All About Care (South West) Limited

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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

The service was well-led by capable, compassionate and inclusive leads. Robust policies were in place for staff to speak up whenever they had concerns and an open culture encouraged them to do so. The management team led by example to promote an inclusive, diverse and equality of opportunity and experience for the workforce. The nominated individual had established robust systems and processes to ensure the service was consistently well-led evolving as improvements were identified. This had led to significant improvements found during our assessment and onsite inspection.

This service scored 68 (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.

Leaders had the experience, capacity, capability and integrity to ensure that the organisational vision could be delivered, and risks were well managed. The provider’s had recruited strong leaders to oversee the running and compliance of the service. This member of staff had put robust systems and processes in place which had led to many of the improvements we found at this inspection. The registered manager told us they felt well supported and was passionate about providing good quality care and supporting staff to do the same. Staff told us the registered manager often supported them with care calls when not providing governance from the office and told us they found them approachable. We received comments including, “The management team who are now running the company, in my view, have been exemplary in their support and professionalism. They have literally had to start from scratch to try and fix the problems which had escalated when they took over in 2023.” People told us the service was well-led. One person told us, “Since the new company has taken over, it’s been absolutely fantastic. They’re the best in the West” and one person said, “It’s very good all the way through. I’ve found them all very helpful” and, “This lot is well-led. I’m ever so happy with them. The girls are so nice and the management are lovely.”

The management team told us they promoted a culture of openness, honesty and transparency. When something went wrong, people received a sincere and timely apology and were told about any actions being taken to prevent the same happening again. There was a culture of speaking up without fear of detriment. When concerns were raised, leaders investigated sensitively and confidentially, and lessons were shared and acted on. We received feedback from staff such as, “Yes, I am able to raise any concerns or issues without any fear because I know I have all the support from my management team” and, “it is the best care company I have worked for in regards to values of the service, the management always listen and are always there.”

The provider told us they were an equal opportunities employer. The provider ensured people felt included in the running of the service and empowered staff to develop further in their careers when opportunities arose. For example, where one member of staff had shown they were compassionate, caring and competent the management team were supporting them to move into a senior position. The provider held regular meetings with the care team. During these meetings relevant concerns and new initiatives were discussed as well as developing ways to improve practice. For example, it was noted that care record notes were decreasing in length since a tick box system had been introduced to work along side them. Staff were reminded what should be added to their records so quality, contemporaneous records were maintained. In addition, a column in the minutes noted if actions had been completed or were ongoing so they were not overlooked. The provider audited staff recruitment records. This was introduced to ensure that all information had been received to ensure records were compliant with requirements. Identified shortfalls were sought and added at the earliest opportunity. Records included equal opportunity monitoring and health details.

At the last inspection we identified a breach of Regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider had failed to effectively assess, monitor and improve the quality and safety of the service provided. At this inspection enough improvement had been made and the provider was no longer in breach of regulation 17. There were systems in place to ensure the quality of the service was checked. For example, medicines were regularly audited. Incidents and accidents were audited and reviewed by management to ensure that lessons were learnt, and actions had been taken. Notifications were submitted to CQC as required. Each month the registered manager and nominated individual met to review audits, staffing, risks and previous months actions. New actions were identified and carried out in a timely way. This ensured the information gathered through audits was used to make positive changes to the service. The nominated individual held monthly office staff meetings. Where a wide range of matters across the service including risk management where shared and discussed.

Staff told us since our last inspection the service had improved and they felt the service was well-led. One staff member said, "The Team who are now running the company, in my view, have been exemplary in their support and professionalism."

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.

The nominated individual and the registered manager had established robust systems and processes to ensure they were constantly monitoring and improving the service. The management team spoke passionately about providing person centred care and learning and improving when they noticed room for improvements. For example, when reviewing care notes, the management team identified they could be improved to reflect the respectful care provided by staff. Staff were asked to revisit policies and guidelines and provided with good example to follow. This led to care plan records being improved.