Quality Support Solutions Limited

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 75 (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. People and their relatives felt listened to by the service. Everyone we spoke with felt their views were encouraged, valued and respected. The staff training, supervision and support systems fully enabled staff to progress within their roles, and to achieve their full potential. Staff were motivated and proud of the service and we found there was a positive culture where people and staff described using or working at the service as being part of a family.

The registered manager was visible and accessible for staff to seek advice and guidance. Many people told us the registered manager often provided their care, and they shared the latest news regarding the service. Staff told us the registered manager was fair, had an ‘open door’ policy and they created a positive working culture to drive continual learning and improvement. There were regular updates for staff through staff through meetings, 1-1 meetings, emails and newsletters. Staff completed mandatory training sessions to understand the vision and values of the service and how their roles contributed to achieving them.

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.

People told us they knew who the registered manager was as they often provided their care. One person said, “The manager is lovely. They often come and help me. I think that’s a sign of a good manager. They get to know what the issues are by being on the ground.” Staff praised the provider who was also the registered manager. They spoke positively about the support they received. One staff member told us, “[Manager] is really supportive and always willing to help out with the care. I think they are professional, very fair and supportive of all the staff.”

Staff told us they had team meetings, as well as 1-2-1 support and supervisions, which provided opportunities for discussing any issues with the service and how to make improvements. Relatives were also positive about the management and told us they were confident should they need to raise any concerns action would be taken.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. The registered manager promoted an open and transparent culture. They encouraged staff to raise issues and concerns so these could be known and addressed. Staff were confident they could always speak up when they needed to and felt listened to and supported. One staff member said, “I would feel very comfortable raising any concerns.”

The provider had appropriate policies and procedures in place to support and promote staff raising issues. The registered manager investigated concerns in a sensitive and timely manner. They identified and acted on lessons from these to continue to improve the service.

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. Staff used a WhatsApp group to communicate, where for example, they wished each other happy birthday and so the entire team could respond which helped to foster a positive team spirit. The provider offered staff either a meal out at Christmas or a gift for each person to express their gratitude for staff commitment to the role.

Compliments from families and people using the service was always shared with staff. The registered manager told us, “As a management team we do this through supervision, as staff will do lovely things above their role and not mention it. When a person mentions it, we always make a point of both thanking and acknowledging it. An example is of a staff member getting copies of old photographs for a person they supported, for a picture frame. They did this in their own time and at their own expense as they knew the [person] wanted to put the pictures out in frames. When the person was showing me, they were telling me how grateful there were to the staff member who had done it.”

If staff had religious needs these were recognised and respected through changes to work patterns. For example, shift changes to support staff who may be fasting. The provider also made adaptions for any staff with specific needs. For example, 1 staff member had a condition that declined when they were tired, so the provider made sure they didn’t work after a certain time.

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 was committed to improving the service they provided. Staff described supervision and appraisal as regular and supportive, with staff praising the level of support they received from the provider.

The provider had a system of checks in place to monitor the quality of the service. This included regular internal audits in areas such as accidents and incidents, risk management plans, staff training, staff supervision, reviews of people's care and required support plans. Actions plans were put in place to address any areas that needed further improvements. Risk assessments addressed people's diverse needs and risk management plans were proportionate and centred around the needs of the person. There was a service improvement plan to ensure management oversight of improvements required and when actions were completed.

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 worked closely with local authorities in terms of commissioning, social workers and community assessment workers. They also had access to local authority training and provider meetings and forums.

Some people were supported to attend the TIBBS dementia foundation, Singing for Dementia sessions. This had proved to be very successful and thoroughly enjoyed by those that attended, including the staff. The provider and the staff also worked collaboratively with both the occupational therapists and district nurses. This happened often when supporting someone new with an assessment for equipment and guidance on how staff were best to support the person with any moving and handling. District nurses were involved with people as and when needed with skin integrity issues and referrals to the falls team often led to collaborative working.

There were numerous other examples of collaborative working such as supporting some people with medical appointments with the GP or specialist services and wheelchair services.

Staff completed handovers (exchange of information) both to and from hospital wards and discharge planners and working with pharmacists regarding prescriptions and GP surgeries. Staff also supported people to attend day care facilities and voluntary work. The provider told us this had also had to liaise with the police for a potential safeguarding concern, supporting the individual through the process and help with communication.

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. Staff told us learning from concerns and incidents was a key contributor to continuous improvement and meant the service continued to change and adapt the support provided and reduce the risk of further reoccurrence. One staff member told us, “We have regular meetings where accidents and incidents are discussed so we can improve our care and learn lessons when things don’t work out.”

The provider was committed to improving the service. They looked at complaints, accidents and incidents, safeguarding concerns and feedback from people to see where improvements could be made. An action plan was produced, and areas of concern addressed if there were any concerns. Supervisions and team meetings were used to openly discuss training needs and further training would be accessed if staff felt they needed it, which in turn better supported safe and effective practice.