One to One Community Care

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 previously in breach of the legal regulation in relation to good governance. No improvement was found at this visit and the provider remained in breach of this regulation.

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 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 welcomed and supported an open culture which was supported by staff feedback to us. Staff were confident in identifying poor practice and told us concerns would be acted on. People told us staff were kind and compassionate and they were happy with the service.One relative told us, “I would absolutely recommend the service, gives me peace of mind, very reliable service.”

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. However, staffing vacancies were impacting on the ability of managers to implement systems and have time to lead effectively due to also providing direct support. The provider was in the process of recruiting to vacant posts with the hope that more time could then be spent overseeing the service. The provider was also not aware of some aspects of governance that were required meaning some areas had not been identified or acted on. Staff told us managers were supportive. A staff member told us, “I am grateful for all the support and opportunities provided by One to One Community Care.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.Staff told us there was an open culture and they were encouraged to raise concerns.Staff were positive about managers and felt that if they raised a concern, it would be acted upon. One staff told us, “My manager is very supportive and approachable.”Although formal feedback had not been collected recently, people and their families felt that if they raised an issue, it would be listened to. One person told us, “I really am happy if I wasn’t I would complain.”

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. However, staff had not received training in equality and diversity and systems required improvement to ensure processes promoting inclusion were fully embedded into practice.Staff felt that they were treated fairly and that managers considered staff work life balance and required working patterns when compiling rotas.

The provider did not have clear responsibilities, roles, systems of accountability and good governance. The quality monitoring systems in place had not identified shortfalls found during this assessment or were effective in identifying themes and trends. Concerns noted at the last inspection had also not been addressed. The lack of effective monitoring systems meant issues may not be identified and lessons may not be learnt when things went wrong. Where incidents had occurred, reviews were not being completed effectively, to ensure any actions were followed up on and lessons could be learnt. This meant the risk of harm to the person and others had not been mitigated, further compromising their health, safety, and wellbeing. There was a lack of robust and effective review of risk which put the health and welfare of people at risk of harm. Effective systems to ensure the safe management of medicines were not in place and there was poor oversight of areas of risk such as falls, pressure area care, and choking. Policies and procedures in place were out of date, generic and not personalised to the service. This evidenced systems and processes of governance were neither robust nor effective. People’s experience of the service was however positive, and we found no evidence that the concerns we had identified had impacted on the quality of people’s care. However, there was poor oversight and governance of the service which placed people at increased risk of harm.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. The provider was working collaboratively with the local authority to help drive improvements within the service. We received no concerns from professionals involved with the service.

The provider did not always ensure continuous learning, innovation and improvement across the service. Systems in place at the time of assessment did not provide sufficient oversight. This reduced the ability of the provider to review information and complete lessons learned, presenting a potential risk to people. Additionally concerns identified at our last inspection in 2022 had not been addressed.The provider had agreed to work with the local authority to put an action plan in place to address the concerns we had found at this inspection and to ensure governance systems were effective going forward.