Call4Care Services 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 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 the legal regulation in relation to governance at the service.

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 was in the early stages of implementing a strategy as well as a shared direction and culture within their homecare service. There had been recent changes at all levels in the management and leadership structure so the new team and their strategy needed to be embedded and sustained over time. Their approach to support and develop the staff team, particularly with the additional complexities of live-in staff, needed time to become established.

The provider was undergoing a period of significant change in the leadership and management of the service. This included changes at director, nominated individual and registered manager level. The nominated individual is responsible for the oversight of the regulated activity. New systems and processes they were introducing needed time to be embedded into practice. The new manager was recruited primarily to work with children and young people so was transitioning to manage the adult homecare service. They had applied to CQC to become registered manager. Records showed the recent new management team were supporting staff through regular supervisions and team meetings as well as appraisals. Positive feedback was received from staff about the management arrangements.

The new manager was keen to embed a positive culture in the service where staff felt they could speak up and their voices would be heard. A staff handbook provided useful and relevant information. Staff surveys were undertaken to seek views from staff. Team meetings took place regularly and different policies and procedures were spoken about. This supported staff expand their knowledge as well as talk about key policies and areas of service provision.

Some improvements were needed to ensure that live in staff were fully able to access all team and individual opportunities such as team meetings or training and development, which could be difficult due to their working hours and patterns. Some staff had initially been employed to work with children and young people before starting to work in an adult supported living setting or as a live in care worker. The provider valued their workforce and was keen to ensure staff were included and developed which would time to embed into practice.

Governance arrangements were not always effective. The provider was developing audits and quality assurance processes of key areas of service provision such as medicines, care records and daily logs. However, these systems had not been embedded and sustained over time. A new care planning system was recently introduced so audit processes were reviewed alongside this. Audits had not picked up the issues we found in the areas of care planning, risk assessments and medicines. We also found that reports such as an annual safeguarding report had not included information about all safeguarding incidents, which meant opportunities for learning lessons and improving processes might be missed. The provider had not identified that some of the processes in place were primarily focused upon the area of children’s support, which sat outside of their CQC registration.

We found a breach of regulation in the area of good governance.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information with relatives and any professionals for the benefit of the person receiving care and support. This included ensuring that recommendations and instructions from health professionals were followed.

The registered provider at the start of the assessment failed to ensure legal regulations were followed which led to them providing an unregulated service to young people under the age of 18. In response, CQC used our regulatory powers to restrict the provider from caring for people under the age of 18. During the assessment there was a change of provider. The new provider and manager were aware of the concerns.

Some of the documentation we saw was developed for the provision of services to children so the new management team were introducing and embedding various new systems and processes. An electronic care planning system was recently introduced but further decision making was ongoing about whether this fully met their requirements. The provider was supportive of the assessment process and acted upon suggestions offered. They were keen to deliver good quality care provision to adults receiving care in their own homes.