Wishes Care and Support Yorkshire Ltd- Richmond

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. This is the first inspection for this service. This key question has been rated requires improvement. This meant the service management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care. The service was in breach of legal regulation in relation to governance of the service.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Managers of the service worked well together and were open about improvements that needed to be made. There had not been a formal improvement plan in place, but following feedback from commissioners they had started to form an action plan and make some of the required improvements. There were a range of policies and procedures in place. Some were not for this service and others had an incorrect service name on. One staff member said, “It’s not just a job I am really passionate about it.”

The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively, however they had not ensured appropriate oversight or systems were in place to ensure consistency. The provider and managers valued people who used the service and staff. The new manager of the service had applied to register with CQC.

The service fostered a positive culture where people felt they could speak up and their voice would be heard. Staff told us they could raise any concerns and were listened to.

The service valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who work for them. Staff were asked during the recruitment process if they required any specific additional help or support to enable them to complete their roles.

The service did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate. There were some audits in place, however these were not sufficiently robust and had not identified the concerns found during the assessment or ensured appropriate action was taken regarding medicines records, capacity and consent and recruitment checks. Managers did not have a clear structure or overview for audits, governance or oversight. There was very limited formal provider oversight. There was no evidence of ongoing analysis or lessons learned and no overview for recording of safeguarding’s.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

The service did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always actively contribute to safe, effective practice and research. We saw some people had completed questionnaires and spot checks were completed by managers, but there was no evidence of analysis or action taken following any feedback received. Staff told us that staff meetings were used discuss with staff the learning from incidents and things that could be done to improve the service. One said, “Once dealt with we are given advice on how incidents shouldn’t happen again.” However, we found there was no evidence of ongoing analysis or lessons learned.