Covenant Healthcare Ltd Also known as Heritatge Healthcare Coventry

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 changed to 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. Staff understood the importance of a whole team approach to providing good care and their role in working together to achieve this. Staff told us the registered manager and senior staff demonstrated their vision and values for the service in practical ways. For example, staff were able to contact the senior staff if they wanted any additional advice to improve people’s care and said this was provided. One staff member told us, “We all work together cordially to improve care. Whenever you call, they will take your call because it could be a challenge.” The registered manager told us what they wanted for people. They said, “It’s about making sure people we support receive excellent care, to aspire for the best for them, for their needs to be met and for them to have opportunities for preferences to be met.” The registered manager sought feedback from staff on any barriers to delivering the service, including within staff meetings. The registered manager also used staff meetings to thank staff for their contribution to delivering Covenant Healthcare Limited’s visions and values.

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. Staff were complimentary about the knowledge and approach of senior staff and how they worked alongside them, to understand people’s needs and any challenges staff faced. Staff regularly saw senior staff and the registered manager. One staff member said, “We see the registered manager often. They are so down to earth. Sometimes they [registered manager] work on care calls. For example, if we need a lift they will drop us to the [person’s] house. We can call them, and they respond well.” Another staff member told us senior staff took both people’s and staff’s needs into account. The staff member said, “[Senior staff] think about [people] but they think about the staff too.” The registered manager now felt more supported in their role, following embedding of support through their franchise arrangements, including sharing information with other registered managers. Systems were in place to support the registered manager to re-validate their nursing registration.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Staff said they were listened to, so had not needed to raise any whistle-blowing concerns. One staff member said, “The company is good. They are professional and if there is an issue they respond instantly. [Senior staff] are accessible and the [registered] manager is also accessible.” Staff knew how to raise such concerns, if they wanted to and were confident these would be addressed by senior staff. One staff member said, “If ever I see anything I shouldn't be scared and be bold and speak up and report to [senior staff]. If it is not [resolved] we would take it up from there and let CQC know.”

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. People receiving care told us how much they appreciated the inclusive approach taken by senior staff. One person said, “I am learning as much from [staff] and about their culture as they are from me.” Staff told us they were treated fairly. One staff member told us about the support provided when discrimination had been experienced by staff and said, “Any issues we raise they [registered manager and senior staff] are quick to respond.” The registered manager had arranged specific training and awareness for staff who supported people from different cultures.

There had been improvements in the way the service was run and the governance arrangements. People and relatives told us they were asked for their views about the care provided through surveys and said senior staff regularly checked they were receiving the care they wanted. Improvements had been made in the quality checks made by the registered manager, and this was being supported through franchise arrangements. This included checks made by the registered manager to ensure people received their care calls at the times planned and for the duration required. The registered manager and senior staff undertook spot checks on staff practice and calls to people to check they were happy with the care provided. In most cases, the registered manager’s audits now identified where action was needed and evidenced this was taken. There had also been improvements in the accuracy and consistency of the majority of people’s care planning arrangements, including in relation to medication and PEG, [Percutaneous Endoscopic Gastrostomy tube], support required. This helped to ensure staff had the guidance they needed to care for people. People’s care plans were more tailored to reflect their wishes, and people were referred to in more person-centred ways. The oversight of people’s medicines had improved, however, further development of governance systems was needed in this area, to ensure senior staff always identified and addressed any recording errors. Staff also required further guidance within people’s care plans on where key legal documents, such as RESPECT forms were located in people’s homes. The audits in place had not identified there were still inconsistencies in care planning recording in relation to people's mental capacity assessments.

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 and relatives told us they were treated as partners in care. One person said they were asked for their views on the care provided and their responses were listened to. A relative told us, “We do get telephone calls, they will ask for my opinions on a review.” People were also asked for their opinions on the service provided through annual customer satisfaction questionnaires. We saw the results of these had been positive. Staff told us they were encouraged to provide feedback on people’s care needs and gave us examples where staff worked closely with other organisations so people would receive the care they wanted. Senior staff gave us examples showing how they had developed effective working relationships with other health and social care professionals. One staff member said, “We have the district nurses ‘phone numbers and even at the weekends, communication is good.” We saw staff had received compliments from other health and social care providers about the approach taken to partnership working. This had resulted in a positive experience of care for a person with complex health needs. The registered manager let staff know their contribution to people’s care was valued through Carer of the Month awards and by letting staff know when compliments about the care they delivered had been received. The registered manager gave us examples showing how they had used their knowledge of local networks, organisations and charities, so they could signpost people and staff for additional support, where appropriate. Some relatives told us they were not aware they could access their family members care records online, where their family member’s permission had been granted, but felt able to approach the provider and get access to this.

The provider considered continuous learning and improvement across the organisation and local system but some processes for ensuring opportunities for taking learning across the provider’s teams and from external feedback needed to be further developed. We found an incident which had not been escalated to the registered manager for their consideration. In addition, opportunities for taking learning from previous inspections needed to be consistently embedded. There was no evidence of harm to people, but further development of systems would help to ensure people continued to receive person-centred care, with risks to people further reduced. For example, by ensuring care plans and records always accurately reflected the support staff had provided to help people to manage their health and medicines. However, people told us if they provided feedback on their care it was listened to, and action was taken to improve their care further. One person told us, “They do listen and put things on the WhatsApp group chat, if things need to change.” The registered manager gave us examples showing how they had taken learning and embedded it. This included in relation to learning taken about the accuracy of assessments they received from other health and social care professionals. For example, relating to equipment people required, and details of people’s prescribed medicines. The registered manager had introduced further checks to ensure people received the support they required in response to this learning. Senior staff considered any patterns and trends where incidents, concerns or complaints had been received. These were investigated and action plans put in place so learning could be taken from these incidents.