Archived: Dependable Care 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 assessment we rated this key question requires improvement. At this assessment the rating has changed to inadequate.

This meant there were widespread and significant shortfalls in leadership. Leaders and the culture they created did not assure the delivery of high-quality care.

The service was in breach of the legal regulations in relation to good governance.

This service scored 29 (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 did not have a shared vision, strategy and culture based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not understand the challenges and the needs of people and their communities.

The provider did not provide any documentation with information on their vision and strategy for the service. Staff were unable to share any visions or cultural expectations for the service.

The provider had not identified the risks of a closed culture within the service. A "closed culture" is a poor culture that can lead to harm, including human rights breaches and abuse.

The provider did not have inclusive leaders at all levels who understood the context in which they delivered care, treatment and support, or who embodied the culture and values of their workforce and organisation. Leaders did not have the skills, knowledge, experience and credibility to lead effectively, and they did not do so with integrity, openness and honesty.

There was no registered manager at the service and the provider had not ensured effective leadership was in place since the previous registered manger left the service 4 months before our inspection. The provider informed us an a temporary manager was in place from an agency, however, this person was not available during or after our inspection and the provider was unable to confirm this person was suitable for a leadership role.

The provider or temporary manager had not identified the concerns identified throughout this inspection report which showed a lack of skill to manage the service effectively.

People and staff did not always know how to speak up.

At the time of our inspection, there was no named leader available for staff or people to escalate any safety or quality concerns with. The named temporary manager was not at work during the inspection and staff and people had not been made aware of this. Staff supervisions were not being completed which meant staff did not have the opportunity to formally raise concerns through the supervision process.

No freedom to speak up policy was in place or shared with us during or after the inspection period.

The provider did not value diversity in their workforce. They did not always work towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The provider failed to ensure they had oversight of how staff work was allocated. The provider told us they did not get involved with the rotas and this was being completed by an agency staff member who was not available at the time of the inspection. Leaders told us they had not been able to offer equal opportunities to male staff based on people’s preferences. For example, when speaking with a male staff member, they told us they had not received work from the provider for a number of months but would like the opportunity to do so in the future.

In the absence of a registered manager, the provider could not demonstrate they had been offering supervision to staff to provide them with an opportunity to raise, discuss and address any concerns relating to their work.

The provider did not have clear responsibilities, roles, systems of accountability and good governance. They did not use the systems that were in place to identify potential risk, preventing them from proactively addressing and mitigating risks to people and staff.

The provider did not have a registered manager at the time of the inspection, and the Nominated Individual told us they were managing the service whilst there was no registered manager in post. However, when asked questions regarding the service or the people they supported, they were unable to give us detailed answers in relation to the people they were providing care too, how care was provided and the systems and processes in place to ensure high quality care was provided. Following the inspection, we requested reassurances around this, in particular the information and records which the provider was unable to share during the visit, however information was not shared.

The provider failed to ensure effective governance systems were in place across all aspects of the service. The provider failed to ensure effective audits were carried out to identify the risks we found during the assessment. We found a lack of person-centred care guidance; limited recruitment checks with missing information on the suitability and safety of the staff working for the service and a lack of effective training and support for staff. The provider was unable to evidence they were aware of any of these issues because effective audit processes were not in place/or were not being followed.

Leaders told us care provision was monitored by an agency staff member who was reported to be on annual leave, the provider was unable to evidence that care provision was being actively monitored at the time of our inspection, placing people at risk of harm.

No effective business contingency plan was in place taking into consideration the absence of individuals normally tasked with call monitoring and care provision. This meant people and staff did not have access to a competent person to raise concerns with regarding their care.

The provider had not understood their legal responsibilities as a provider in relation to notifying the commission of changes. When we attempted to contact the provider to announce the inspection the contact details we had been given were not correct. When contact was made, the nominated individual told us they no longer had access to their registered email address and a new phone number and email address were in use. We advised the provider they were responsible to ensure this information was kept up to date and this needed urgently changing which was completed the following day.

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. For example, the provider had not maintained accurate and up to date care records. This meant information shared with the local authority would not be accurate and up to date. The provider could not demonstrate they had been proactive to contact other health professionals in relation to people’s health needs if required.

At the time of the inspection the local authority informed us they were not commissioning with the service, therefore they were unable to share feedback about the service.

The provider did not provide evidence they focused on continuous learning, innovation and improvement across the organisation and local system. Systems and processes in place at the time of the inspection were not being used and therefore no information was available to staff and leaders to effectively identify areas where improvements could be made. Where this information had been collected, opportunities for improvement had been missed, for example, when people were documented to have been showing signs of emotional distress, no action was taken to identify the causes and find a solution to support that person.

A staff member we spoke with told us they felt they needed more training, and this was highlighted within the training matrix which showed that people were not up to date with their training. Although the information was available to leaders, this had not been used to improve staff training compliance.

Although the provider was actively registered to provide care for people with learning disabilities, none of the staff had received learning disability awareness training. This meant the provider had not worked proactively to ensure the staff were suitably trained should they provide care and support to autistic people and/or people with a learning disability as this is stated as a service specialism on the provider’s CQC statement of purpose. A statement of purpose is where a provider tells us about the service they provide and who they provide it to.