Live in Care

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 good.

This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

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.

Managers were passionate about delivering high quality care and support and promoted a positive culture. Their approach aimed to achieve good outcomes for people and this vision was cascaded to the carers.

One staff member told us that they felt very confident when they went to a new client. They thought the management team were very professional and very caring towards both the clients and the carers and because of this they felt very reassured and comforted.

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.

The registered manager told us they were trying to get the best out of people [office team and care staff], because they wanted them to grow.

They were also keen to expand their knowledge and they did this through various means, for example by attending events and accessing forums where they networked and learned from other managers.

People and their relatives told us the management team were; “Competent, approachable.”; “Approachable, helpful.” and “Effective.”

The registered manager had the support of the nominated individual who was also the director of the service. They were present in the office daily and met with the registered manager every morning to discuss what went on in the service, as well as attend the bi-weekly management meetings. They were involved in the quality monitoring of the service and provided support to the registered manager who they felt had a good oversight of the service and had faith in them.

The registered manager was aware of their role and legal responsibility to be honest with people when things go wrong and to report any incidents

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

Staff told us they felt able to raise issues with the management team and they were aware of how to report concerns outside of the service. They were contacted by the office team on a regular basis and there was a system in place to ensure staff could contact the management team out of hours.

One staff member told us they can call the office any time and that they are very accommodating.

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.

Diversity and inclusion were encouraged. Where needed reasonable adjustments were made to support staff.

Staff were very complimentary of the management/office team. One staff member told us they felt the support was “really amazing” and that the office team knew all the carers and matched them to people. Other comments from staff included; “I am so happy with this company, [they are] professional to the core” and “They are good, they treat people with dignity, they call everyone every week, [they] try to match the carer which is very important for both [people and staff].”

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. However, some of their governance systems had not been robust enough or robustly operated to identify the concerns we did during the assessment.

These systems were not always effective in identifying the areas of improvement we had during the assessment. For example, following processes set out by the provider's policies, best practice guidance and recommendations and shortfalls in relation to medicines and risk management.

The service had an office/ managerial structure in place with clearly defined roles and responsibilities to provide oversight of the service.

Systems were in place to monitor the quality of care and service provided to people. These included, for example, audits of the care documentation and medicines administration records, reviews of people’s daily records, staff file audits and review of accidents and incidents.

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 service worked in partnership with other professionals and organisations to make sure people received a good standard of care.

A health and social care professional working with the service told us the management team had always been happy to discuss and then embrace the amendments they asked them to make.

The registered manager told us about some of the projects they were involved with to give back to the community, such as fundraising for the local hospice and clothing recycling for charity.

They also told us about providing support to people and relatives by signposting them to various ways they could get funding for care and assistance during such assessments.

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.

The service had a thread of learning and continuous improvement throughout. They had a service improvement plan in place which included actions from quality monitoring systems as well as plans to develop the service and practices.

The management team were very open to receive our feedback throughout the assessment and shared this with the office team so they could all contribute to implementing improvements. The registered manager provided us with an action plan summary at the end of the assessment to tell us how they were planning to act on the areas of improvement we identified.