Graceful Care - Wandsworth

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 inspection, we rated this key question good. At this inspection, the rating has remained good.

This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service 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’s aims, objectives and values were included in a service user and staff handbook which were issued to people and staff. These were based around the values of Privacy, Dignity and Respect. The philosophy of the service was around quality care, respecting people’s rights and their wellbeing.

People and their relatives told us the culture in the service was good. This was reflected in the feedback we received from staff. Comments included, “I have met with the Managers, they have empathy with what happens in our house”, “It is a good organisation”, “They are a good organisation, the regular carers bend over backwards for my [family member]” and “Very good company to work for, the management is very good.”

The service had a culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People using the service told us that were able to raise any concerns with the provider and were confident that the managers would take these seriously. Managers and staff understood the importance of reporting safety concerns and learning lessons when things went wrong.

Care workers completed incident reports if they were witness to any safety concerns which were then investigated by managers. Service concerns were investigated thoroughly and where appropriate, were shared with the local authority or other professionals. This demonstrated an open culture based on honesty. There was evidence that the provider used incidents to learn lessons, for example following an incident around medicines, the provider arranged a medication forum for care workers to learn from.

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

Feedback from people, relatives, staff and healthcare professionals indicated that there was an open culture in the service. People we spoke with told us they would have no hesitation in contacting the office if they had any concerns. Staff also said they were given opportunities to provide feedback and were confident that the provider would listen to them.

A health care professional added, “The Graceful Care team communicates well with us and are transparent and proactive when things don’t go as planned.”

The provider used a range of methods to gather people’s views about the quality of service. This included spot checks and home visits where people’s concerns were heard. People were also given the complaints procedure in a service user handbook which they were issued when they first began to use the service.

The provider valued and listened to the views of staff. This was done through regular supervision meetings.

The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

Staff told us they were part of a diverse team, treated equally and fairly, and they felt able to speak up.

The provider operated an equal opportunity recruitment process. Managers understood the importance of having a fair and inclusive workplace for all staff to work in. Staff were provided support to inform their knowledge and understanding of equality, inclusivity and fairness in the workplace through an Equality and Diversity policy.

The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.

Governance systems were well-established, effectively operated and used to regularly check and audit the quality and safety of the service.

The service ensured care plans were current by conducting regular reviews and monitored staff supervision, appraisal and mandatory refresher training.

In addition to this, the provider reviewed care visit times and medicines records were reviewed daily and weekly. There was a schedule of spot checks and telephone monitoring to gather the views of people using the service and to assesses care worker competency.

The quality assurance team carried out comprehensive audits, which covered policies, care records, staff files, a thorough medication audit and some aspects of which were based on the CQC standards.

A healthcare professional said, “I do meet with them regularly to reflect on the service and we are in contact regularly day to day. At present I don’t have any concerns about the service.”

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

People, and their relatives, told us that care workers liaised with the relevant health professionals when needed. They said, “If [family member] is not feeling well, they contact the office and the GP or Pharmacist” and “They check her skin. When she had a sore, they got the District Nurse to look at it, the nurse prescribed some cream, and her sore is better now.”

Care records contained details of health care professionals to contact should the need arise.

A healthcare professional said, “The Graceful Care team work well with the local authority to share information and agree any follow up actions.”

The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contribute to safe, effective practice and research.

Managers understood the importance of having an open culture of learning and continuous improvement to ensure people consistently received high quality, safe care and support.

Managers told us all the audits and checks that were completed were routinely analysed to identify performance shortfalls and learn lessons, these included improvements based on the quality checks and also the electronic call monitoring system so the service could continuously improve.