The Business Centre

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 remained unchanged. The service was in breach of legal regulation in relation to good governance.

This service scored 46 (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 always have a clear shared vision, strategy and culture. The management team held regular staff meetings to discuss the expectations of the service and any improvements needed. However, these were not always recorded effectively about the actions taken and did not record staff voice. Staff told us they received regular supervisions, but the provider did not collect staff views through annual surveys. This meant the provider may miss opportunities to drive improvements from staff ideas and suggestions. The registered manager told us they attended bimonthly management forums and social media groups in their local area where they share information with other registered managers about good leadership and governance.

Not all leaders understood the context in which the provider delivered care, treatment and support. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively. The providers processes were not always effective in driving improvements so we could not be assured the leadership were capable in their oversight of the quality and safety of the care being provided. People and relatives told us they knew who the registered manager and leaders were. One person told us, “The office staff are always helpful. Now and then they come out and see us, check everything is ok”. All staff spoke positively about managers and leaders, comments included, “They are lovely, and very supportive” and “Management are lovely, I get on well with them, I can tell them about any problems”. The management were inclusive leaders who worked alongside staff to provide care and support to people

People and relatives told us they would share any concerns or changes with the registered manager and leaders. However, not all people and relatives said they felt listened too. For example, 1 person said they had requested a call time change, but the provider was unable to give them a regular time. Another person said if they requested an earlier time, they would need to cancel their call. A relative told us they had raised some concerns with the management team and felt their relationship has deteriorated because of this.Staff told us they felt confident sharing concerns to managers and leaders, and they would be listened to and acted upon. The provider had a whistleblowing policy in place.

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 service promoted an inclusive and fair culture, and all staff we spoke with told us they were treated equally and were happy to work as a team. They told us there was good teamwork. Leaders provided drivers to take some staff to and from shifts. One staff member told us “If you are running late or if it is dark, you can have a lift between calls”. Staff had received training in equality and diversity, however the service policy cited another care agency throughout, so we could not be assured the policy was relevant to The Business Centre. The provider was unable to explain the reason for this.

The provider did not have clear responsibilities, roles, systems of accountability and good governance. They did not act on the best information about risk, performance and outcomes, or share this securely with others when appropriate. The provider failed to ensure the management team maintained effective oversight of the Electronic Call Monitoring system. They did not have appropriate policies and procedures in place to maintain and manage the system. This meant we could not be assured alerts were received or responded to or if it identified when a staff member had not attended a call. The provider did not have effective oversight of carer allocation where we found carers were logged into locations simultaneously and had not identified when carers did not stay at their allocated calls for the specified duration. For example, we saw a person had a planned call time for 10-12pm. The call for the person stated “carer required” on the data we received. This had not been identified through internal audits and there was no evidence the call had been attended. This placed people at risk of harm. We discussed this with the provider to ensure immediate action was taken.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners. We received limited feedback from external health professionals. One health professional told us the service collaborates well and share’s information appropriately once staff are aware they are involved. However, they described staff implementation of actions as variable, sometimes advice had been actioned and followed, and other times it had not. The registered manager told us they work in partnership with district nurses, social workers, the reablement team and dieticians. There was evidence of this is people’s care plans.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always actively contribute to safe and effective practice. Some areas of improvement had not been identified through the management spot checks, audits or processes. These audits were not always effective in highlighting shortfalls and driving improvements at the service. The service’s Electronic Call Monitoring (ECM) system was not operating effectively to ensure staff were allocated appropriately and we were not assured actions had been taken where there had been risks identified. This is the fourth consecutive assessment where improvements have been required in the key question well led.