WR Care Services

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 newly registered service. This key question has been rated 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 68 (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. People and their relatives told us they felt safe, were treated with dignity, respect and supported with their care needs which aligned with the provider’s aims and objectives for the service. Staff demonstrated a knowledge of provider’s aims and vision for the service. This meant people experienced care that was consistent the provider’s values, and this shared culture was consistently embedded amongst the staff group.

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. Leaders had the skills, knowledge, experience, and credibility to lead effectively. They did so with integrity, openness, and honesty. People and their relatives told us they knew who to contact if they experienced any problems.

Staff told us that the registered manager was approachable and fair. Staff told us the management of the service supported the team to carry out their roles effectively. A staff member told us, “I am happy with the way the manager and other staff treat and support me”. We found leaders were knowledgeable and supported their staff closely, ensuring effective succession planning by encouraging their team to gain professional qualifications. Leaders were transparent and very responsive to feedback given. The provider shared an operational plan in response to feedback provided on the day of the inspection. This meant people and staff had confidence in leadership, and experienced a stable, values-led service.

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

Staff had access to a clear, in-date, whistleblowing policy. Staff were regularly invited to team meetings, supervision and were able to share any feedback and concerns appropriately. Staff knew who to contact if they needed to share any issues. Staff told us they felt able to speak to management and would be listened to. This meant that people experienced an open, more responsive and transparent service.

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. The provider ensured staff completed training on equality and diversity when they started work. We found no evidence that staff had experienced any discrimination at work.

The provider had clear responsibilities, roles, and systems of accountability. Systems and processes to monitor the service were in place, but not always effective. They did not always act on the best information about risk, performance, and outcomes, or share this securely with others when appropriate.

The provider carried out basic audits of medicines administration, care plans, accidents and incidents, complaints, safeguarding and care monitoring. However, these audits were not always detailed and did not cover every aspect of care related to these subjects. For example, medicine stock control was not included in the medicine audit. Safeguarding and complaints audits did not highlight themes or trends. Further, they did not always contain clear actions to be taken, and lessons learnt, for example, from the outcome of complaints or accidents and incidents.

There were no audits to monitor if staff had arrived at their care call on time or had stayed for the duration. There were no audits of daily notes.

The service evidenced communication with staff where concerns were found in care provision. However, the service did not always ensure that good practise was embedded as a result, for example, staff signing people's MAR charts once medication was administered. This meant leaders had a lack of oversight of the service and people’s safety.

There were a number of occasions when the provider did not make required statutory notifications to CQC around safeguarding alerts that had been made to the local authority. This reduced external oversight designed to help keep people safe. We gave feedback to the provider, and they took action to address the concerns found on inspection.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement. People’s care records evidenced regular working with professionals to ensure a smooth transition between services. Partners told us that the service contacted them regularly to ensure people had access to assistive equipment, health care, or alerted them to changes in people’s needs. Partners told us “They responded well to support the clients. I do feel they put the client first.” This meant people experienced more coordinated, timely and joined‑up care.

The provider did not always focus on continuous learning, innovation and improvement across the organisation. They did not always encourage creative ways of delivering equality of experience, outcome, and quality of life for people.

The provider did not always document lessons learned from auditing or safety events. For example, where medication had been misplaced in a person’s home, there was no documented action to begin stock counts as part of medicines audits.

Leaders had a good understanding on how to make improvement happen, but their approach was not always effective.

The registered manager and management team genuinely welcomed our feedback and took action to look for ways to improve.