Hand of Hope Homecare Services 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

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.

This is the first assessment for this service. This key question has been rated requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to good governance.

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.

The provider had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities. The provider held staff meetings and a member of staff told us the registered manager always asked them for feedback.

Not all leaders understood the context in which the provider delivered care, treatment and support. They did not always embody the culture and values of their workforce and organisation. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively, or they did not always do so with integrity, openness and honesty. For example, the registered manager did not evidence their skills and knowledge in relation to submitting statutory notifications. The registered manager told us they had recently undertaken training with a local authority, and told us they, “now realise they should raise even if it’s a concern”. We were not assured the registered manager had the skills nor understood their knowledge of meeting the legal regulations. Registered care providers must send CQC notifications in response to specific events that could impact the safety, well-being or rights of people using the service. These notifications are legally mandated and must be submitted without delay if the event is serious or significant.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Staff told us management were supportive, approachable and we were told’ “I can ask to meet managers if I need to”.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The provider did not have clear responsibilities, roles, systems of accountability and good governance. They did not act on the best information about risk, performance and outcomes, or share this securely with others when appropriate. The provider did not evidence they had established systems and processes to quickly identify, monitor and manage people using the service with high level of risk. Audits were not effective in identifying issues as they did not identify the concerns CQC identified during this inspection. Following the site visit, the provider updated their action plan with some of the concerns we identified. A review of the electronic call monitoring data provided by the registered manager showed staff did not always receive sufficient travel time between calls. This data showed staff often logged into calls at times that would not be possible taking into account the distance they were required to travel between calls. Therefore, the registered manager did not operate this system to ensure they had suitable oversight of the delivery of people’s care.

We discussed with the registered manager their regulatory responsibility in relation to submitting statutory notifications to CQC. We were not fully assured as the registered manager told us they submitted some notifications, “But not all of them”.

We found improvements were required in the provider’s records. We identified some care plans referred to people as ‘her’ when the gender was noted as male. The audit of the daily notes did not identify if consent was obtained before delivering care. The audits did not identify risk assessments had been completed, for example, in relation to emollient creams being a fire risk nor correct information being recorded within people’s medicine records. The provider did not conduct audits of their recruitment files to ensure safe recruitment in line with their policy. We have notified the relevant authorities of our concerns. This demonstrated the provider did not have effective oversight of the service nor understanding of their regulatory responsibilities. The provider had not established effective systems to enable them to ensure compliance with their legal obligations and the regulations.

The provider did not always 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. The provider’s lack of oversight and monitoring of the service impacted the effectiveness of collaborative working and sharing of information. Professionals told us they had experienced difficulties in obtaining information from the provider and meeting with them.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not always actively contribute to safe, effective practice and research. Our inspection identified due to the lack of governance and oversight of the service, the provider did not focus on continuous learning, innovation and improvement.