Option Care Ltd

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 requires improvement. At this assessment the rating has remained 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 at the service.

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 clear shared vision, strategy and culture which was based ontransparency, equity, equality and human rights, diversity and inclusion, and engagement. However, the concerns we identified in relation to governance meant that this was not always peoples experience.Some people shared positive feedback about the culture of the organisation. One relative told us, “I have learnt a lot from [staff]. They know what they are doing. They are efficient when doing it.” Without exception, staff spoke positively about the culture and direction of the service. In contrast, other people and relatives raised some concerns. One person said, “The carers are working a lot of long hours and sometimes I see they are tired.” A relative told us, “They need to follow their procedures. Ensure staff are trained for that [person] and have the experience for that [person].”

It was clear that the provider had a shared direction and culture. They told us, “We set up Option Care to support people to live in their own homes. Our mission is to make sure we build a compassionate team. We want carers to be kind and respectable. We work with value-based recruitment. We go the extra mile to put a smile on [people’s] faces.” More time was needed to embed the improved governance procedures and ensure that the shared direction and culture was implemented in practice for people who used the service.

Whilst leaders had some knowledge and understanding of the issues and priorities within the service, oversight and governance had not always been effective. This meant that leaders did not always utilise skills, knowledge, experience and credibility to lead effectively.

The service operated in two different local authorities from one ‘location’. We consider a location to be a place where a provider routinely plans and co-ordinates care, and from which they manage the regulated activity (of personal care). Both registered managers operated across both local authorities and one of the registered managers had additional commitments across the working week. This meant the senior management team could not be present across both local authorities every working day which impacted on their oversight of the service. The provider told us that they had reviewed the current arrangement and were in the process of recruiting for a registered manager to work across one of the local authority areas to improve governance and oversight.

We received mixed feedback from people and their relatives about the management team. One person told us they did not think the service was well managed. Another person said, “I think the manager is good. He deals with any issues I have.”

The leadership team carried out spot checks and provided feedback and training where needed, which demonstrated commitment to staff development. However, whilst leaders were aware of areas of concern, shortfalls in governance meant they did not always act promptly to ensure the quality of people’s care was addressed in a timely manner.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Staff told us management were supportive and approachable. One staff member said, “Whenever something is making me unhappy or something I see I don’t like I tell my manager, the problem has to be known by someone else, I am not to be supressed, yes at Option Care I can speak up. If you are not happy you cannot discharge your duties correctly.”

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. Staff told us they enjoyed working at the service and felt well supported by the management team.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

The provider had a service improvement plan in place, and staff and management meetings took place regularly. However, it was unclear about how the improvements had been prioritised and it was not always clear about how and when actions had been completed. The systems had failed to identify the concerns we found during this inspection. This demonstrated that governance systems were not effective in identifying and addressing risks. We raised this with the provider who took action to address the shortfalls and improve their governance.

The provider did not always understand their duty to collaborate and work in partnership, so services worked seamlessly for people. They did not always share information and learning with partners or collaborate for improvement.

We received mixed feedback from professionals about the effectiveness of the providers communication and collaborative working. Whilst some professionals shared positive examples, other professionals told us they believed information, observations and learning could be shared in a more timely manner. The provider was currently working with professionals to address and respond to these concerns.

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.

We received mixed feedback from people and their relatives about whether improvements had been made in response to matters highlighted. Some people and their relative told us that improvements had not always been made when they raised concerns. However, one person told us that, “There was one new [issue of concern] and I shared that with the manager and they sorted it out.”

We were not assured that the provider had always used learning from previous incidents in a timely way, to prevent the reoccurrence of similar concerns. For example, one local authority who commissioned care with the provider had identified concerns across multiple areas of the service which had similar themes. Whilst the provider was now working with the local authority to address and respond to these concerns, we were not assured that improvements had previously been implemented promptly to minimise and mitigate any known risks to prevent recurrence. One professional said, “The timeliness has improved since [the concerns were] raised”.

The provider told us that, in response to feedback provided at the inspection, they would ensure that moving forward, all service improvement actions would now be clearly prioritised based on risk, impact on people using the service, and regulatory requirements. These improvements would support the provider to consistently focus on continuous learning, innovation and improvement across the organisation and local system. The provider told us, “We want to be the provider of choice. We set out to be a service that listens and is responsive…We value integrity and we need to make sure we make changes to our service.”