Assured Care Southport

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

Our rating has changed from inadequate to requires improvement. We identified one breach of the legal regulations. Since our last inspection the provider had introduced several new systems and audit tools to improve the overall governance and oversight of the quality of the service. Whilst this addressed many of the significant shortfalls we identified last time, we found some systems had either not yet been embedded or were not fully effective. Examples can be found in the safe and effective key questions. Staff could explain their individual roles clearly however did not understand the providers overall vision and strategy. Some staff felt communication between office-based staff and care workers still needed to be improved to ensure important information about people was consistently shared. Despite this, staff did feel there was an open culture where they felt they could speak up about any concerns about peoples care and felt able to whistle blow on poor practice. Systems were in place to ensure staff were treated fairly and equitably within the workplace.

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.

Staff did not understand the vision of the service and could not describe the shared direction they worked towards. One staff member told us they thought it was, “To give the best care we can to people and hopefully all the staff have the hours and all the training they need.” Staff did tell us they felt they all worked well as a team and felt this was important. Most staff said they would recommend Assured Care Southport to others. However, one staff member said this would not be the case. They explained this was due to communication issues with the management team rather than concerns about the care people received. The registered manager described how they expected staff to conduct themselves in their role and told us they reinforced this in team meetings.

There was a lack of process in place for staff to be able to understand the vision and strategy of the organisation. The provider had a statement of purpose which included some information about the providers vision, however this lacked detail. We raised this and the registered manager provided assurance this would be fully reviewed. Since our last inspection, the registered manager had been holding regular team meetings. This demonstrated staff were involved and consulted on decisions made about the organisation.

In general, staff felt they were supported by a compassionate and inclusive leadership team. We were told, “I feel listened to, I get good support” and, “Yes, feel I can go to managers with anything.” Throughout our assessment we found the entire management team were committed to improving the quality of the service and eager to demonstrate the improvements they had made since our last inspection. Additional management training had been sought and the skills and knowledge of the management team had improved.

Since our last inspection the provider had recognised their personal areas of development and had sought advice and support from external consultant agencies. New systems and processes had been introduced because of this support. The provider had developed an improvement plan following our last inspection. however, this was not sufficient and lacked details of all the areas which needed to be improved, and how they planned to address this.

Staff felt confident in speaking up about any concerns they may experience and told us they felt they would be supported. They told us, “I definitely feel supported by managers. Very approachable. Yes, feel listened to. Have worked with [Name] in the community a lot, so could go to them with anything” and, “Yes, concerns are always listened to, and I have good communication with managers.” Staff confirmed they had access to appropriate policies to support them to raise concerns.

The provider had policies and procedures in place which guided staff through the process to speak up. Team meetings and supervisions were held which gave staff opportunities to meet with their line manager in a group and individual setting where they could raise any concerns and share their views.

Staff told us they felt treated fairly. One staff member gave a personal example of support they had received and told us this had remained confidential. Staff spoke of a good morale amongst the team and told us they enjoyed working for the provider. Comments included, “It's been a long time since I've been this happy, so I have no interest in going anywhere else. Most enjoy the atmosphere amongst staff, we all get on” and, “Everyone gets along with everyone, especially when doing double ups and the team and get to know people on training. I do enjoy going to people's homes and having a chat and getting to know them.” The registered manager described the personal risk assessments they had in place for staff, for example, around physical health and pregnancy.

Policies and procedures were in place to ensure people were treated fairly and equitably. This included when staff had protected characteristics under the Equality Act 2010.

Staff confirmed members of the management team undertook spot checks and completed competencies on their ability to perform to a high standard. The registered manager described the auditing systems they had put in place since our last inspection to address the failings identified. This included the support from external consultants. However, the registered manager told us that they were aware some processes had yet to be implemented or were not yet embedded into practice. They said they were aware further work was needed in this area.

There was a range of policies in place that provided sufficient guidance to staff and leaders in ensuring safe practice. Systems were in place to enable audits to be completed however, not all had been used. Other audits which had been completed were not effective as they had not picked up the issues we found at this assessment. For example, care plans had been rewritten and were now subject to regular review. However, no recorded audits had been completed to review the quality of the risk assessment and care plan in place. We found a small number of care plans did need some further detail to ensure they fully reflected people’s needs. Regular medication audits were now undertaken; however, they did not pick up the prescribing discrepancies we identified. The provider had a policy stating where people were supported to manage financial expenditure then regular checks should be made on this. No checks were made of any financial expenditures made by staff on behalf of a person. Staff recruitment files had been audited for completeness, but we found some gaps still existed which had not been picked up by the providers systems. The recording and monitoring of accidents and incidents had improved since our last inspection, however the new systems introduced were not always consistently followed. This made it difficult for us to see all accidents and incidents had been appropriately reported to other agencies.

People told us they were happy with the care they received from Assured Care Southport, and they were supported to access support from other services and agencies when they needed it. One person told us, “In three years I'm very happy and never had a problem, people ask me, and I always recommend them to people. If my family needed care, I would send them to Assured Care.”

Both the care staff and management team were able to demonstrate how they worked collaboratively with health professionals. For example, making referrals to community physiotherapists, GP or pharmacy.

Partners who had worked with the service did not all feel the provider worked collaboratively with them. For example, partners shared examples when they felt responses to concerns were not responded to in a timely manner and told us although people who used the service were generally happy with the care they received, some had raised concerns about the effective running of the organisation. We discussed this feedback with the registered manager who described the period following the last inspection as very difficult and conceded relationships with some partners had been difficult.

Care records demonstrated effective multi agency working for people. The registered manager told us they were now signed up to updates from the CQC to keep updated on required standards and also to enable them to share best practice with the staff team.

Staff demonstrated an understanding of using creative ways of delivering equality of experience. One staff member described how they successfully supported a person reluctant to regularly wash and bathe to agree to a routine they were comfortable with. They described how focusing on the heat of the home as well as involving them in making choices built up this trust and agreement to care. Not all staff could recall being involved or consulted on any outcomes or lessons learnt following an accident or incident occurring. The registered manager described how they gathered feedback from people however added more work could be done and was planning some updated surveys to be sent out to people and their family members.

There were systems in place to demonstrate learning, improvement and innovation, however, not all had been fully embedded into practice to demonstrate continuous learning was a focus. For example, accidents and incidents were analysed and trends analysis undertaken of incidents such as falls. However, not all falls were recorded on the correct form which meant they were not always picked up as part of analysis.