Galilee Care

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

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At our last assessment we rated this key question good. At this assessment the rating has changed to inadequate. This meant there were widespread and significant shortfalls in leadership. Leaders and the culture they created did not assure the delivery of high-quality care. The service was in breach of legal regulation in relation to the lack of robust quality assurance and governance at the service. There was a lack of robust oversight of the safety and quality of care. There was a lack of systems in place to gain feedback from people, relatives and staff.

This service scored 25 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not have a shared vision, and they did not understand the challenges and the needs of people and staff. Although the majority of staff fed back positively about the leadership, they were not given an opportunity to feedback where improvements could be made to the service. There had been no staff surveys or general staff meetings for them to contribute to the running of the service and influence changes. One member of staff told us, “When there is a problem, the manager will listen, but she won’t do anything. Anything that goes wrong, you’re blamed. Staff have left because of this.” There was a closed culture where staff did not always feel they could raise concerns.

The leaders of Galilee Care did not have the skills or knowledge to lead effectively. They had not recognised the closed culture at the service, or the detrimental impact this had on people being supported. They lacked knowledge about the issues and challenges at the service, and did not appropriately challenge poor or inappropriate practice. Although staff told us leaders were supportive, we found they had failed to ensure staff were working with a care rota that was manageable. The provider told us of the care calls and systems, “I know it is an issue. The system is no good.”

People did not feel they could speak up and that their voice would be heard. People and relatives in the main, told us when they contacted the office to raise concerns, no action would be taken. Some people and relatives told us that because of this lack of action, they had stopped contacted the office. Although the majority of staff told us they were able to speak up, there was no evidence of any discussions by staff with the leaders to discuss their concerns around the lack of travel time and that they were unable to spend the entire planned care call with people. One member of staff told us, “I wouldn’t want to speak up because I will be blamed for something.”

There were staff who felt the leadership team were inclusive and valued diversity. However, there were other staff who felt there was a lack of equality in how they were treated. Some staff fed back their frustration on continuously raising where improvements were needed and felt ignored.

Systems in place to monitor the delivery of care were not robust and this impacted on the care that people received. The provider told us staff used an electronic portal to sign in to calls when they arrived and when they left the person's home. The provider told us they used this system to ensure staff turned up for calls and they stayed for the duration of the call. However, there was no robust oversight of this. We identified from records staff were regularly not staying for the full length of the call. The provider told us if staff were running late or had missed a call they would be alerted by the online system. However, given there were calls that did not factor in travel time, this increased the risk of staff not arriving at calls when they were due. There were insufficient systems in place to robustly audit the care and make improvements where concerns had been identified. We asked to see audits of the quality of care being provided and these lacked detail on areas for improvement, and where they did, they had not recorded when action had been taken. The audits they did not identify all the concerns we found.

The provider did not understand their duty to collaborate and work in partnership, so services worked seamlessly for people. They did not always share information and learning with partners or collaborate for improvement. Whilst the leader shared some health concerns with professionals about people’s needs, the provider had not taken steps to share their concerns around the level of packages of care that were not being managed well or safely. They continued to accept packages of care from the funding authorities without considering the impact of this. The provider also failed to share all safeguarding concerns with the local authority.

The leaders did not focus on continuous learning, innovation and improvement across the organisation and local system. There was no analysis of the overall incidents to look for trends, themes and triggers to try and reduce the risk of incidents which placed people at risk. By reviewing incidents, this can leave to implementing changes that lead to continuous improvement. This might involve reviewing the timings of people’s care calls and whether staff had sufficient travel time, so they were not late.