A2Z Home Care Services Limited

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• 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 inspection for this newly registered service. This key question has been rated good. The registered manager had governance processes to monitor the quality and safety of the service. There was room for improvement with their audits to ensure issues were identified. Staff felt well supported by the registered manager and their colleagues and felt comfortable they could raise any concerns. However, the registered manager was the only person available with care experience for support; they had a plan to address this by developing an existing staff member. The registered manager was responsive to our feedback and took action to address the issues we found.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff gave positive feedback about the culture of the service. They felt well supported by their manager and colleagues. A member of staff said, “I'm happy that we have a manager who is always willing to help when we need it.”

The provider had policies to support equal opportunities and inclusion. For example, their recruitment policy included guidance for employing people with a learning disability.

Staff felt well supported. A staff member told us, “My manager is always very helpful and very supportive.”

The registered manager was the only person available for on call support to staff. Whilst there was a director of the service, they did not have any care experience. Following our visit, the registered manager told us they were developing a staff member into a care co-ordinator role.

Staff confirmed they knew who to speak with if they had concerns. A staff member told us, “Yes. It’s my manager.” However, not all staff knew what whistle blowing was and they did not know what to do if they had a concern about the manager. Another member of staff said, “Maybe I will share with my colleague and maybe we will talk.”

The service had a whistle-blowing policy. This advised staff to report any concerns to the registered manager or director of the company. If they did not feel comfortable with this, they were advised to inform the police, local authority or CQC as appropriate.

Staff confirmed they were treated equitably.

The service had an equality and diversity policy.

The registered manager had processes to monitor the service. They were aware these would need to be adapted as the service grew to ensure they maintained effective oversight.

The registered manager completed a range of audits to monitor the quality of the service. This included care records, daily logs, MAR charts and personnel files. None of these had identified any issues, such as those we found with care records and recruitment files and potential gaps in staff knowledge. There was no call monitoring audit, but the registered manager advised they reviewed visit logs daily and would know if staff had been late or cut a visit short.

People’s relatives gave positive feedback about communication with the service.

The service had very little involvement with other professionals. The registered manager told us they had made referrals to district nurses when people needed support with pressure care; they were unable to give examples of how they worked with any other professionals. They told us, “We have no ongoing meetings with any other professionals as no need for it at the moment but would attend if it was.”

Another professional confirmed the service was managed well. They told us, “I have been working with A2Z for several years and find them to be professional in the care they provide.”

People’s care records had limited evidence of involvement with other professionals.

Staff attended team meetings which included development of the service. A staff member said, “We have meetings. We always discuss things about clients and how we can improve our service.” Whilst the registered manager ensured staff completed training, feedback from those we spoke with suggested there remained gaps in their knowledge such as managing risks related to eating and drinking and pressure care.

Staff meetings were held. We reviewed the minutes of 1 held in July and found these included reminders for staff to complete training and advised them to complete no more than 2 per day to ensure they absorbed what they had learned. Following our visit, the registered manager was responsive to our findings and advised they would devise a moving and handling competency template and add the issues we found, such as discrepancies in people’s care records to their service improvement plan with a short timeframe to action.