- Homecare service
Taunton Deane Support Services
Report from 12 July 2024 assessment
Contents
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
At the last inspection of the service, published in April 2023, we found people's quality of life was not enhanced by a culture of learning and improvement. People were not always treated respectfully or with compassion. People's care and support plans did not always accurately reflect their range of needs or risk. Neither the provider nor the registered manager had effective oversight of the quality of care or people’s safety in all settings. This had led to people receiving poor or unsafe care. The provider was therefore in breach of the regulation in relation to good governance. At this assessment we found significant improvements had been made and the provider was no longer in breach of this regulation.
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.
The registered manager, and staff in different settings, told us they had worked hard since the last inspection to improve the service. It was clear the culture had been significantly improved. Many new initiatives had been introduced to help support improvements and communication throughout the service. One staff member told us, “There has been lots of good work going on to improve the services and good support within the organisation.” At each of our visits we found the culture was honest, open and inclusive. Staff spoken with were confident, happy and felt well supported. One member of staff said, “I would say that staff feel happier and more supported now.”
The registered manager and individual service managers worked well together and led by example. The registered manager said, “I have said to them [the service managers], we are all one team and none of us can do our jobs well without the support of each other.” Where staff did not reach the standards required appropriate action had been taken. For example, 1 staff member had their probation extended and the provider’s disciplinary procedure had been instigated for another.
Capable, compassionate and inclusive leaders
Service managers spoke very highly of the registered manager and vice versa. Staff spoke highly of the service managers. One member of staff said, “[The organisation] has had lots of changes. [Service manager name] is good.” The service managers felt that significant improvements had been made in the support they received. One said since the registered manager had been in place, “Things have improved 100%.” Another told us, “The previous area managers were not really responsive. [Name] always gets back to me straight away and she has visited 3 or 4 times already, the most any area manager has done before.”
People and their relatives were listened to and their views acted upon. This was another area where improvements had been made. People were encouraged to talk with staff and service managers; in some settings people had regular ‘house meetings’. This helped to make sure people were fully involved and had opportunities to make suggestions about their care and support. The provider also used surveys to gain people’s views and ideas. One relative said, “They sent a questionnaire last week and they have come periodically.”
Freedom to speak up
Staff felt able to speak up and were confident they would be listened to. One service manager said, “If staff have any concerns I will always sit and chat these through with staff and this seems to mean a lot to them.” Another service manager told us that 1 person had raised concerns about staff and this had been dealt with.
The provider had policies and procedures to enable people and staff to make complaints or raise concerns. Compliments were also recorded.
Workforce equality, diversity and inclusion
The registered manager said, “When I first started, I had to build trust with staff as there have been so many changes in the senior management team. I was aware of the improvements needed and what needed to be put in place, so I have spent time with all of the service managers.” They had also attended staff team meetings in various settings and introduced ‘drop in’ sessions for all new staff. Staff were very happy in their roles. One member of staff commented, “It’s a lovely place to work. I feel well supported.”
The provider had policies and procedures to make sure staff were fairly recruited and treated. The registered manager had supported 1 staff member in raising a grievance using the provider’s policy. This had been resolved to the staff member’s satisfaction.
Governance, management and sustainability
Service managers and staff felt there had been great improvements throughout the service. These included changes to the management team, in communication, involvement, oversight of services and record keeping. Staff told us they were much happier in their roles. One member of staff said, “Things here are very good now.”
At the last inspection we found quality monitoring had not been effective in identifying and addressing shortfalls. At this assessment we found significant improvements had been made. However, it was acknowledged that further improvements were still needed in care planning and recording as “We are not quite there yet.” There were plans in place to continue to make these improvements. There were systems to effectively monitor standards of care and ensure ongoing improvements to the support people received. Monitoring arrangements had been developed and embedded into the culture of the service. This made sure improvements were made and sustained.
Partnerships and communities
People were active members of their local communities, using the local facilities. One person said, “I am going to meet my girlfriend. We are going to the pub for lunch.” Another person said, “I like going to where I do music and craft. I go to the gym and also go swimming. I went on holiday with my mum.” One person was extremely proud of volunteering for a national charity, and was very keen to show us their uniform. One relative told us, “They do little social events and things to get her involved with, things like disco; everything is fine really.” People told us staff helped them to keep in touch with friends and family by calls and visits.
The registered manager told us they had strong relationships with external colleagues which included health and social care professionals. One service manager had worked with a national charity to make sure that 1 person who volunteered was officially recognised for their work.
One professional told us, “I just wanted to say how great the team at [1 setting] are to work with. Staff are always on time, friendly, communicate really well, and always have [people] fully prepared for the day. It is really appreciated by all of us.”
The provider had a written set of values, “Brave, Positive, Kind, Inclusive and Passionate.” These were chosen by the people they supported. They represented what was important to each individual and what lifestyle they wished to lead. This was then supported by staff.
Learning, improvement and innovation
Since the last inspection, the provider had taken action to address the shortfalls we highlighted and make the improvements needed. These had been built upon by the registered manager since they had been in post. Staff told us they felt the culture, communication and support within the service had significantly improved. People were benefitting from a much safer, responsive and consistent service. The registered manager told us, “Overall I feel there have been lots of improvements, but we are not where we would like to be. The day-to-day support for people I think is very good but our record keeping could improve. Care plans are up to date and are regularly reviewed but I feel in terms of making them more person centred they often require more detail. This is what we are currently working on.”
The provider and registered manager used audits and quality monitoring tools to review and improve the service. They also worked closely with the local authority’s quality assurance team. Each service manager had an action plan for each of the settings they were responsible for. These fed into the service’s quality assurance tool. Each service manager signed off improvements when they had been completed. New processes to improve quality and feedback had also been introduced such as ‘drop in’ sessions to support staff in care planning, regular area meetings and ‘house meetings’ in some settings where people shared accommodation. Staff (including the registered manager) had been nominated for awards for good or outstanding work through the provider’s own awards system. A learning disability panel chose the winners.