Everycare West Kent

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 Good. At this assessment the rating has changed to Inadequate. This meant there were widespread and significant shortfalls in 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 governance at the service.

This service scored 36 (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 did not have a clear vision, strategy or ensure a positive culture within the service and there had been a lack of action taken by the provider to improve the shared direction and culture. Senior staff told us they did not always feel supported by the provider and that improvements or changes to the service were difficult to progress. The manager said, “I feel I have brought stability and knowledge to the service. I support the team and am not afraid to go out there and carry out care calls. I have been trying to build up confidence in the office and ensure staff have the correct training to carry out tasks. I hope I make them feel fully supported which they haven’t had before. But I don’t feel I have the support I need. Sometimes I feel I run the agency single-handedly.”

There was a poor culture within the agency. The manager said it was difficult to arrange staff meetings as trying to get staff in the office had been, “A hard battle, they (staff) either don’t want to come due to certain staff being in the office, or don’t see the point given how previous managers treated them once here.” However, the staff we spoke with said they had never been invited to a meeting. Staff said there was no, “Confidentiality within the agency and senior staff show favouritism.” They also said, “Definitely no action taken when you raise things. [Provider’s name] ignores your emails.” However, the manager felt they were making progress with improving the culture within the staff team although they said there was further work to do.

Although people fed back positively on the new manager and the manager had the skills and knowledge to lead the service they were not able to put this experience into practice diligently enough to help ensure people received a consistently high-quality service. They told us they felt pressurised and the workload was such that it did not enable them to methodically work through areas that needed addressing, such as people’s care plans and without an electronic care planning and call monitoring system, they were unable to ensure they had good management oversight.

The provider had not ensured the service always had a registered manager in post. It had been 2 years since the last registered manager had left and de-registered. Although the new manager informed us they were now in the process of registering with CQC, in the interim, the provider had not carried out any quality checks of the service. The provider had not ensured CQC were notified of incidents, accidents or safeguarding concerns in line with their registration requirements. For example, the unexplained bruising on one person or the missed calls had not been reported as safeguarding incidents to us.

People were able to speak up and their opinions were listened and responded to. Everyone said they felt comfortable contacting the manager or the office should they have any concerns and that appropriate action would be taken in response.

Complaints were recorded and followed up on by the manager. For example, some people had requested a change in carer and their wishes were respected. One person asked for a change to the time of their lunchtime call and the manager told us this had been implemented straight away.

Satisfaction surveys were carried out with people and staff. We reviewed the responses from the recent people’s survey and read that people were happy with the service they received. They commented, “Extremely happy. Love the company. Everything is wonderful”, “Staff helpful and co-operative” and, “We are delighted with Mum’s care. The carers are so lovely and allow Mum to live independently at home.” People told us staff adapted the care to their requirements. For example, one person liked staff to salute when leaving, rather than saying goodbye which they did. They also asked staff to watch the news in the morning, so they could discuss the topics during their care calls.

Although people and family members were happy with contacting the office, care staff told us they did not always feel comfortable speaking up. Some care staff told us they felt they were, “Penalised” if they chose to speak out.

Although the provider and manager valued diversity in their workforce some care staff told us they felt staff were not treated equally. They said they felt care staff with children had preferential treatment and one member of staff told us they not felt supported when called a racist name. Other care staff told us however, “We have a couple of staff from different cultures and backgrounds.”

Staff undertook equality and diversity training. The manager told us, “All staff have the same access to support levels. We have a chat about things and resolve any issues between staff. Equality training is done by all.”

The provider did not have clear systems of accountability or good governance processes in place. Senior staff said they found it hard to get everything done, telling us, “If one of us goes out to assess a new client, that leaves one in the office trying to manage everything.”

Audits were not sufficiently thorough or robust. Medicine checks failed to identify staff were not properly completing MAR charts and senior staff had neglected to ensure staff were annually competency assessed for medicines. Care plans were not reviewed for completeness, and there was no structured analysis of accidents and incidents. In the absence of a registered manager, the provider had not completed any audits to ensure overall quality of the service. Additionally, some people received care calls that were shorter than scheduled or not arranged at appropriate times.

There was no system to maintain oversight or drive improvements and these shortfalls had not been identified by the service prior to our visit. The provider had not ensured there was a process to identify when a staff member failed to attend a care call. Instead, the manager relied on the person or family members to report missed visits.

There was a lack of quality assurance checks for staff which meant staff being able to work independently and administer medicines before being signed off as competent and care staff were not given time to read people’s care plans. One told us, “I haven’t read all the care plans back to back yet as I have been busy.”

The provider said an electronic care planning system would be introduced within the next few weeks. They acknowledged office staff shortages and said they planned to stop taking on new care packages at present. Yet, the manager had previously said, “We’ve been given a few new packages of around 30 minutes, so I’ve lined a few up for next week and the week after.” This created a risk of the service being stretched further, potentially impacting the quality of care provided.

The provider understood their duty to collaborate and work in partnership. Senior staff told us, “We have a good relationship with the district nurses. Normally if we have an issue, they are quite quick to resolve things.” The manager said, “We work with GPs, district nurses, the incontinence nurses and the speech and language therapy team. There is good communication between us.” They added, “I know we need to have a better community presence, and I am looking at a couple of coffee mornings.”

Despite this, safeguarding information had not been shared with social care partners and the agency had continued to take on new packages in the knowledge they may not be able to consistently meet people’s needs. For example, due to staff working around school hours.

The provider had not always focused on continuous learning, innovation and improvement across the service. Senior staff told us, “We have been promised a new care system for months and we are only now just about to get it.” Senior staff said, “We are getting the electronic care planning system which will include MAR charts, policies and procedures. It will speed things up. However, [provider’s name] doesn’t want to move the service forward. We need a bit more support from [provider’s name] to help ensure we can provide the best care that we can.” Following our inspection, despite asking the provider for information on the action they planned to take in response to our visit, they did not acknowledge our request or respond to it.