Residential Care 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.t 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.

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 had a strategy for the service. However, this was not consistently understood, implemented and shared in the context of providing a supported living service.

The manager was not always clear in their understanding of what a supported living entails in term of good practice requirements, including the REACH standards, and the expectations people might have for progress and development in their support. For example, standard 3 states that “I have my own home”, however people were not being adequately supported to personalise their rooms according to their tastes and preferences. Reach standard 7 states, “I choose how to stay healthy and safe”, however people were not being adequately supported to eat healthier meals in that vegetables were not always offered for every meal.

The provider's vision and values were not understood and shared by people and the staff who supported them.

Not all leaders understood the context in which the provider delivered care and support to people. They did not always demonstrate they had the skills and knowledge of the good practice requirements in regard to operating a supporting living service, so people’s potential was always maximised.

For example, the provider has not always recognised that the premises were primarily people’s home and that it should be made as homely as possible according to their preferences. During the assessment, we saw that some aspects of the communal areas were being used to store the service records, instead of an office elsewhere.

However, people and their relatives spoke well of the registered manager saying they were compassionate. Staff spoke highly of the senior staff. Staff described the registered manager as approachable, supportive and caring. One staff member told us, “The Manager is very supportive and helpful. I can call them anytime if I need help or have any doubts. They’re always available and pick up the call.” A relative we spoke to said, “The manager and staff let us know of any concerns and invite us to meetings.”

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

Staff told us they felt comfortable raising concerns and would feel safe to whistleblow if needed. Comments included, “I know I can raise a concern, and it will be dealt with.” Staff told us they trusted the registered manager and felt listened to. There were clear whistleblowing and safeguarding policies in place that aligned with national guidance.

Relatives gave examples of their positive engagement with the registered manager and staff when they wanted to raise issues important to them.

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.

People were supported by a diverse staff team, reflecting the diversity of the people living at the service. This enabled staff to readily identify and meet people’s cultural needs and preferences.

Staff told us that the registered manager and provider treated staff equally and had not observed discrimination.

The provider had an equality and diversity policy, and staff had completed equality, diversity and inclusion training.

The provider’s quality assurance systems were not always effective as these had not identified the shortfalls we identified at this assessment. They did not always act on the best information about risks.

The registered manager completed audits of the quality of care and care records at the service. However, these had not identified that risk assessments were not always implemented effectively to mitigate risks to people associated with their healthcare needs. Medicines audits were carried out but these had failed to pick up that people who needed as and when required (PRN) medicines, did not have a protocol in place, even though the box for PRN checks was ticked yes.

The infection prevention and control (IPC) checks had also not identified that the policy was not always being effectively adhered to, in regard to hand hygiene.

Notwithstanding the above, audits about other aspects of the service such as those related to the safety of the premises were carried out appropriately.

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.

People were supported to access their local community in ways that reflected their needs, preferences and interests. This included support to attend healthcare appointments, places of worship, day centres, swimming and social activities. Staff also supported people to maintain contact with relatives and others who were important to them.

The provider involved relatives and professionals when planning or reviewing people’s care. This partnership arrangements supported joined-up care and helped people remain connected to their communities.

The provider did not always focus on continuous learning, innovation and improvement across the service. They did not always encourage creative ways of delivering a service that consistently focused on improving outcomes and the quality of life for people.

The service was not always provided according to the latest good and innovative practice in relation to the provision of a supported living service and for people with a learning disability. For example, it has long been established that constipation is a feature that could be detrimental to people with a learning disability. However, this was not being adequately monitored for one person at risk of constipation. The supported living setting is also people’s homes, and the service was not fully promoting the standards of good practice in relation to a supported living service, so people could live as independently as possible.

The provider operates other services for people with a learning disability and autistic people where areas for improvement had been identified in particular around the implementation of CQC statutory guidance Right support, right care, right culture. However, cross learning and cross checking of the quality and safety of the services have not been adequately taking place so people using the service always live as optimum a life as possible.

Notwithstanding the above, there were procedures in place to ensure learning happened when there were incidents and accidents. Staff were encouraged to reflect on their work, share experiences and identify opportunities for development.