Competent Healthcare Ltd

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

During this assessment we looked at 3 quality statement in the key question of well led. The overall rating for this key question combines scoring from quality statements we looked at during this assessment and quality statements scores in line with findings from our last inspection, where the service was rated good. The provider did not have effective governance systems in place to monitor and improve the quality of care and safety of the service. The provider had not always reported significant incidents to local safeguarding teams or CQC as required. This was a breach of Regulation 17 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

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.

Staff were positive about the support they received from the provider during their induction into their role. In some cases, for staff who had moved from abroad to work for the provider, this involved providing practical assistance around accommodation and transport. Staff told us they felt that senior staff were approachable and told us that senior staff being multi-lingual helped them to integrate into their role, especially when adapting to a new culture.

The provider had recruited the majority of their staff from abroad. They had systems in place to help staff adapt to life in the UK. This included providing practical support with adapting to living in a new country and supporting staff to undertake English language qualifications. At the time of our assessment, The Home Office had suspended the provider’s sponsorship licence. The registered manager confirmed they had made representations to The Home Office to appeal this decision.

The registered manager had limited oversight of the service. They had delegated key tasks to senior staff without implementing systems or checks to oversee or monitor their work. Senior staff were not always clear about which tasks they were responsible for. This resulted in some tasks such as auditing being missed, incomplete or completed work being inaccessible for others to review. During the assessment, the registered manager had confirmed that the quality manager and deputy manager had left the company with immediate effect. They were unable to confirm who would be assuming their duties in their absence.

There was limited oversight of the quality and safety of the service. Documentation to support the judgements of this assessment were not always available for CQC to review. The registered manager and senior staff were not always aware where requested documents were located or whether they had been completed. This included audits, staff training and supervision records, records and assessments related to people’s care. The registered manager confirmed that some audits in key areas were not being completed. This included audits of care plans, care records and call monitoring. Where audits had been completed, there was limited assurance that they were effective in identifying issues or driving improvements. For example, medicines audits did not identify where people were not receiving their medicines as prescribed. Where issues were identified in an audit, such as lack of supply of medicines, the provider did not act in response to resolve issues or reduce risk of issues reoccurring. The provider had a business continuity plan in place to help ensure the service would run safely in the event of an emergency, such as severe weather. However, they had not completed an analysis of people’s care needs to determine how their care should be prioritised in the case of such a circumstance. This reflected deficiencies in contingency planning and how staff would be utilised 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.

During our assessment, the registered manager confirmed the deputy manager and quality manager had left the company with immediate effect. Their responsibilities included overseeing the quality of the service and identifying and driving improvements. The remaining senior staff were focussed on the everyday running of the service, as opposed to working on learning, improvement and innovation. The registered manager confirmed that at present their focus was on stabilising the service in light of recent departures of senior staff.

The provider had developed an action plan detailing where and how improvements to the quality and safety of the service were needed. These actions were in line with issues identified by the local authority during recent engagement with the service. However, there was no evidence that the action plan had been updated, reviewed or learning had been implemented to promote improvement. The provider had not completed an analysis of incidents and any learning was not consistently shared with the wider staff team to embed improvements. There were no records of team meetings, individual/group supervisions where learning or themes around quality improvement were discussed. This meant that there was limited opportunity for staff to contribute towards a shared learning culture.