My Carer

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 requires improvement.

This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

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

This service scored 61 (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 that was consistently embedded across the service.

Whilst leaders and staff demonstrated a commitment to providing person-centred care, this was not always reflected in the systems and records used to plan, deliver and review care. As a result, the provider could not always demonstrate how people's individuality, rights, preferences and protected characteristics were consistently recognised and promoted.

Leaders and staff spoke knowledgeably about people's individual needs, preferences and life histories. Staff described long-standing relationships with people and their families, which helped them understand what mattered most to people and how they wished to be supported. This demonstrated staff shared values centred on providing compassionate, person-centred care.

However, leaders had not ensured these values were consistently translated into care planning and recording systems. Whilst care plans contained information about people's support needs, they were often task-focused and did not consistently capture important person-centred information such as communication needs, emotional wellbeing, cultural preferences, preferred routines, personal goals and other aspects of people's identities. Daily records also varied in quality and frequently focused on tasks completed rather than the person's experience, wellbeing or outcomes achieved.

This created a disconnect between the provider's stated commitment to person-centred care and the evidence available to demonstrate how that approach was embedded in practice. The provider could not consistently demonstrate through documentation how people were supported as individuals or how their preferences, choices and wishes informed the care they received.

The registered manager acknowledged these shortcomings and recognised that, although staff knew people well and worked hard to provide personalised support, care records did not always accurately reflect this knowledge. They told us action was being taken to improve the quality and person-centred nature of care planning and recording to ensure people's individuality, wishes, preferred outcomes and characteristics important to their identity were clearly documented and consistently communicated.
 

The provider had compassionate and inclusive leaders who understood the context in which they delivered care, treatment and support. Leaders were visible within the service and demonstrated the values of the organisation through their actions and interactions with staff.

Leaders had a good understanding of the challenges and priorities within the service and took action to address concerns when these were identified. There was evidence that poor practice was challenged appropriately and that staff contributions were recognised and valued.

Staff spoke positively about the registered manager, describing them as approachable, supportive and responsive. One staff member told us the registered manager “is approachable and I feel she values my input. When I have had concerns in the past about a client those concerns have been acted on promptly.”

Staff felt confident to speak up and believed their views would be listened to and acted upon. One staff member told us, “Yes. Our office staff are always willing to listen. Even if it's just to get thoughts off your chest after a hard shift.”

Feedback from staff demonstrated leaders promoted an open and supportive culture where people felt able to raise concerns, seek guidance and contribute to service improvement.
 

The provider fostered a positive culture where people and staff felt able to speak up and were confident their voices would be heard.

Policies and procedures were in place to support speaking up and raising concerns. People and staff told us they felt comfortable sharing their views and discussing concerns openly with the provider. Regular meetings, surveys and contact with the management team provided opportunities for feedback to be gathered and discussed. However, there was limited evidence to demonstrate how feedback from people and staff was analysed, used to drive continuous improvement or communicated back to those who had provided it.

Staff told us they felt comfortable raising concerns and sharing their views. One staff member said, “I have no qualms about airing my concerns or voicing my opinions.”

People told us they knew how to raise concerns and felt confident they would be listened to. One person said, “I could phone the office and tell them. It happened once, and it wasn't their fault, it was sorted out straight away.” Another person told us, “I suppose if I needed to, I would call the office. I trust them, I should imagine they would put it straight right away.”

People said their views were sought through surveys and regular contact from the service. One person explained, “They call me and ask me if I am happy with the way I am being looked after,” while another said, “If I wanted something, the carers take it to the office and I get a response.”

This demonstrated people and staff felt able to speak up, share feedback and raise concerns. Leaders had created a culture where concerns were listened to and acted upon. However, systems did not always demonstrate how feedback was used to inform learning, improvement and development of the service.
 

The provider valued diversity within their workforce and worked to promote an inclusive and fair culture by supporting equality and equity for people who worked for them.

The provider promoted equality, diversity and inclusion and worked in line with the Equality Act 2010. Policies were in place which outlined the provider's responsibilities to prevent discrimination and ensure people received care in a fair and equitable way. Leaders spoke positively about the importance of creating an inclusive culture where people and staff were treated with dignity, respect and fairness.

The provider recognised the workforce had limited diversity, which they told us reflected the local recruitment market. Recruitment opportunities were advertised openly and the provider told us applications from people with different backgrounds had been limited. The provider described their recruitment practices as fair and inclusive, with opportunities available to all applicants regardless of their protected characteristics.

Staff told us they felt respected, valued and supported within the organisation and described the culture as welcoming and inclusive. Feedback from staff indicated they were treated fairly and felt able to be themselves at work.
 

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.

There was a registered manager in post at the time of the assessment. Whilst they were visible within the service and knowledgeable about the people they supported, and the day-to-day operation of the service, leadership and governance arrangements were ineffective. Leaders were unable to demonstrate they had effective systems in place to assess, monitor and improve the quality and safety of the service. As a result, they could not provide assurance that people consistently received safe, personalised and well-coordinated care.

