Karrek Community

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 changed to outstanding. This meant service leadership was exceptional and distinctive. Leaders and the culture they created drove and improved high-quality, person-centred care.

This service scored 89 (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 very clear shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the challenges and the needs of people and their communities.

The directors and managers had a clear vision for the service which focused on providing support for more complex individuals, whose needs were difficult to meet. The service was flexible, responsive and focused on enabling people to live their best lives. This ethos meant the service routinely provided more support than had been commissioned when they had identified a need. For example, the provider had provided, at their own expense, an additional waking night staff member to ensure a person’s safety. This need had been recognised by the multi-disciplinary team supporting the person but not promptly commissioned.

Professionals were constantly complimentary of the support provided by both parts of the service. They recognised staff skills and the service’s dedication to providing individualised care. Professional’s comments included, “Their proactive stance ensures that the service remains adaptable and resilient in meeting the needs of those they support” and “[Karrek] consistently demonstrates a high standard of care that is both responsive and person-centred”.

People who used the service were consistently complimentary of the support they received. Their comments included, “I did complain about my previous care company. I am happy with this company. They have always been exceptionally good” and “Everything about this service is more professional, more caring than anything I’ve had before. It has helped me adjust to major life changes”.

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.

People were complimentary of the service and it’s leadership. They told us, “It is easy to contact the office and things are attended to promptly”, “I’m 100 per cent clear how to contact the office and why I might need to do so” and “I have the impression staff are happy in their role and how they are managed”. Relatives also praised the service’s leadership and commented, “I have always found managers skilled and flexible” and “It’s a very well managed service.”

Staff spoke positively of their leaders, the support they provided and the effectiveness of on call arrangements. Staff comments included, “Our managers, to be honest, are very supportive”, “I would recommend working here, [our manager] is always supportive and on the end of the phone if you need them. They are really easy to speak to” and “The managers reply instantly when we ask things which is good. They ask us to always call”.

The provider’s directors set a clear vision for high-quality, person-centred care and fostered a culture of continuous improvement. They were approachable, engaged positively with operational decision making when requested and supported the business development manager and other leaders effectively. Directors were based in the service’s offices fulltime and supported managers during the inspection process.

Involved professionals were consistently complimentary of the service’s leadership and recognised the service’s willingness to take on packages of support that were complex and difficult to sustain. Professionals told us, “The service and leadership has been excellent in my interactions with them including joint working, communication and information sharing. They have always been responsive and prompt in responding” and “Their manager has always made themself available, is approachable and responsive to queries and questions raised. The manager is actively involved in individual cases and has a good understanding of the clients they support”.

The service did not have a registered manager. This role was being actively advertised and prospective managers had been interviewed but not appointed. This demonstrated the provider was fully committed to recruiting the right person for the role. The provider’s business development manager, who had previous experience as a registered manager, was leading the staff team effectively. All staff reported they were well supported by their managers, whose roles and responsibilities were clearly defined.

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

People knew how to contact managers if they had any concerns. Contact details of the service, including information on the complaints procedure, was available in people’s homes. People told us, “I know the office number”, “It’s clear how to contact the office, they gave lots of information at the start” and “If I wasn’t happy about something I would tell staff, then go to the manager”.

Staff were also able to voice their opinions both during supervision and team meetings and told us, “They listen to our ideas”. Records of staff supervisions and team meetings showed action had been taken and changes made to procedures in response to feedback and suggestions from staff.

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 provider valued the diversity of their work force. The cultural and religious needs of staff were respected and requests for reasonable adjustments to working patterns were looked on favourably.

Staff told us they were treated fairly by their managers, were well supported and encouraged to develop their skills. Their comments included, “My colleagues all seem happy in their roles”, “Staff sickness rates are very low here” and “The managers always ask if you want to step forward. They encourage you to do [additional] training, so I am going to do a diploma qualification. They are really good”. The provider’s managers used staff development plans to support and encourage staff to gain the skills and experience necessary to develop their careers.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

The provider had robust quality assurance and auditing processes designed to drive improvements in performance. Where issues had been identified, these were discussed in regular senior leadership meetings and plans developed to make necessary improvements.

Prior to the inspection these processes had identified that a small number of staff were working excessive hours. Additional monitoring had been introduced, and managers had met with the staff involved to discuss these concerns. Following inspection feedback the provider reviewed and updated their working hours policies and overtime authorisation procedures to ensure staff and people were protected from risks associated with working excessive hours.

The provider had arranged for regular mock inspections to be completed by non-operational staff to assess and monitor performance. Where these processes identified issues, action plans were developed detailing how improvements should be made. These action plans were regularly reviewed by directors to ensure planned actions were completed.

Professional’s feedback on the service’s leadership was consistently positive, valuing the effectiveness of the service’s communication. One professional, who worked regularly with the service, told us, “I cannot praise them enough, and even if there are times when I need to raise any queries they are dealt with immediately and resolved”.

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 service worked in collaboration with health and social care partners to support people to achieve their goals and aspirations. Professional’s were consistently complimentary of the service’s approach and effective communication. Their comments included, “I find them to be very professional”, “I have found them to be proactive in raising issues and concerns and making contact to feedback to us” and “They are quick and efficient at communicating with me.”

There was also strong evidence of collaborative working with families and other stakeholders. This ensured continuity of care and supported positive outcomes for people and their families. Relatives told us, “They are very helpful, reassuring and tell me not to worry. They are always asking us how things are, checking up and reviewing” and “The feedback from the care staff about how [my relative] is when with them, is actually really useful to us. There are lots of nuances to [my relative’s] care, which they do pick up on.” Where informal support arrangements had broken down, the service had engaged positively with professionals to ensure impact on people’s wellbeing were minimised.

Some relatives were unable or unwilling to access the service’s digital recording system. A paper-based system had been developed to enable visiting relatives to review the activities people had engaged with and the support people had received.

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.

Managers and staff were committed to learning from any incidents that occurred. They responded positively and proactively to feedback provided during the inspection process.

People knew how to contact managers and were confident any issues raised would be resolved. Their comments included, “I haven’t had much cause to contact the office. I see it is a well-run service. Now and again someone from the office has checked how the care is working out for me” and “The office have been in touch with me all the time, but nothing has needed sorting out. Everything has gone according to plan, they just put me at ease. I’m confident, if I was unhappy about anything, they’d listen and put it right”.

Professionals recognised the provider’s commitment to improving performance and learning from incidents that occurred. Their comments included, “Feedback is welcomed and acted upon, and there is a culture of openness and transparency”.