assessment, the managers have developed an action plan to track progress against improvements needed. However further time was needed to ensure all actions were embedded and effective in improving people’s lives and outcomes.

The provider did not always understand their duty to collaborate and work in partnership, so services worked seamlessly for people. They did not always share information and learning with partners or collaborate for improvement. We received mixed feedback from healthcare professionals and stake holders about the engagement of managers. Whilst some professionals said staff worked well with them and they implemented their recommendations; other stakeholders had felt their recommendations had not been acted on and there had been reluctance on occasions amongst managers to engage with them.

However, we were aware the registered manager had made referrals to relevant services when people’s unmet needs or new emerging risks had been identified.

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, outcomes and quality of life for people. They did not always actively contribute to safe, effective practice and research.

Further work was needed to evidence learning and improvements from accidents and incidents. Whilst the registered manager provided several examples of how the service had learnt from significant incidents, there was limited evidence how learnings from all of these had improved the outcomes for people across the service to promote safe and effective practices. Following our assessment, the registered manager and the provider’s representatives reflected on our feedback and their own assessment of the service and had started to work on actions and measures to improve the service.