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Care 4 Care Headquarters

Overall: Good read more about inspection ratings

59 Ashridge Way, Morden, Surrey, SM4 4ED (020) 8715 7223

Provided and run by:
CARE 4 CARE SERVICES LTD

Report from 4 July 2024 assessment

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Well-led

Good

Updated 12 August 2024

Based on the findings of this assessment we found the service had improved and addressed the outstanding breach we identified at their last inspection relating to how they operated their governance systems. This meant the provider now operated their governance systems effectively. People were complimentary about the way the service was managed, and how approachable the office-based managers were. The provider promoted an open and inclusive culture which sought the views of people receiving a service, their relatives, and staff working for them. The provider worked in close partnership with external health and social care professionals and agencies to plan and deliver people's packages of care and support.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Shared direction and culture

Score: 3

Managers and staff told us they aimed to give people they supported the best quality person-centred care they could. The managers had a clear vision for the service and told us they routinely used individual supervision and appraisal meetings to remind staff about the provider’s underlying core values and principles.

The service aimed to give people consistently good care and staff worked together to try and achieve this. Individual and group staff meetings and work performance appraisal were routinely used by the provider to remind staff about their organisations underlying core values and principles. An external health care professional told us, “The provider does not have a blame culture which allows care staff to be open and honest. This ensures a high standard of care delivery.”

Capable, compassionate and inclusive leaders

Score: 3

Staff told us the service was well-managed by the office-based staff and their field supervisors. They said they received all the support they needed from the managers and their supervisors. A member of staff remarked, “The service is managed very well. The management team is accessible and supportive. They ensure we have the resources and guidance needed to perform our roles effectively, and they foster a positive and professional working environment.” Another member of staff added, “The service is managed well by the office-based management team who are all approachable, supportive, and responsive to our clients and the care staff team needs and wishes.”

The managers had the relevant skills, knowledge, and experience to effectively lead the service, which they did so with integrity, openness and honesty.

Freedom to speak up

Score: 3

The provider valued and listened to the views of staff. Staff told us they were encouraged to contribute their ideas about what the service did well and what they could do better during regular meetings with their managers and fellow co-workers. A member of staff said, “We have monthly team meetings where we are able to get together as a group so we can share our views and ideas about what the service does well and what we can do better.” Another member of staff added, “I get many chances to voice my opinions about the agency, and the supervisors pay attention to what we have to say. For instance, they have made adjustments to timetables and provided more resources in response to our criticism.” The registered manager told us the provider had a complaints policy which detailed how people could raise concerns if they were dissatisfied with the service they received and the process for dealing with their concerns.

The provider promoted an open and inclusive culture which sought the views of people using the service, their relatives, and staff who worked for them. They used a range of methods to gather people’s views and find out what they thought about the quality of the home care service they received from this provider. For example, people using the service and their relatives had numerous opportunities to express their views about the agency through regular contact with the office-based managers, either in-person during a home visit spot check on staff or a welfare check call by telephone. People were routinely invited to complete the providers own customer satisfaction surveys. In addition, the provider had a complaints policy which detailed how people could raise concerns if they were dissatisfied with the service they received and the process for dealing with their concerns.

Workforce equality, diversity and inclusion

Score: 3

Care staff told us the registered manager and office-based staff treated them well. They said they got all the support and guidance they needed from them.

Staff had ongoing opportunities to reflect on their working practices and professional development including, regular individual and group meetings with managers and their fellow co-workers. The provider valued and listened to the views of staff and they were encouraged to contribute their ideas about what the service did well and what they could do better.

Governance, management and sustainability

Score: 3

It was clear from feedback we received from the managers and staff they now had a better understanding of their roles and responsibilities in relation to assessing, monitoring and managing the quality and safety of the service they provided to people. A member of staff told us, “The managers and supervisors regularly carry out surprise spot checks on us when we’re visiting our clients to see how we are performing. It they are not happy with the way we do things they follow the check up with a face-to-face or telephone supervision meeting to discuss what they saw and what we could do better.” Another member of staff added, “Office-based managers and senior staff carry out regular spot checks on our working practices to ensure we are following procedures correctly and providing the best care possible we can.”

Following the last inspection, the provider implemented an improvement plan to address identified concerns. This included an ECM system to better coordinate staff call visits, improved record-keeping, and enhanced governance systems. Office-based managers showed improved understanding of the importance of learning lessons and continuous improvement to ensure person-centred and safe care. They conducted thorough audits on staff training, observations of staff practices, coordination of call visits, medication management, complaints, safeguarding incidents, and stakeholder feedback. Audit results were regularly analysed to identify issues and improve services. The provider transitioned to an electronic system to oversee call visits, care planning, and medication management, significantly improving service monitoring. The system automatically alerted managers if staff missed scheduled visits or failed to administer medications on time. An external healthcare professional noted the provider's robust and efficient governance systems significantly contributed to high-quality care. We found no discrepancies in record-keeping, unlike in the previous inspection. Managers understood their regulatory responsibilities and made timely notifications to the CQC. The previous CQC inspection report was displayed in the office and on their website, as legally required.

Partnerships and communities

Score: 3

People told us staff supported them to stay in contact with external health and social care professionals and agencies as and when they needed them.

The office-based managers told us they regularly consulted external health and social care professionals and agencies, welcomed their views and advice, and shared best care practice ideas with their staff team. A member of staff told us, “I work closely with community professionals and agencies, taking on board their advice and guidance. For example, I have collaborated with healthcare professionals to develop care plans that meet the specific needs of the individuals I support.” Another member of staff added, “We work closely with GPs, district nurses, palliative care nurses, occupational therapist and paramedics, and always take any professional advice and guidance they provide us.”

External health and social care professionals expressed being generally satisfied with the way the provider collaborated with them. One external health care professionals told us, “The provider remains good at reporting any incidents involving our clients and addressing situations quickly and efficiently.” Another added, “The provider excels in collaborating with external health and social care professionals. Communication channels are open, efficient, and timely, allowing for seamless updates and coordinated care plans. They are proactive in seeking input and integrating feedback from external professionals, which greatly enhances the overall care provided to our clients.”

The provider worked closely with various external agencies including, GPs, district nurses, occupational therapists, social workers and Local Authorities. This was underpinned by a policy of relevant information being shared with appropriate services within the community or elsewhere.

Learning, improvement and innovation

Score: 3

It was clear from the feedback we received from managers and staff they recognised the importance of learning lessons and continuous improvement to ensure they maintained person-centred and safe care for people they supported.

Safeguarding concerns, complaints, accidents, incidents were all routinely reviewed, analysed, and responded to with emerging themes identified. Appropriate action was always taken in a timely manner to administer the risk of similar incidents reoccurring. Audits and checks, and the gathering of stakeholder feedback was routinely conducted by the office-based managers and senior staff to monitor and learn how to improve the quality and safety of the service they provided people. An external health care professional told us, “They [the provider] have shown a strong commitment to continuously improving their services and delivering high-quality care to our clients.”