CLARITY HOMECARE (BRISTOL)

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• 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

We only assessed the governance quality statement in this key question. We found a breach of regulations. The provider acknowledged there had not been clear and effective governance, management and accountability in the previous 12 months. They had addressed this before our visit by bringing in senior and experienced managers to make improvements and ensure good practice was embedded. Shortfalls were being addressed, and an improvement action plan was in place. The management team were open with us about areas that needed to improve. However, governance and accountability systems were not always in place, effective or embedded. Electronic call monitoring was not being overseen, staff did not complete detailed records and statutory notifications had not always been made as required. Staff had not always received training or supervision. Audits were not being completed as required. Checks and monitoring had not identified all the shortfalls we found. We did not find any evidence of harm to people, but this was a breach of regulations relating to good governance. Staff were positive about recent changes and the support they were now receiving from the management team.

This service scored 62 (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.

We did not look at Capable, compassionate and inclusive leaders during this assessment. The score for this quality statement is based on the previous rating for Well-led.

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.

Staff told us there had been a lot of changes recently. They were now being supported by the operations manager and the business development manager. The operations manager explained they had been brought in on consultancy basis to make improvements. They were open with us about some of the areas that needed to improve. They were working closely with the business support manager to make improvements including staff training, improving recruitment processes and record keeping. A member of staff told us, “There wasn’t clear guidance before. No feedback from management, but now it’s changed. I feel comfortable with the operations manager. She’s clear about what we need to be doing.” Another staff member told us, “Last year and the beginning of this year, no sense of direction and we have direction now. The manager is listening and tries to help us.” We were also told that there was now more general support for employees. One member of staff told us, “Carers are getting support, especially with childcare and having flexible working hours. We have more team meetings and staff are vocalising themselves more now as they weren’t feeling heard before.” The operations manager told us not all care staff had been completing the daily log of visits on the electronic recording system and were just ticking a box when a task had been completed. Training on record keeping was being cascaded to all staff to make improvements in this area. The lack of records meant that care could not be fully reviewed and monitored. The management team acknowledged there had not been clear and effective governance, management and accountability over the last 12 months as the service had grown. Shortfalls were being addressed, and an improvement plan was in place. The provider took action to respond to the concerns raised during this assessment and improve their governance systems and practices.

During this assessment, we found governance and accountability systems were not always in place or effective. An electronic call monitoring system was in place. This meant office staff could oversee the timings and length of visits to people. However, there was a lack of evidence that this was being checked to ensure people received consistent care based on their needs and time preferences. The timings of visits were not consistent. Staff had not always received the training they needed to support people safely. The management team had found gaps in training compliance and had taken action to improve compliance and competency. Not all audits were being completed at the required intervals. For example, there was a lack of medicines audits, and no financial audits were completed. Not everyone’s care was reviewed within six weeks of starting a service or thereafter every three months. There had been improvements in recent months, but audits and checks had not identified all the shortfalls we found. The provider had failed to notify CQC of events such as a serious medication error, an allegation of theft and the absence of the registered manager. Notifications were submitted to CQC after our visit. An improvement plan was in place and the business development manager had identified several areas for improvement including recruitment procedures, the training, supervision and support of staff and audits. The operations manager had completed a risk rating for everyone supported by the service to ensure people received appropriate care in the event of an emergency.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.