Sugarman Health and Wellbeing - Dorset

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 provider 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.

The provider was in breach of legal regulation in relation to good governance.

This service scored 64 (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 values were displayed within the office and feedback from staff identified a culture of wanting to work together as a team to deliver high quality care. The registered manager told us they were assured staff worked in line with the providers values through supervision and spot checks.

Leaders did not always have the skills, knowledge, experience and credibility to lead effectively.

For example, the provider and registered manager had failed to identify governance processes were not always in place to identify errors, shortfalls and omissions in relation to care quality and safety. This meant they were not able to drive improvement within the service. The provider and management team had not always worked in line with regulatory requirements; they had failed to always submit notifications to CQC when potential safeguarding concerns had been identified. However, the registered manager knew people well and was passionate about their role. The registered manager told us they felt supported by the provider. Staff described management as approachable and supportive.

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

Staff said they felt confident to raise concerns and they felt assured they would be taken seriously and addressed. A whistleblowing policy was in place to support this open culture.

The provider 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 were valued and supported by the provider at work. Staff comments included, “It is great to have an office that you can go to where the staff are all helpful and supportive”, and “Management at Sugarman are extremely supportive. I consistently feel listened to.” An equality and diversity policy was in place and staff completed training.

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.

Governance systems were either not in place or operating effectively for the provider to have oversight of the service, and therefore they had not identified the shortfalls found at this inspection. For example, staff informed management appropriately of incidents and management completed follow up actions. However, they had not always been identified as a safeguarding concern where appropriate. The provider failed to identify they had not always informed the local authority safeguarding team or submitted statutory notifications to CQC as required by law.

The provider did not always ensure staff had the required training and competency checks for their role. The provider could not be assured training in learning disabilities and autism met the core capabilities code of practice. The provider did not complete moving and handling competency assessments. Checks were being completed on staff administering medicines; however, they required more detail so the provider could be assured staff had completed training and developed the skills to safely support people. This placed people at risk of avoidable harm.

However, other audits were in place, for example around medicines records and daily notes. These audit outcomes were shared with the staff team to drive improvement.

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

The registered manager did not report all safeguarding incidents. This meant there was limited opportunity to reflect on events, receive support from external professionals and develop the service.

However, we received positive feedback from professionals about how the provider worked in partnership with them to meet the complex health needs of a person. One professional said, “Communication is appropriate, and recommendations are acted upon in a way that supports positive outcomes for people using the service.”

The provider 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.

The registered manager was open and engaged throughout the inspection. They told us they felt supported in their role. They had regular meetings with their line manager and other registered managers within the organisation, where they discussed lessons learnt and created documents with highlights to share with staff. For example, staying awake during night shifts, sepsis and how to cope in hot weather. Information was shared with the staff team to drive improvement.