Right At Home (East Lancashire & Ribble Valley)

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 key question was previously rated good. This key question has improved to outstanding. This meant service leadership was exceptional and distinctive. Leaders and the culture they created drove and improved high-quality, person-centred care.

This service scored 89 (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 clear shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an excellent understanding of the challenges when providing home care to people.

Staff understood their responsibilities and were committed to ensuring people received person-centred care in a safe, efficient and imaginative way. All staff shared the same commitment to providing a high standard or person-centred care that put people’s outcomes and experiences first. Staff said, “I have worked for several care companies over the years and can honestly say hands down Right at Home have been nothing but amazing. I’ve always been supported, always felt listened to and never pressured.” This was a common sentiment when speaking with staff, who felt part of a culture that was always focussed on people receiving the best care they could deliver.

The ethos of the service was made clear throughout the induction period and in subsequent meetings and spot checks. The registered manager had ensured there were clear accountabilities and values to live up to over a number of years. Standards were kept high with clear and consistent messaging from leaders, and person-centred role-modelling. For instance, encouraging mutual staff support between peers and recognising the positive impacts of this on their team and people who used the service. A staff member told us, “I get regular unannounced spot checks and that’s how it should be – we should always be delivering high standards.” Survey results were meaningfully analysed and reflected on to ensure the culture remained refreshed and focussed on meeting people’s needs.

There was a consistency of opinion from relatives and people we spoke with that the leadership of the service was extremely strong and dependable. Whilst one relative we spoke with could not recall speaking with the registered manager, all others shared positive examples of their interactions. They said, “They introduced themselves and they are always there at short notice. The whole office team is, they work so well together,” and, “The carer speaks really highly of the management and you can tell they’re all on the same sheet.”

The provider had consistently inclusive leaders who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation.

Staff were proactively supported to complete additional learning and qualifications to further their career in social care. This meant there was clear succession planning for future leadership roles, helping continuity of service and ultimately care for people – they received support from staff who were consistently led and supported.

Leaders at every level were visible and lead by example, modelling inclusive behaviours. The registered manager was supported by other leaders who had clearly defined areas of responsibility, which helped staff know who to go to and when. Recent surveys, externally sourced, indicated 100% positive responses regarding the capability and compassion of leaders.

Every member of staff described leaders as caring and supportive at all times. They consistently gave examples of flexibility and working with them when they encountered challenges. One member of care staff told us, “They are very supportive if I have any personal or health problems and need to amend my schedule in the short term.” Another said, “When I had to take time off unexpectedly they were amazing – the support was there.”

This compassion was balanced with clarity around expectations of staff, and strong role modelling of what was expected in the role. Leaders had significant relevant experience and understood the challenges of each of the roles in the teams they led. They supported their teams inclusively, listened actively to improve the service, and celebrated success.

Staff had full confidence in leaders and their openness. One said, “They give you the confidence to go the extra mile.” Leaders capably drove significant partnership projects than made positive changes to people’s lives.

The provider fostered a positive culture where people and staff knew they could speak up and their voice would be heard.

Policies, procedures and induction information for staff made it clear how to raise any concerns. Where staff did so, these were listened to openly and from a position of learning.

Supervision meetings were held regularly, as were spot checks and a peer support meeting. All staff felt they could raise issues with leaders, and that these would be dealt with effectively. Staff told us, “I can speak freely and if anything is raised by myself, I always receive feedback from my manager,” and survey results indicated they always felt they could speak up.

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.

There were appropriate policies to support equality and diversity. Staff did not report any concerns and felt well supported.

The provider had clear responsibilities, roles, systems of accountability and extremely strong governance. They used these to manage and deliver high quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes.

The registered manager understood their role and ensured others were accountable.

Rotas were closely and comprehensively managed by staff who understood the systems they used and the impacts of errors or delays, which were extremely rare. Realtime auditing of records meant any errors in record keeping could be addressed whilst it was a risk and before it had an impact on people.

Auditing arrangements were particularly strong, with the provider’s regional quality assurance lead undertaking regular assessments of all aspects of the service. This benchmarked quality and outcomes against the provider’s other services and fundamental standards of care. Findings were detailed, qualitative and helpful in terms of the registered manager being able to factor in to an ongoing service action plan. This meant governance arrangements helped maintain high standards of care, proactively shared good practice and identified areas where there could be more improvement.

Where the provider excelled in helping people achieve outcomes they were proud of, they took the good practice learning from this and shared via case studies. This meant the provider encouraged innovation and improvement as part of it’s culture, and understood the link to better outcomes for people.

Leaders always proactively looked for ways to scrutinise and improve their own processes and systems. For instance reviewing external quality reports of the provider’s other services to seeing where lessons could be learned – in this case improving specific areas of risk assessments following some signposting by CQC in another inspection.

The service used regular and targeted surveys to ensure it had detailed feedback to go alongside it’s governance work. This meant the provider was utilising all opportunities to assess and improve its service, which in turn meant high standards of safe care for people, and an assurance that this could be sustained.

The registered manager submitted statutory notifications to relevant bodies such as CQC. They demonstrated an extremely strong understanding of the health and social care landscape and how their model of care supported people within that. They demonstrated a strong understanding of legislative and other impacts on social care and planned accordingly.

The service understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

The service had sought out and developed strong relationships within the local community and worked effectively with a range of partners to improve outcomes for people across a range of contexts. For instance, they set up a cinema club at a local care home, so that people who used the service (as well as the care home residents and members of the public) could have a dementia friendly space to enjoy films. This brought about increased social interactions. One relative said, “You could see people brightening up! There was tea and biscuits and they got to meet people in a different way. It was lovely and really well organised.”

The provider also set up a lunch club, whereby people who used the service could meet, interact with others, and enjoy a range of different menus. One volunteer said, “They have been so supportive. They help with the meals, the costs, and they are on hand for additional care support if it’s needed. It really brings people together and they get a variety of meals that they might not have or choose at home.”

These initiatives had positive impacts on people’s health and wellbeing, and demonstrated the provider’s understanding of the importance of community in people’s lives. They (the provider) also worked proactively to increase awareness of dementia in the wider community through fundraising work and ad hoc events, like coffee mornings.

The provider shared information and learning with partners and collaborated for improvement. For instance the registered manager attended provider forums where they could share good practice and other information with others working in social care. They were receptive to advice and guidance. People had complete trust in their staff, who formed an important part of their network of support.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

Quality assurance work, spot-checks, surveys and staff supervisions all contributed to the provider’s ongoing learning approach. Staff were supported to complete additional learning, meaning the service had a more robust set of leaders, and staff had the opportunity to develop career paths.