During an assessment under our new approach
Leaders promoted a learning culture and people could raise concerns. Managers investigated incidents but did not always monitor the effectiveness of any changes introduced. People were protected and kept safe. The facilities and equipment met the needs of people, were clean and well-maintained and any risks mostly mitigated. There were enough staff with the right skills, qualifications, and experience. Leaders did not always make sure staff completed required training, received appropriate and regular appraisals and oversight of staff employed via the Primary Care Network. Medicines were not always well managed.
People were involved in assessments of their needs. Staff reviewed assessments taking account of people’s communication, personal and health needs. Care was based on latest evidence and good practice. Staff worked with all agencies involved in people’s care for the best outcomes and smooth transitions when moving services. Staff made sure people understood their care and treatment to enable them to give informed consent. Staff involved those important to people took decisions in people’s best interests where they did not have capacity. When people were assessed as not having capacity to make a decision, the service involved relevant parties to support in decision making on behalf of the person.
People were treated with exceptional kindness and compassion. Staff protected their privacy and dignity. They treated them as individuals and supported their preferences, going beyond their roles at times, to achieve positive outcomes. People had choice in their care and treatment. The service prioritised teamworking and staff wellbeing.
People were involved in decisions about their care. The service provided information people could understand. People knew how to give feedback and were confident the service took it seriously and acted on it. The service was easy to access and worked to eliminate discrimination. People received fair and equal care and treatment. The service worked to reduce health and care inequalities through training and feedback. People were involved in planning their care and understood options around choosing to withdraw or not receive care.
Leaders and staff had a shared vision and culture based on listening, learning and trust. Leaders were visible, knowledgeable and supportive, helping staff develop in their roles. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. Staff understood their roles and responsibilities. Managers worked with the local community to deliver the best possible care and were receptive to new ideas. There was a culture of improvement with staff given time and resources to try new ideas. Governance arrangements lacked sufficient robustness and required strengthening to reduce the likelihood of risks occurring and to provide assurance that required actions were appropriate, actioned and implemented.
We found a breach of regulation in relation to Good governance. We have asked the provider for an action plan in response to the concerns found at this assessment.