Morecare Services(UK)Ltd

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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 2 breaches of the regulations. The provider did not establish effective quality assurance systems to oversee the service and staff practices, and monitor the outcomes for people. The registered manager did not use the systems to identify shortfalls in the quality and safety of the service and ensure that expected standards were met. The registered manager and provider did not inform us about notifiable incidents in a timely manner. The registered manager and the staff team respected diversity in their workforce. Staff felt they were fairly treated, their wellbeing was considered and the registered manager encouraged the culture of supportive team. Staff agreed the provider would continually review and improve the culture of the organisation in the context of equality, diversity and inclusion.

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.

The registered manager acknowledged and respected diversity in the workforce. They took action to improve where there were any disparities in the experience of staff with protected equality characteristics. The registered manager communicated with staff to share any ideas or suggestion to ensure staff were included and were able to contribute to the service. The registered manager praised their staff team and the work they did. They said, “[The staff team] is a supportive team, and they are good listeners. [Staff] support us because it makes the work easier and we support each other”. Staff felt positive about the service and were confident that their concerns and ideas would result in positive change to shape services and create a more equitable and inclusive organisation. Staff agreed the provider would continually review and improve the culture of the organisation in the context of equality, diversity and inclusion. Staff felt supported and treated fairly. Staff said, “If you value life, you will enjoy this job”, “Staff are happy. I love this job” and “They are always there to support”. Another carer told us they were completing further qualifications and they were positive about “the support I’ve received.”

The registered manager recognised and valued diversity in their workforce, and encouraged discussion about those differences. They worked together with staff towards an inclusive and fair culture by improving equality and equity for staff who worked at the service. The registered manager used different ways to engage with and involve staff, with a focus on hearing the voices of staff. The registered manager made reasonable adjustments as and when needed to support their staff team. Staff were able to seek support when they shared concerns and ideas that resulted in some positive change for staff.

The registered manager told us they communicated with staff to share information and act on the best information about risk, performance and outcomes, and shared this with others when appropriate. The registered manager told us they worked with other management team to carry out checks and audits as part of oversight and monitoring of the service. The registered manager told us they oversaw and managed behaviours and performance of staff as and when needed in a form of spot checks. The registered manager told us about the checks as part of the quality assurance system to ensure they were able to monitor the quality of the service effectively. Most staff thought the service was managed well. Staff said, “The service is okay. They are doing great. They are doing fine” but another staff added there was “room for improvement.” Staff agreed they felt comfortable going to the registered manager or other management team with any concerns and they would be listened to. However, the evidence we have collected demonstrated the provider and the registered manager did not always ensure there was effective quality assurance system used to have a clear oversight of the service and its quality on a regular basis.

The registered manager did not ensure staff had clear guidance in care plans and risk assessments to follow when supporting people so they could receive the care tailored to them and be in control of their lives. There was no effective systems and processes to review and identify patterns or trends from accidents, incidents, and complaints as part of provider’s internal reviews. The registered manager did not always ensure the risk assessments reflected the current needs of people and the checks they carried out to ensure their safety. This was recorded inconsistently in people’s daily notes. We identified a number of discrepancies with daily notes that provider’s audits did not identify. For example, gaps of visits, not clear entries regarding medication support, nutrition and personal care. The audits did not include information pertaining to how the registered manager was proactively monitoring the provision of people’s care and support according to assessed needs, and the quality of the service provided. We found incorrect people’s details or names filed onto multiple people’s daily notes. The provider and the registered manager failed to demonstrate they had an effective systems to seek, review and analyse feedback from people, relatives and other stakeholders so they could use it for reviewing the service, its quality and to make improvements and development of the service. The registered manager did not encourage meaningful discussions with staff to review their practice, feedback about it and make necessary improvements to the quality of the service. The registered manager did not ensure CQC was consistently notified of significant events at least on 11 occasions. The lack of effective governance and oversight meant the provider and the registered manager were unable to promptly identify concerns that could put people at risk of harm or injury.

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.