Capital Staffing Services Ltd

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 assessment the rating has changed to requires improvement. This meant the management and leadership did not always provide consistent oversight to 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 62 (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.

Staff and professionals described leaders as visible, committed and engaged in care delivery. One member of staff told us, “The overall vision is to support people with complex care needs to stay at home with their family as long as possible. We are there to support the family, ensure the clinical care is being done and allow the family to get some rest.” Senior managers demonstrated a strong understanding of the complexities of people’s needs and worked closely with families and commissioning partners. Parents reported senior leaders were approachable and responsive, reflecting a culture focused on openness and collaboration.

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.

People and relatives, staff and external professionals consistently praised the registered manager, clinical lead and CEO. External partners noted the leadership team had recently “improved” systems and oversight and commented positively on the provider’s ability to manage people’s clinical care effectively.

Leaders were in close contact with people and their representatives and demonstrated detailed knowledge of each person’s care. Staff told us senior leaders supported them and treated them with kindness and compassion.

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

Staff told us they felt comfortable raising issues and were aware of whistleblowing processes. One member of staff told us, “We get opportunities to raise issues or concerns. They take things on board and try to resolve things.” Parents also confirmed they could raise concerns freely and that managers responded quickly and constructively.

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 came from a diverse range of cultural backgrounds, and families reported staff treated them respectfully and understood their cultural needs. There were no concerns raised about discrimination, and evidence showed staff supported people in line with their protected characteristics and cultural practices. Staff also described leaders as fair, approachable and supportive.

Despite positive feedback from people, relatives and external partners, the provider did not always have robust systems and processes of good governance and oversight.

The system of audits and checks of records were not always sufficient or effective. Audits of care and medicine records covered only two people each month, which was insufficient given the nature of the care being delivered and the scale of risk in the service. Medicine and care record audits did not detect the out-of-date information and gaps in MARs and daily records we found. The provider had not conducted an audit of staff files so had not identified the incomplete employment histories for some staff.

The provider was also not fulfilling their legal responsibility to maintain up-to-date and accurate records of each person’s care. We were unable to view one person’s care and medicines records as they were kept in the person’s home, and no copies were held by the provider.

The issues with governance created risks to safety, consistency and the provider’s ability to assure ongoing quality and oversight.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information with partners and collaborated for improvement.

External partners praised the provider’s collaboration, describing communication as regular, responsive and helpful. Professionals confirmed the provider worked proactively with them on risk management and safeguarding demonstrating strong partnership working. One external partner told us, “Capital is the only agency we use to support medically complex children and young people. They are quick to implement care and always fulfil shifts. They are very much involved in our approach to child protection.”

The provider did not always focus on continuous learning, innovation and improvement. The provider’s improvement plan policy stated, ‘regular audits are a vital tool in the continual drive for improvement.’ However, we did not find the systems of audits was achieving this stated aim. Although leaders took steps to address issues once identified these actions were reactive. Persistent gaps in documentation, lack of robust auditing and failure to identify issues with quality showed learning systems were not always effective.

Some processes in place to gather feedback were not always effective. The provider had recently conducted a satisfaction survey; however, they received very few responses. People told us senior managers were in regular contact, however there were no record of the feedback gathered from informal conversations which would help identify trends and themes and drive improvements.