COOCI Associates LLP

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 inspection we rated this key question good. At this inspection the rating has remained good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

The service was in breach of the legal regulation in relation to governance at the service.

This service scored 75 (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 provider promoted a shared vision and direction which was communicated to staff through inductions, supervisions and team meetings. An open and inclusive culture was evident, with staff encouraged to speak up, raise concerns and contribute ideas to improve care and support.

The registered manager demonstrated an open, honest and transparent approach throughout the inspection. They were receptive to feedback, welcomed professional challenge and demonstrated a commitment to learning and continuous improvement. Their leadership approach supported trust and confidence among those involved with the service and helped foster an environment where feedback was valued.

A professional involved with the service described it as a high-quality, well-led and person-centred organisation. They told us they had consistently experienced high standards across the organisation and described case managers as organised, knowledgeable and responsive when supporting people with complex needs. This feedback demonstrated the provider’s values and expectations were reflected in the approach of staff and the support provided to people.

Staff described a culture of continuous learning and improvement. They told us they were encouraged to share feedback, reflect on practice and contribute ideas to improve the service. The provider responded to feedback about training by seeking alternative training providers where improvements were identified and supported staff through peer support meetings, management development and regular communication. Staff commented, “I am invited to team meetings and able to contribute my views and suggestions,” and “The service allows us the autonomy in our roles whilst being in the background to provide support and guidance when needed.”

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

The service was led by an experienced registered manager who had been in post for a number of years and demonstrated an understanding of their responsibilities for the day-to-day management of the service. They were knowledgeable about the needs of people using the service and worked effectively with a wider team of partners to support the delivery of safe, effective and person-centred care. The registered manager was supported by colleagues who provided additional expertise and oversight, contributing to a collaborative approach to service leadership and continuous improvement.

Staff consistently described managers as approachable, knowledgeable and responsive. They told us there was an open-door culture where concerns could be raised and advice sought at any time, including in emergencies. Staff felt leadership promoted effective communication, provided clear guidance and supported them to deliver high-quality, person-centred care. A staff member commented, “I am very proud to work under this company. I have worked for several care providers, but this provider is obviously superior in the excellence they deliver.”

Relatives spoke positively about the management and leadership of the service. They described the service as well managed, professional and responsive, with effective communication and forward planning. One relative told us, "The service is very well managed and professional to my knowledge. They have competent staff and very good record-keeping. I have no concerns." Another relative told us, "General communication is very good. There are good channels of communication established at an early stage, and this has been maintained ever since. The agency is always available to be contacted if required." They said, "The agency seems to be very well managed. They anticipate problems and come up with solutions before any significant issues arise. Their planning strategies often look several years ahead. They seem to have extensive and significant experience in their sector, which enables them to provide the best possible healthcare for the people they support."

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

The provider had a whistleblowing and complaints policy in place. Information about how to raise concerns was accessible to staff, including pictorial guidance displayed on the office notice board.

Staff were supported to raise concerns through supervision and team meetings, which provided opportunities for open discussion and escalation of concerns. Staff told us they felt confident raising concerns with managers and understood how to use the provider's whistleblowing procedures if required. They said concerns would be listened to and acted upon appropriately. Staff described being encouraged to contribute their views through regular communication and team meetings.

People using the service and their relatives were supported to raise concerns and share feedback through established feedback mechanisms, including spot checks and surveys. Opportunities were available during multidisciplinary team meetings and care reviews for people to express their views and raise concerns about their care and support.

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.

Systems were in place to promote workforce equality, diversity and inclusion. Staff had access to equality, diversity and inclusion training, supported by policies which promoted an inclusive working environment. Staff’s religious, cultural and individual needs were recognised and supported an inclusive working environment.

The provider did have clear responsibilities, roles, systems of accountability. However, governance systems were not always fully effective in ensuring quality and accuracy of records, and consistent identification of areas for improvement.

A programme of audits was in place covering key areas including recruitment, care records, medicines management and risk assessments. However, governance systems were not sufficiently effective in identifying and addressing gaps in practice.

Staff training was not included within the audit schedule and compliance with the Mental Capacity Act 2005 was not reviewed as part of care plan audits. Audit processes had not identified gaps within care records relating to the assessment and management of individual risks or mental capacity documentation. Medicines management audits had not identified practice was not consistently aligned with the provider’s own medicines management policy. Recruitment audits had not identified shortfalls found within recruitment records, and oversight of staff training was not sufficiently robust to ensure all completed training was recorded and evidenced.

This meant the provider’s governance systems did not provide effective oversight and assurance, key processes, records and policies were being consistently implemented across the service. Following feedback, the provider was responsive and took action to strengthen auditing and monitoring arrangements.

The registered manager was aware of their responsibilities in relation to notifying us of events they are required too. They presented as open, honest and transparent and was compliant with the requirements of the duty of candour regulation.

The provider clearly understood and carried out their duty to collaborate and worked in partnership, and services worked seamlessly for people. They always shared information and learning with partners and collaborated for improvement.

The provider demonstrated highly effective and consistent partnership working with a range of health and social care professionals involved in people’s care. From the point of initial assessment and throughout their involvement with the service, case managers worked proactively with multidisciplinary teams to coordinate complex care, share professional expertise and ensure recommendations were implemented in a timely way. This collaborative approach enabled the coordinated management of people’s complex care needs, with professional input contributing to decision making and day to day support.

Staff described effective partnership working with health and social care professionals involved in people's care. They gave examples of working collaboratively with therapists, community teams and specialist nurses to implement clinical recommendations, develop personalised programmes of care and ensure changes to people's needs were communicated and consistently implemented by the wider staff team. A staff member commented, “We work closely with health and social care professionals involved in people’s care to ensure they receive safe, consistent and effective care.”

Feedback from external professionals was consistently positive, with particular reference to effective joint working and the providers ability to manage complex care. Professionals told us the service was their preferred case management provider, highlighting the team’s effective communication and collaborative working with families, therapists, support teams, solicitors and other professionals. They said case managers coordinated complex rehabilitation programmes, actively facilitated multidisciplinary working, and enabled professionals to work towards shared rehabilitation goals supporting positive outcomes for people.

The provider’s collaborative approach was valued by external professionals and supported effective joint working to meet people’s complex and changing needs.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

Systems were in place to support learning, improvement and innovation. Staff engaged in reflective practice reviews, which supported learning from individual work with people and promoted on going reflective practice.

Accident, incidents, safeguarding’s, notifications and complaints were reviewed at monthly provider meetings. This provided oversight of key areas of risk and concerns, identified themes and informed organisational learning and improvement. Learning identified through these processes were shared with staff through team meetings, supporting their understanding and driving improvement in their practice.

Meeting minutes showed the provider remained up to date with relevant guidance, legislation and best practice guidance to support ongoing improvement of the service.

The provider was responsive to feedback provided during the inspection and took prompt action to begin addressing identified areas for improvement. Whilst some changes were in the early stages of implementation, their approach demonstrated a commitment to learning, continuous improvement, and strengthening the quality of the service.