Candlelight Homecare Service Limited (East Sussex)

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 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.

This service scored 61 (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 clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not always understand the challenges and the needs of people and their communities.

There had been conflict at the service, and this had impacted on the current culture. All staff spoken with told us about the negative impact the purchase of another company had on the service. Whilst all acknowledged this was improving the impact was widespread. Staff told us the speed of the purchase had not allowed them time to adjust to the changes, both for existing Candlelight staff and incoming staff. Staff said they did not feel the provider had been open and transparent. Incoming staff told us the provider had promised that nothing would change for them, but it had and resulted in staff unhappiness and distrust of the provider. Some staff spoke about confusion around their working patterns, travel and pay, some of which still needed to be resolved.

Staff told us that they had felt supported by the registered manager and colleagues throughout but had not felt supported by the provider. They also told us they did not think the registered manager was fully supported. However, the registered manager told us they had felt supported throughout and continued to feel supported. Although they did acknowledge they could understand how staff felt due to all the conflict and distress that occurred.

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.

The registered manager was fully involved in the day to day running of the service. They had worked at the service for many years and knew staff and people really well. Due to the issues that had arisen the nominated individual had spent time at the service getting to know and supporting staff. The registered manager was supported by a team who had a clear understanding of their own roles and responsibilities and how these roles worked together. They provided support to the registered manager in managing the service. Despite the concerns that arose from the merger of the services the registered manager and team had worked hard to try and ensure people received the care and support they needed. They acknowledged what had not worked and actions they had taken to resolve issues. They knew improvements were needed and they remained committed to continuing those improvements made and ensuring they were fully embedded back into the service.

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

Staff understood the whistle-blowing policy and told us they would report any concerns to the registered manager or senior staff. They told us that the recent engagement with the nominated individual had given them confidence to also approach them with any concerns. There was information displayed throughout the office which included details of where staff could raise concerns outside of the organisation. Staff were confident any issues raised would be addressed. The registered manager told us staff were able to contact the provider or managers for guidance and support at any time.

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.

Staff equality and diversity was valued. Staff received training in equality and diversity. They were encouraged to share concerns and ideas through day-to-day discussions and supervisions. The registered manager supported all staff to ensure they were not at risk of unfair treatment and discrimination due to their background or culture. Staff told us they felt valued and everyone worked well together. They said their individual needs and culture were respected.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes. Improvements were needed to ensure records were fully completed and care plans and daily notes fully reflected the support people needed and received.

The providers computerised system meant the provider had oversight of the service based on information submitted by the registered manager. This informed the registered manager when checks, audits and reviews were due. However, the shortfalls we found in relation to the care plans, risk assessments and PRN guidance had not been identified.

Care plans and risk assessments did not always include relevant, up to date guidance. This included communication, skin integrity, mobility, personal care, and nutrition. These were reviewed and audited but these were not always updated to include current and relevant information.

Improvements were needed to the daily notes. Daily notes did not give a full picture of what people had done each day and did not always identify what actions were taken when concerns were identified. For example, one entry stated a person had declined aspects of their care but there was no information about why or what other steps staff had taken to monitor the person’s welfare or offer the person alternative support. The registered manager told us they were aware improvements were needed to ensure these fully reflected the support people had received.

The impact on people was mitigated because in general they were supported by a consistent staff team. However, improvements were needed to records to ensure they were completed and provided consistent guidance for staff.

A provider action plan had been developed for improving and developing the service in the long term. We were told the provider was currently reviewing the care planning system to identify if it met the services needs.

The provider 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 registered manager and staff team had developed positive working relationships with services who supported people. Staff told us how they would contact relevant external professionals and other organisations to help them meet people’s needs. The management and staff worked with other organisations to support the local communities where they worked. This had included open events and charity fundraising.

We did not receive any feedback about the service from health and social care professionals.

There was a focus on continuous learning, innovation and improvement across the organisation and local system. However, due to the recent issues at the service the provider had not actively contributed to effective practice, learning, and research.

Some staff told us that communication was not always good at the service. The registered manager acknowledged this. They told us that staff meetings had been cancelled due to staffing issues caused by the merger. These meetings were due to restart which would aim to improve communication across the service.

There was a program of ongoing development for staff to ensure they had the knowledge and skills needed to continually develop the service. A new online training program had recently been introduced and this included further training in areas we had identified there were shortfalls within the care plans. This included skin integrity and nutrition.