Emerald Training and Medical Staffing

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.

This is the first assessment for this service. This key question has been rated 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.

We found the provider to be in breach of 1 legal regulation in relation to good governance.

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 shared culture. The registered manager and staff worked collaboratively with relevant healthcare services to ensure delivery of care. A clear management structure was in place. Staff had clear roles and responsibilities and were informed of their roles and reporting arrangements. Staff spoke positively about the management of the service. A staff member told us “[Registered manager] tells us about work practices so we can improve. We feedback about people and any difficulties we may have and can openly discuss these things. We are like a family here and you want to come to work.”

The provider had inclusive leadership. The service operated in an open way and the registered manager was visible at all levels and available for staff when needed. A staff member told us “The registered manager is a good listener and supportive in a moral, emotional and academic way and encourages you. She tells us we can do it and this is the way to do so”

The provider fostered a positive culture where staff felt they could speak-up and their voice would be heard. Staff told us they knew how to speak-up if they had concerns or something went wrong. They felt the registered manager supported them and listened to them. A staff member told us “I will let [registered manager] know if I am not satisfied, I will say it. She will take actions if needed.”

The provider valued diversity in their workforce. The registered manager and staff worked together as a team. Policies and procedures were in place for workforce equality, diversity and inclusion.

The provider did not have clear good governance. Effective systems and processes were not in place to assess, monitor and improve the quality and safety of the services being provided to people. There was a lack of audits in place to check and monitor all aspects of the service, identify areas of improvement and address shortfalls.

We found due to the lack of clear and effective governance systems, improvement was needed in various aspects of the service, such as accident and incidents, assessing risk, environmental risk, recruitment, staff performance, medicines, person centred care and consent to care. There was a lack of measures in place to obtain feedback from people and relatives.

Systems in place to manage people’s finances were not robust. Finance records completed for people only showed the amounts spent and a running total. Receipts were not kept in a systematic order and there was no information which showed the receipts had been cross referenced and accounted for against the finance records. Monthly finance checks had been completed. However there was no information to show what had been audited and checked to ensure people’s finances were being managed safely and appropriately.

Personal Emergency Evacuation Plans (PEEPS) were in place for each person. However, provided insufficient details about people's conditions that could impact on their ability to leave the premises in the event of an emergency and guidance on how staff should support them.

We spoke with the registered manager about the issues found during the assessment. The registered manager was open and receptive to feedback and willing to learn from the feedback. The registered manager took prompt actions including registering staff for the care certificate, putting in place hospital passports, cleaning schedule, a system to record and monitor healthcare appointments, immediate action to rectify the kitchen and communal areas and actions to mitigate the risk of falls in the garden area. We will follow this up at the next assessment.

The provider did not always understand their duty to collaborate and work in partnership. Staff and management worked with the external partners, such as the local authority commissioners and other health care and social care professionals to provide joined up care.

However, care records did not always detail people’s needs and lacked information about engagement with healthcare professionals which provided effective oversight of people’s healthcare.

The provider did not focus on continuous learning, innovation and improvement. Robust systems were not in place to support learning and improvement. There were limited audits and regular staff meetings did not take place to monitor the quality of the service and share good practice. Accidents and incidents had not been analysed to identify lessons learnt to help continually improve the service and embed best practices.