Santos Care 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

The service was not well led and the rating remains inadequate. Not enough improvement had been made and we identified 1 breach of the legal regulations. There was a lack of effective governance and where audits were completed they did not accurately reflect the care being provided. The registered manager was largely absent from the service but had not notified us of this, as required by law. The nominated individual and registered manager were unable to provide accurate information about the service, including who received support and who they employed. There was a lack of accountability and limited evidence of learning since the last inspection. We found continued concerns to those identified at the previous 2 inspections.

This service scored 25 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The nominated individual and registered manager acknowledged that improvements were still needed. The registered manager advised they had not really been present in the service since the last inspection. The nominated individual advised they had recruited a new manager, but then later stated they intended to submit an application to become the registered manager themself. There was a lack of transparency from the nominated individual and registered manager about most aspects of the service. Information about the number of staff employed was repeatedly changed and the precise figures remain unclear. The nominated individual and registered manager initially withheld information about who they provided a regulated activity to and provided names and care plans for only 3 people. However, later in the assessment the nominated individual advised they were supporting 7 people with a regulated activity. However, staff told us they felt supported by the management team and found them approachable. They told us team meetings took place where they felt confident to raise concerns or make any suggestions.

During the site visit the nominated individual told inspectors they had asked the care coordinator to remove the ‘red’ showing in people’s electronic records, as they did not want inspectors to view it. They told us the ‘red’ related to the administration of prescribed medicines. This meant we could not be assured of the accuracy of the information contained within the electronic records. The service was disorganised and there was a lack of clear defined leadership. Roles and responsibilities were unclear and processes used to review the quality of care and drive improvement were sporadic and largely ineffective. A consultant present during the site visit discontinued their support following the assessment and the provider appointed another consultant with the aim of driving improvement.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

There was a lack of clarity between the nominated individual and registered manager roles and some staff we spoke with thought the care co-ordinator was the manager of the service. The registered manager described their involvement in the service since the last inspection as ‘sketchy’. The nominated individual and registered manager lacked detailed knowledge about who received support and who they employed. Information they provided was inconsistent with both records and also each other. Staff told us they were confident about who to contact if they had any queries about the support they provided. However, 1 staff member named a manager who was not on the initially supplied staff list. We were advised by the nominated individual that this was an oversight and that they were currently employed as a care co-ordinator.

There was a lack of governance systems to monitor the quality of care which posed a risk to people. Concerns identified at the last inspection had not been addressed and there was limited evidence to suggest progress was being made. This was evidenced by 4 continued breaches from the previous inspection. The nominated individual shared an action plan with us, where they had scored themselves as 79% compliant. However, some actions that had been marked as met, were in areas where we found concerns. For example, ‘Ensure accurate information in care plans and medication records’ was marked as met, but medicines information was unclear in people’s care plans. A further example, ‘Implement a robust system for the regular review of care plans and risk assessments’ had been marked as met, however care plans and risk assessments did not always accurately describe people’s risks or how staff should support them safely. A quality assurance matrix was provided. However, this was sparsely populated and did not include corroborating information. It only included 3 SU names, despite the nominated individual and registered manager telling us they supported 7 people.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.