Best West Bridgford Home Care Ltd Also known as Home Instead Central Nottingham and West Bridgford

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

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 had not always created a culture that supported the delivery of safe, care and treatment.

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 had a clear vision, strategy and culture, as set out in their statement of purpose, which reflected principles of equity, equality, human rights, diversity and inclusion. The management team and staff demonstrated a shared commitment to delivering a high‑quality service that met the needs of people and their communities. Staff and relatives spoke positively about the service. One staff member told us, “This is an excellent company to work for. I like that we have time not only to complete our tasks but also to sit and talk to clients. I am very happy here.” A relative told us, “We’ve appreciated the support from staff. They have supported not only my [family member] but us as a family and have always taken the time to talk with us.”

The management team were compassionate, inclusive and experienced. However, we identified shortfalls in safe care oversight, which meant leaders did not always have sufficient assurance that staff were following the provider’s policies and procedures. This impacted the effectiveness of leadership and governance arrangements. Despite these shortfalls, staff at all levels demonstrated openness and honesty throughout the assessment and acted in line with the provider’s values. Staff spoke positively about the management team. One staff member told us, “Everyone in the office is approachable, I know who to contact when necessary and I feel supported in difficult situations.”

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. The registered managers were able to demonstrate multiple ways people, relative and staff could speak up. This was confirmed by relatives and staff. One staff member told us, “I find the office staff friendly and approachable, and we are invited to regular coffee mornings. I also get on with the other care professionals. I would feel confident raising any issues with my supervisor but haven’t had to do so.” This meant staff felt valued, supported and able to raise concerns openly without any fear or repercussions.

The provider valued diversity within their workforce and worked towards creating an inclusive and fair culture. They promoted equality and equity for staff, which was reflected in feedback we received. Staff told us they felt listened to and supported by management. One staff member said, “I find Home Instead very accommodating whenever I have requested to change my availability.” Another told us, “The reason I returned was because of what a nice place it is to work. If I have a problem, I know I can go to the office and sort it out at any time. “This meant staff felt valued, contributing to a positive and inclusive workplace culture.

The provider had clear responsibilities and roles, however there were shortfalls in systems of accountability and effective governance arrangements. They did not consistently act on information about risk, and outcomes, or ensure this was used to improve care.

Whilst there was a range of policies in place and audits were completed, these systems were not effective to identify or address risks. For example, staff did not always follow policies and audits did not identify concerns we found which related to risk management, missing or incomplete care plans. Incidents were not always reported to management, and mental capacity assessments were not always completed where required. This meant the provider could not be assured people consistently received safe care and treatment. The registered managers were receptive to our feedback and told us they had taken immediate action.

The provider did not always demonstrate a clear understanding of their duty to collaborate and work in partnership to ensure services were delivered seamlessly.

The registered managers made referrals to health professionals when required. However, where other professionals were involved in people’s care, such as district nurses or mental health services, care plans were not always in place to provide staff with clear guidance on how to collaboratively work in partnership. Staff did not always inform the management team of the outcomes of professional visits or how this changed the support people required.This meant the provider did not always have oversight to ensure people’s care was coordinated and delivered in line with professional guidance.

The provider did not always have effective systems to support learning and continuous improvement. While incidents, audits and feedback processes were in place, these were not always used to, drive learning or improvements. For example, incidents were not always reported or escalated in line with policy, which limited opportunities for analysis, learning and service improvement.

Audits did not always identify concerns relating to risk management, incomplete care planning, mental capacity assessments, partnership working or incident reporting. This indicated learning from quality monitoring was not always translated into improvement actions. In addition, information shared by partner professionals was not consistently reflected in care plans or communicated to staff, reducing opportunities to learn and adapt care in line with best practice.

The registered managers demonstrated a willingness to learn and improve. The registered manager responded positively to our feedback with the aim to make all the required improvements and took immediate action with staff where concerns were identified. This showed the provider recognised the need to strengthen systems for learning, improvement and innovation to ensure safer and more effective care outcomes for people.