Caremark Cheltenham and Tewkesbury

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 remained 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 82 (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 vision and values of the service were clear, person-centred and shared with all tiers of staff groups. The whole service direction was shared with staff during team meetings and one to one supervision. Managers demonstrated a positive listening culture that promoted trust and understanding between them and staff.

Staff were able to confidently comment on the shared values of the service and told us the staff team endorsed the values and future developments of the service. These included, compassion, respect, safety, quality and reliability. Staff comments included, “We aim to make a meaningful and positive difference in the lives of people and the wider community”, “I learned about these values through initial training sessions and refresher courses. I demonstrate them in my role by providing excellent home care, supporting individuals to maintain their dignity and independence, and “I ask questions that will give me more insight to what the [person] can do independently without endangering themselves…I listen and guide clients instead of being rigid.”

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 always did so with integrity, openness and honesty.

Managers lead with integrity, openness and honesty and ensure the organisational vision could be delivered and risks professionally managed. Managers lead by example, modelling inclusive behaviours and cooperative relationships. Managers at every level were available and a visible part of the service. This included the nominated individual who was involved in staff induction and was ‘hands on’ with weekly catch ups with field care supervisors, as well as a more in-depth monitoring meeting monthly.

Managers told us there was a good mix of skills and strengths which complimented the development of the service going forward. They were knowledgeable about issues and priorities for the quality of services and were aware of organisational limitations, whilst continuing to develop their strategy. They understood their responsibilities to staff and the people they supported and were equally supported by the provider and franchise to deliver good, effective high-quality care.

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

Staff we spoke with told us they were aware of the whistleblowing policy and knew how to raise a concern if needed. Staff felt confident their voice would be heard and actions would be taken to address their concerns. Staff members told us, “I feel confident in speaking up” and “I feel listened to and supported”. Another staff member said, “It means I can report unsafe or poor practice, even involving colleagues or managers, without fear. I would feel confident raising concerns with the manager or senior management.”

Leaders valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them. This included additional support, flexibility and adjustments to enable staff to undertake their role to the best of their ability.

The service employed overseas sponsored staff as half of their workforce. Leaders told us they looked after their staff and treated them all fairly. They ensured overseas staff had an induction into practices of British culture of which they may not be familiar to support them to integrate into the delivery of care and into their local community. Records showed staff had completed training in Equality Diversity and Inclusion.

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 a comprehensive system of auditing and monitoring in place. There were extensive quality assurance processes to consistently and continuously monitor all aspects of the service. Managers used electronic systems to monitor the service which produced lots of data to analyse and was a more efficient way to have full oversight of the service provision and quality of care.

Audits were carried out daily, weekly, monthly and quarterly according to specific checks and staff roles. Actions were allocated to different team members and checked and/or chased to ensure completion. Sample checks of audits were taken and double checked. Trend analysis and care call analysis were completed to give further insight into emerging themes of the service provision out in the community. The service had good oversight from the nominated individual who met with managers weekly as well as the larger franchise management team. This included a quality manager who visited at least twice annually and provided additional support as and when needed. Managers aimed to have a culture of continuous learning and improving and use of best practice. Managers were considering the benefits of using Artificial Intelligence (AI) and are in discussion with a software developer to create new systems and a dashboard for quick oversight.

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.

Leaders worked closely with other health and social care professionals to ensure people’s needs were met. Leaders attended regular multi-disciplinary meetings to provide input and gain information for the people they supported, so they were fully aware of the person’s overall needs.

Stakeholder feedback we received was positive and they described Caremark Cheltenham and Tewkesbury as proactive, dependable and reliable.

One professional who worked closely with the service told us, “I have consistently had positive experiences with the entire management team at Caremark. They have always been approachable, responsive, and co-operative when dealing with enquiries, including those of a sensitive nature. As a local authority, we have a high level of confidence in the organisation. This is demonstrated by our commitment to four block contract arrangements with Caremark, a joint highest in the county, covering a wide range of provision. Among the wider provider market, Caremark stands out as one of the most proactive organisations in terms of engagement. In my experience, they are consistently keen to participate in sector development/innovations and contribute constructively to service improvement discussions in any forums that are held by the council or the Gloucestershire Care Providers Association.”

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 told us they constantly reflected on the care delivered and responses to issues to improve the service. The registered manager had recently enrolled onto a leadership and management course. The field care supervisors were undertaking a ‘train the trainer’ Positive Behaviour Support (PBS) with the PBS Team in order to write their own plans and support the care team.

Managers had completed Level 3 safeguarding training and a leadership course. They liaised with the local authority to have an upskilling day with the dementia lead for staff as well as training for supervisors in assessment planning.

Leaders used a training matrix to track staff completion rates and identify which training was overdue or required a refresh. Compliance was very good and training was based on the Care Certificate (the Care Certificate is an identified set of standards that health and care professionals adhere to in their daily working life). In addition, bespoke areas of interest specific to people’s individual needs were undertaken, such as dysphagia and Parkinsons awareness.

Managers used trend analysis to identify where training already provided required improvements. For example, following some medicines errors all staff had a full refresher day, field care supervisors had an increase of presence in the community and there was extra support for reflective practice.

A log had been developed to distinguish between a complaint and an issue raised. Managers asked, ‘how can we be better?’ Issues were responded to in a timely manner to avoid them escalating to a complaint, being proactive rather than reactive.