Ranger Home Care Ltd – Main Office

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 57 (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.

The provider held staff meetings virtually. One member of staff told us, “The managers know all about my client. They are available and contact me and my client regularly.”

Staff expressed pride in their work and a shared commitment to delivering high-quality care. However, there was limited evidence of a shared strategic direction being embedded across the service. For example, the staff meeting minutes did not demonstrate collaborative engagement and shared staff discussions.

The registered manager said, “I think the key thing for people is that I am on the ground as a manager, I have physical presence. I answer the phones, and I want to know what is going on.”
 

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 did not always have the skills, knowledge, experience and credibility to lead effectively. Adequate quality assurance systems had not been implemented to ensure people’s care mitigated risks to their health, safety and wellbeing. Shortfalls were identified in areas such as assessing risk, recruitment, staff training and medicines management. This did not demonstrate the provider fully understood the regulatory context in which they delivered care, treatment and support. Oversight from the leadership team had not always identified issues we identified, in a timely and effective manner. The provider had not always kept up to date with best practice guidance.

Staff and relatives consistently praised the management team for being approachable and responsive.
 

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

Staff told us they felt empowered to approach management with any concerns. One staff said, “Anything I was worried about or unprofessional – I would ring the manager.” Relatives also told us they knew how to raise concerns and felt confident to do so.
 

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.

All staff were positive about working for the service and felt they were treated with respect. One staff said, “I have supervision with my manager. They come here and discuss my work and any training I may need.”

The registered manager told us, “We do ask the question unofficially to people – if they have a preference of what carer they would like, e.g. Farsi speaking, ethnicity, clarity of speech. I protect my carers from this so they won’t be put in a position where they could be abused.”
 

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 maintain effective oversight of people’s care planning and risk assessments to ensure people did not experience risk of avoidable harm. Governance systems were not always effective in identifying risks and ensuring actions were taken. The systems and processes used for medicines management had not identified concerns related to administering medicines, and the covert administration of medicines. Audit systems were not effective in identifying the concerns found during our assessment, particularly in relation to safe care, maintaining clear records, medicines management, training, and recruitment.

Evidence gathered during the assessment revealed that the systems and processes used did not always support staff in providing appropriate care for individuals. People’s care records did not always include significant information, such as the support they needed for specific high-risk conditions. We found gaps in information in staff files reviewed as part of recruitment. There was no effective system in place to audit staff employment records to ensure they contained all the required information before working with vulnerable individuals.

The lack of oversight by the registered manager meant that governance of the service needed improvement.
 

The provider did not always understand their duty to collaborate and work in partnership, so services worked seamlessly for people.

We saw some evidence of the service working with occupational therapists, district nurses and GPs. Input from specialist consultants, GPs and information from social services were seen in the care plans. Management staff could explain how they worked with other professionals. However, the registered manager told us there had been some challenges working with community teams. The registered manager said they perceived some professionals as wanting to place people straight into a care home instead of reviewing their care and risks in line with their wish to remain at home with support.
 

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not always actively contribute to safe, effective practice and research.

The provider showed us case studies they had created to learn and improve from. However, it was unclear how any identified learning had been shared with all staff in the service to drive improvement and improve the quality of life for all people using the service. We saw feedback survey results; however, it was unclear what action had been taken in response.

There was limited evidence the provider had systems and processes in place to embed learning and continuous learning throughout the organisation.