Governance systems did not effectively identify, assess or manage risks within the service. Quality assurance processes were limited and failed to identify a number of concerns found during the assessment. Audits were not routinely completed and there was little evidence of effective oversight, monitoring or follow-up of areas requiring improvement. This meant leaders did not have a clear understanding of the quality of care being delivered and were not always aware of shortfalls within the service.

Leaders had introduced an electronic care planning and recording system and believed this would improve record keeping and oversight. However, they had relied heavily on the system's standard templates and prompts and had not ensured records contained sufficient additional information to reflect people's individual needs and preferences. Leaders had not fully recognised that the system required tailoring and detailed information to support effective care delivery and oversight. As a result, records often reflected the information requested by the system rather than providing a comprehensive picture of people's care and support needs.

The provider had not ensured the electronic system was used effectively to support person-centred care, risk management or decision-making. Important information relating to people's preferences, communication needs, personal histories, emotional wellbeing and desired outcomes was not consistently recorded. This resulted in an over-reliance on staff knowledge and experience rather than accurate and accessible records. The provider was unable to demonstrate how the system supported effective oversight or assured leaders that people were receiving appropriate care.

We found widespread concerns relating to care planning, consent processes and record keeping. Care records were not consistently accurate, complete or reflective of people's current needs. Information relating to communication preferences, personal routines and characteristics important to people's identities was frequently missing or lacked sufficient detail. Mental capacity assessments and records relating to decision-making had not always been completed where required. These issues had not been identified through the provider's own monitoring processes, demonstrating significant weaknesses in oversight.

We also identified weaknesses in arrangements relating to consent and information governance. Formal consent had not consistently been obtained before photographs were published on social media and staff had not been provided with sufficient guidance regarding the appropriate use of social media. This meant people could not be assured their privacy, wishes and personal information were consistently protected.

Leaders were unable to demonstrate effective systems for reviewing whether care continued to meet people's changing needs. Changes in people's circumstances, support requirements and associated risks were not always reflected in care records, and the provider could not consistently show how care was reviewed and adapted over time. This increased the risk that changes in need would not be recognised or responded to appropriately.

The provider could not demonstrate that information relating to quality, risks, incidents, outcomes and learning was routinely analysed and used to drive improvement. Concerns identified during the assessment had not been recognised or addressed through existing governance systems, indicating leaders did not have effective oversight of the service.

Although leaders responded positively to feedback during the assessment and took action to address some concerns once they were identified, the issues found were longstanding and had not been recognised through the provider's own governance processes. This demonstrated that systems for monitoring, oversight and continuous improvement were fundamentally ineffective.

Overall, leaders could not demonstrate they had effective oversight of the service or that systems in place were sufficient to identify risks, maintain accurate records, monitor quality or drive improvement. As a result, people could not be assured they would consistently receive care that was planned, monitored and reviewed in line with their needs and preferences.

The provider understood their duty to collaborate and work in partnership with others so services worked seamlessly for people. They shared information appropriately, worked alongside partner organisations and used collaborative relationships to improve outcomes for people.

One professional told us, "Communication with their staff was always open and constructive. They worked well alongside other services, shared information appropriately, and were proactive in contributing to safe and coordinated care." They told us the provider's involvement "made a real difference" and that the "person's quality of life noticeably improved as a result of the care and support they provided."

The provider recognised the value of involving professionals whose expertise and knowledge could contribute to improved outcomes for people. One professional told us, “My Carer works collaboratively with health and social care professionals to ensure safe and effective care.” Another professional said, “My experience with My Carer has been positive. They appear committed to continuous improvement and to providing safe, effective and person-centred care.”

Feedback from professionals demonstrated the provider was proactive in building effective partnerships, sharing information appropriately and working collaboratively to help people achieve positive outcomes.
 

The provider did not always focus on continuous learning, improvement and innovation across the organisation. Systems were not always effective in demonstrating how feedback, learning and service performance were used to drive improvement and improve outcomes for people.

Staff told us opportunities were available to discuss issues, share experiences and contribute ideas for improvement. However, records of staff meetings were limited and did not consistently demonstrate that meetings had taken place regularly, that learning was shared, or that actions arising from discussions were monitored and reviewed. This reduced assurance that staff had consistent opportunities to contribute to service development and improvement.
Despite this, staff spoke positively about opportunities to share their views. One staff member told us, “We discuss any problems that have occurred… It is always a good opportunity for us all to share our experiences and to discuss things that are bothering us.”

Staff received regular one-to-one meetings with managers which supported their development and performance. However, the provider had not implemented additional mechanisms, such as staff surveys or anonymous feedback systems, to help gather wider workforce views and identify potential concerns or improvement opportunities.
Feedback from people and their relatives was received through cards, letters and direct communication with the service. Positive feedback was shared with staff and displayed within the office. However, there was limited evidence demonstrating how feedback from people, staff, relatives and partners was systematically analysed, used to identify trends, or translated into service improvements.

As a result, the provider could not consistently demonstrate how learning, feedback and quality information were used to evaluate performance, improve people's experiences or drive continuous improvement. This limited the provider's ability to evidence an organisation-wide approach to learning and service development.