Accolade Support and Care 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 assessment we rated this key question Good. At this assessment 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.

However, the service was in breach of legal regulation in relation to submitting notifications of other incidents in relation to safeguarding and serious injury events as required in line with their registration requirements.

This service scored 71 (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 leaders demonstrated a positive, compassionate and inclusive culture that promoted trust and understanding between them and the people using the service. One health and social care professional told us, “I think they are exceptional and are one of a small handful of providers in the county I’d be confident of in looking after a loved one. This is an excellent provider in my professional opinion. I wouldn’t hesitate in recommending them.”

The provider set out cultural expectations and values from the initial staff induction, and we saw this was reinforced in staff guides and meeting minutes which kept this at the forefront of staff practice.

All staff we spoke with told us the culture was positive and they felt the leadership was open and fair. Staff told us, “I enjoy working for Accolade because the level of person-centred care that is given and I feel they go above and beyond duty of care for clients. Also, they care about us as their employees. They take time to listen to what you have to say, and the office door is always open if you need to talk. they are very supporting” and “It’s a positive team, close team, we all come together in meetings. You have different personalities and that is expected. We see them a lot. Open door always here.”

We received positive feedback from health and social care professionals about the service stating, “I just think of them as a high-quality care agency. I honestly don't have a negative or a could do better experience to offer you to date” and “Contact fluctuates between weekly and monthly dependent of circumstances, but we have a highly respectful, working relationship.”

The provider had exceptionally 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 always did so with integrity, openness and honesty.

There was a strong and capable leadership within the service that embedded positive values attitudes and behaviours throughout the staff team and care provided. The registered manager was supported by a deputy manager and office team. The registered manager had completed an office structure roles and responsibilities audit to review and update the office teams areas of responsibilities and encourage better ways of working. One staff member told us, “I enjoy how management always supports growth in care knowledge and professionalism.”

The registered manager took time to ensure they updated their own skills and knowledge through attending workshops, partnership meetings and completing care shifts. The registered manager told us that the management team had recently signed up to complete level 3 safeguarding training and further commented, “I am signed up to Gloucestershire County Council newsletters, Met Office weather alerts, Skills for Care updates, and Proud to Care, through which we receive training opportunities. Relevant information and training updates are regularly shared with the team.”

People and their relatives told us the service was well managed commenting, “Yes it’s well managed and I can speak with the manager anytime”, “[registered manager] is the boss, and she comes over as a very caring person, she does have empathy and she likes things done properly. I’ve always been quite impressed with how they run things” and “Communication is good and [registered manager] keeps an eye on things.”

Staff spoke highly of the registered manager and the leadership of the service commenting, “The management is really amazing they do give a listening ear to staff we do get adequate training, personal protective equipment and everything that we need to provide first class care” and “My line manager is very approachable and does listen to me and if she was not available, I could speak to any of the other managers with every confidence that they would listen to me.”

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

Staff were aware of whistleblowing procedures and knew how to share any concerns. The registered manager told us that staff were given the whistleblowing policy and encouraged to follow this if needed.

Staff told us they felt confident to do this and that they would be listened to. They said comments such as, “My line manager is the guardian so I can speak to her privately and we will write concerns in writing if they are serious and they will be reviewed” and “I usually go to my line manager with everything. If I had an issue with them there is another lady in the office that we can go to and raise things with.”

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.

The staff team was diverse with a good mix of experience and skills. Staff had good opportunities to learn and progress within the service and there is support for upskilling and taking on different roles and areas of interest. The provider employed some staff members from overseas via sponsored visas and had provided additional support where needed to these staff. The registered manager told us, “I want to always be fair to everyone. A lot of staff are on healthcare visas, but we are one team. We provide a lot of support when they come.”

Staff told us they felt valued and had equal and fair opportunities within the service commenting, “I just finished my [higher qualification] which was sponsored by Accolade and equality training was part of this. We have to report any discrimination immediately and raise it confidentially so only the manager knows.” and “I’m offered opportunities to grow within the organisation and make a difference in the lives of all our care recipients.”

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.

We found there had been an inconsistent approach in notifying CQC of any significant incidents. We found 9 notifications comprising of 7 safeguarding’s, 1 death and 1 serious injury notification over the last 12 months that had not been reported to CQC in line with the providers legal regulatory requirements. Although incidents have been managed and investigated appropriately, they had not been reported to CQC in line with legal requirements. The provider told us this had been an oversight; however, this had not been identified in any monthly audits. Due to this, the service was in breach of the regulation relating to notifications of other incidents. The provider was transparent during this inspection and told us they would put robust checks in place to ensure going forward appropriate notifications would be submitted.

There had been a period of staff changes and restructuring within the office team and systems which had impacted on completing some of the provider’s governance processes. We saw that medicines audits had not been undertaken during this time. The registered manager acted on our feedback during the inspection and completed a comprehensive medicines audit which they shared with us. We saw that any areas requiring improvement had been clearly outlined and actions to address these areas put in place. In addition, the online system had been updated to enable monthly monitoring and audits to be captured going forward. There had been no impact to people as a result of this during this time. The registered manager told us, “Following the changes to our office structure last year, I recognise that the associated pressures impacted my ability to maintain the level of oversight expected. However, I want to reassure you that I am now fully focused on strengthening governance and driving improvements.”

All other quality monitoring of the service was in place and completed regularly. There was a team approach to monitoring areas of the service shared between the registered manager, deputy manager and a team of office staff. Office meetings were held to review any outcomes and ensure the service remained on track for any actions to be completed.

The registered manager shared a new tool they had implemented which planned goals for the three months and revisited the progress of these. The registered manager told us, “We have a review scheduled to review the goals we set in place and how this has gone. Not just myself doing audits, it’s who is more responsible in that area, so one person does the audits for training and recruitment and we support. We all have our areas.”

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.

The provider was involved in their local community and regularly took part and sponsored events that needed support. This included fundraising for local sports teams which people using the service took part in and supporting charities in honour of people using the service.

The Registered Manager and Deputy Manager had also developed links with a holistic centre to increase opportunities for people within the service to attend suitable and accessible activities should they wish to partake.

Good relationships had been established with other professionals, some of whom gave highly regarded feedback about the service and staff team. One health care professional stated, “[Registered manager] is always very helpful and is already informed about any of the cases I'm involved with, so I don't have to explain much context if I speak with her.”

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.

Throughout the inspection process, the registered manager demonstrated a commitment to getting things right and a willingness to learn. From a recent Local Authority assessment, they had embraced the improvements recognised and were working to implement these and during inspection feedback they were open and transparent about areas of improvement needed.

Time had been spent restructuring the office team and strengthening roles to ensure stability within the service. The registered manager was candid about the previous year, which had been challenging and had impacted on the running of the service. Time had been spent supporting staff into new roles and adjusting to these changes, but the team was now in a good place to address areas of improvement and grow moving forward.

People and their relatives told us they would all recommend the service and could not draw on much to be improved. People told us, “They are caring and very nice with (relative) and they leave everything clean and tidy”, “I would definitely recommend the service, I feel they’re great. They keep to regular girls every day and they’re prompt on time” and “They’re a huge improvement on the other ones we had, and Accolade haven’t failed in anything and are very reliable.”