Community Care Direct Ltd

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

The manager was new to the service and was in the process of becoming registered with CQC. The manager had quickly addressed any shortfalls in the safety and quality of the service and had begun to both implement new processes and revise existing processes to address the shortfalls in a timely manner. For example, some auditing processes did not exist so we could not be fully assured the service had an accurate and up to date picture of the safety and quality of the service. Where audit processes had identified shortfalls, there was no evidence that actions to remedy this had been taken from one audit to the next. In the short time the manager had been at the service, they had overhauled systems of accountability and governance to help drive up the safety and the quality of care being delivered. Staff spoke positively about the manager and described them as being supportive, open, approachable and knowledgeable. Staff told us the manager helped instil a positive and compassionate culture which strives for high standards of care. The manager was transparent and collaborated with relevant external stakeholders and agencies.

This service scored 39 (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 new manager had been in post for a month at the time of the assessment. During the short time they had been in post, staff told us they thought the manager to be an inclusive leader who embodied a positive culture and had the skills, knowledge, experience, and credibility to lead effectively. Staff also told us they found the new manager to be open and honest. Comments from staff included, "[Manager's Name] is a breath of fresh air - she has open door Tuesdays but in fact is here every day for people" and "[Manager's Name] is so supportive and experienced." The manager was also keen to tell us how important it was to have a supported and happy staff team, "I have drop in Tuesdays - where staff can call in for a coffee, cake and chat. But staff can call in anytime at all - staff have commented that under the old manager they didn’t like coming to the office - but now they feel comfortable to drop in. It's crucial for me to have well looked after and happy staff. "

The new manager had been in post for a month at the time of the assessment. During the short time they has been in post, they had made significant changes to help improve the standard of care and service being delivered. Changes included the introduction of more senior staff to help rewrite care plans and risk assessments and the introduction of electronic systems to help better support staff and to help better monitor and assess the safety and quality of the service provided. Records and feedback from staff demonstrated an inclusive leader who embodied a positive culture and had the skills, knowledge, experience, and credibility to lead effectively.

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.

The manager had been in post for a month and was open about the fact that the service was not always able to demonstrate it had clear roles, systems of accountability and good governance to help manage and deliver good quality, sustainable care, treatment, and support. Risk assessments were not always in place in people's care records and we were not always assured staff were able to act on the best information about risk, performance and outcomes. The manager was open about the lack of established systems in place and had already begun work to establish an array of safety and quality auditing tools to further improve the quality of care being delivered. One member of staff told us, "[Manger's Name] is a fantastic manager - a breath of fresh air - we couldn’t have got better with them. [Manager's Name] is always available. She's been very ill recently and is still here for us. She has helped me to strike a great work/life balance."

There were shortfalls in systems to help manage the service effectively and monitor the safety and quality of the care being delivered. Some audits were not effective, actions for improvement had been identified but there was no evidence these had been carried out from one audit to the next or audits did not exist at all. For example, although the provider monitored care calls daily for duration and arrival and leave time, these checks were not formally recorded. During the short time the new manager had been in post, they had made significant changes to help improve the standard of care and service being delivered. Changes included the introduction of more senior staff to help rewrite care plans and risk assessments and the introduction of electronic systems to help better support staff and to help better monitor and assess the safety and quality of the service. More robust auditing tools had been introduced, to help implement more effective governance and monitoring. The new manager had also compiled a robust action help to help remedy the shortfalls they had identified in a timely manner.

Feedback from people and their relatives was able to demonstrate the provider understood its duty to collaborate and work in partnership, so it worked seamlessly for people. People spoke positively about the provider and how staff worked as a team, and with external professionals. A relative summed it up by saying, "Although the district nurses manage Mums medicines, staff are so receptive to any changes and feed this back to nurses."

The provider was able to demonstrate that it understands its duty to collaborate and work in partnership, so it worked seamlessly for people. Information and learning were shared with partners to help collaborate for improvement. The provider supported many people who were on an end-of-life care pathway and worked in close collaboration with external professionals working in this field. A member of staff told us, "We have good relationships with the district nurses and Queens Court Hospice. This helps us with the palliative care patients."

The provider evidenced that it understood its duty to collaborate and work in partnership, and to share information and learning with partners and collaborate for improvement. A recent safeguarding had been closed by the local authority who were impressed by the manager's openness and implementation of proactive measures to help learn from incidents and to collaborate for improvement.

The service had not always demonstrated its duty to collaborate and work in partnership to enable seamless care and support for people. Information and learning had not always been shared with partners. The new manager has worked with external bodies to share learning to reduce risks and had introduced a multiple of safety measures to help prevent incidents occurring and was actively promoting a culture of openness, sharing and a willingness to learn and collaborate to help further improve the standard of care and support people received. Further time was required to evidence the effectiveness of these improved practices.

Feedback from the manager and staff was able to demonstrate there was a culture of continuous learning, innovation, and improvement across the service to help encourage creative ways of delivering equality of experience, outcome, and quality of life for people. The manager explained, "There is a lot of work to do here since the old manager left but we have made great progress so far - I have good support and we strive to be outstanding." A member of staff commented, "[Manager's Name] has instilled all new systems - once they are fully up and running, we will have access to everything at the touch of a button such as the most up to date risk assessments etc."

Although the provider was able to demonstrate there was a culture of continuous learning, innovation, and improvement across the service to help encourage creative ways of delivering equality of experience, outcome and quality of life for people, prior to the new manager joining, little or no action had been taken on areas which has been identified for improvement - such as medicines management. Therefore, it wasn't always evident the service had embedded a genuine culture of continuous learning and improvement to help lead to better outcomes for people. Some audits were either ineffective or did not exist. The new manager had a robust action plan to address these shortfalls, further time was required to evidence the effectiveness of these new and improved systems of governance and to evidence the impact the renewed culture had on bettering people's outcomes.