Care 24/7 Healthcare Limited

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 as requires improvement. At this assessment the rating has remained requires improvement.

This meant there were widespread and significant shortfalls in service leadership. Leaders and the culture they created did not assure the delivery of high-quality care.

The service was in breach of legal regulation in relation to the governance of the service. There was a lack of effective systems and processes to monitor and improve the quality of the service.

This service scored 61 (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 and staff 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 management team shared the direction and ethos of the service with staff. Staff were happy working with the service and supported the values that were shared with them when they were first recruited. The provider was clear that people were are the centre of the care provision. A recently recruited member of staff told us, “I like it here as more about people than money and profits. The company want to do the right thing staff are rewarded with a good wage and get travel and that is important staff rewarded more than the company”.

The service has lacked consistent leadership. The service has been without a registered manager since December 2020. Acting managers have been employed but have not stayed in post. The provider was currently managing the service and had confirmed a new manager has been recruited and will be taking up post shortly. An office manager was also recently appointed and had provided management stability. The provider worked closely with staff and supported an open and honest culture. They were committed to establishing an effective and robust management team.

People and relatives were satisfied with the management of the service, and one person told us, “The organisation is very good they are trying to provide a good service and are looking at ways to improve all the time. They are looking to expand, and I hope they can as the service they provide is the sort of service that we all need”.

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

Staff told us they were encouraged to be in regular contact with the management team based in the office. They were able and supported to share their views and any concerns on a regular basis. Visits in person to the office were encouraged and the office space was welcoming. It was decorated with festive decorations with drinks and chocolates available. A speak up policy and procedure was available to staff on the business portal.

Staff told us they felt valued and listened. One told us, “Staff from the office are always on the end of the phone. I contact the all the time for re assurance sometimes just need someone to run something past to make sure you are doing the right thing”. Another said, “The management listens to us they respect our opinions we can tell the office anything and feel free to raise anything and to talk to them openly”.

The service valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who work for them.

Staff were very happy working for the service and told us they were valued, treated with respect, and they did not experience any discrimination or harassment. One staff member told us how refreshing it was to be asked if they could do an extra shift rather than be told. This was a recognition that staff had different needs and priorities on their time. Staff were well motivated and proud of their work and the team they worked with.

The provider was committed to promoting equality and inclusion across the workforce. They showed an empathy towards staff and their individual backgrounds and how these impacted on their working and daily lives. They described adjustment made to support staff that included different communication methods for a staff member with a disability.

The service 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. The service had lacked stable and effective leadership and did not have a registered manager. Systems for quality assessment and monitoring of the service provision and compliance with the regulations had not been fully established.

For example, there was no established system to capture people and their relative’s feedback on the service provided. Staff did not have their practice reviewed within people’s own homes. Systems to capture feedback from staff had not been established. Supervision and team meetings were not used to capture staff views. There was no quality tool in place to review systems used. The service’s policies and procedures had still not been fully adapted and adopted into practice. For example, the supervision and appraisal processes had not been established and the complaints procedure had not been followed to demonstrate how complaints were dealt with effectively.

Although the provider was aware systems needed to be established, and the new office manager was working on auditing systems and making improvements when needed. The improvements made were not enough and the service still did not have effective management oversight or governance.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They shared information and learning with partners and collaborate for improvement.

The management team were positive about their links with local health and social care teams. They were proactive when approaching other organisations. They had an open positive attitude to receiving support and understood how and where they could access support from. They worked with local people and employed local people and were looking to expand the service locally.

The service had not always focused on continuous learning, innovation and improvement across the organisation and local systems. The lack of leadership had not motivated creative ways of delivering equality of experience, outcome and quality of life for people. The current service provision is small, and the provider recognised the importance of learning and improvement as part of the service’s development. They confirmed the new manager once in post would work with the office manager to develop this aspect. The provider responded positively to the feedback from the assessment process implementing some improvements immediately.