Cott's Care Solutions

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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 identified one breach of regulations. We found the provider had not always operated effective governance systems to monitor the quality of people’s care and the management and recruitment of staff. Effective systems were not always being used to ensure staff had access to completed care records about people’s support requirements. The provider’s own monitoring systems had not identified inconsistencies in the recording of the administration of people’s medicines in the provider’s new electronic care management system. The provider had not ensured staff had fully understood the coding system when recording the administration of people’s medicines. The registered manager was reviewing the management structure and the service. They had plans in place to improve the running of the service which would have a positive impact on the people the service supported and the morale of the staff team.

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.

Not all staff were positive about the culture and direction of the service. Several staff members expressed concerns about the culture of the service, approach of management and the inconsistency in their working hours. Some staff felt their views were not always acknowledged or valued on a professional or personal level. However, some staff reported they had seen a recent improvement.

Staff’s concerns were raised with the registered manager who explained they were reviewing their management structure to improve their support and oversight of their workforce, and to empower staff to voice their concerns without any negative repercussions. They said, “This [management restructure] came about after listening to both our management as well as the community teams, to ensure the organisation has more management workforce to deal with raising matters better and quicker due to the expansion of the business. This demonstrates a good culture and shared direction.” However, further time was needed to ensure the registered managers actions would improve and sustain a positive and consistent culture across the service.

Some staff shared they had faced some challenges with the management team and felt that an inclusive approach had not always been prioritised. For some staff, they had felt this had impacted on their well-being. However, they reported they had recently started to see some positive changes and felt their views were now being considered. Staff told us they had better direct contact with the registered manager who was taking actions to help improve their care management systems and the communication with staff.

The provider was reviewing their management structure and approach to enable them to have clearer insight into the challenges staff faced when supporting people. However further time was needed to embed their ideas, and to ensure the quality of care people received and the staff support was consistent and in line with their values and vision. The registered manager had systems in place to ensure staff were trained to meet people’s specific needs. They stated they worked in partnership with the Home Office Sponsorship scheme and supported new staff to understand the British culture

Most staff felt confident in raising concerns about the people they supported and were assured actions would be taken by the management team such as referring people to health care services. However, some staff felt they would like to share their experience of supporting people and be more involved in decisions made about people’s care and support requirements.

The registered manager was reviewing the staff feedback system and staffing structure with the aim to improve their working arrangement and ensure staff voices would be heard. However, more time was needed to ensure the improved communications would be maintained.

Some staff felt their experiences of workforce equality had not consistently been positive, and they had been given variable work schedules. Staff reported they appreciated that the registered manager was working on enhancing the organisation's culture and promoting fairness in how work was distributed among the staff team.

The provider mainly recruited skilled workers from abroad using the home office sponsorship scheme. As part of this process the provider is required to provide work and pastoral care in line with their sponsorship license. However, the provider had not consistently operated effective systems to ensure they addressed any inequalities and disparities within the workforce, such as staff’s working hours and making reasonable adjustments with a clear focus on those with protected characteristics under the Equality Act.

Staff told us their work and delivery of care to people was checked regularly, and they felt the systems for communication with the office and the management team was improving.

We were not assured the provider's monitoring and governance systems were always effective. The provider did not operate effective auditing systems to monitor the completeness of people’s care records and the accuracy of people’s medicine administration charts. Records of staff recruitment checks and staff supervision, including observation checks were not consistently maintained or detailed enough. This meant the registered manager could not be assured that some staff had been safely recruited and had the skills to deliver care to people. The provider had not ensured staff fully understood the medicines coding and record-keeping requirements on their electronic data management system. The provider did not have effective oversight to ensure all significant events were notified to CQC. Since our assessment, the registered manager has become more involved in the daily management of the service and reviewing the provider’s processes to help drive improvements across the service.

People and their relatives told us communication from the service was generally good. They said staff worked well with them and kept them informed of any concerns or any referrals to health care services.

All staff consistently reported they would share any concerns about people’s health and support needs with their managers who would take action and refer people to the appropriate specialist health care services. The registered manager stated “Working with various stakeholders makes us understand the importance of information sharing. In order to deliver satisfactory service in the community, we liaise with agencies such as the Police, District Nurses, families, transitioning teams from and within the Gloucestershire local authority- Adult Social Care, the Safeguarding board etc. Together with these agencies, we ensure that a client is at the centre in order to provide them the best care they deserve, in a fair and personalised way according to their needs. Therefore, as and when information is requested, we comply and provide appropriately.”

Health care professionals who worked in partnership with the service told us staff worked openly and collaboratively with them. One professional said, “I have always had good, prompt, appropriate responses from the office staff which appear to have been promptly passed on to the Carers where appropriate. Cotts Care have proved good at providing feedback to me when needed and their attendance at MDT meetings has been constructive and positive.” We were told the service worked collaboratively with the commissioners of care to enhance their systems to demonstrate they were fulfilling their commissioned hours and service level agreements.

Systems were in place for staff to inform their managers if they had concerns about people’s health and well-being. Managers were responsive and escalated any concerns about people to relevant health care professionals and people’s families.

Most staff said they were informed of any changes in people’s care requirements after incidents or significant events; however, others felt communication from the office could improve to ensure staff had all the information they required to support people when support needs had changed.

The registered manager provided examples of how they had learnt from staff feedback and had evaluated the service’s processes. For example, they had made changes to their electronic data management systems to help to improve the accuracy of people’s care records and communication with staff.