Domiciliary Care Agency Surrey

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 remained good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 75 (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 ensured that a vision for the direction of the organisation was shared with staff. Staff received a handbook and the provider’s mission statement when they joined the service. Team meetings were held in the individual supported living services and the managers of these locations met regularly for meetings with the registered manager. Virtual ‘town hall meetings’ were arranged for staff from the wider organisation to attend and the provider’s website kept staff informed about important events and shared success stories.

New starters were welcomed to the organisation by the provider’s chief executive. This made them feel appreciated and part of a wider organisation. Within the individual supported living services new staff were allocated a “buddy.” Buddies are members of staff with the skills and experience to provide guidance and support to new colleagues through their probationary period. This meant that staff were encouraged to share the provider’s vision as soon as they started work.

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Staff felt supported in their roles. Staff told us that managers were visible and approachable. One member of staff told us, “They are friendly but professional. There are boundaries” The provider promoted the well-being of staff. Debrief meetings took place after incidents, enabling staff to share how they felt. The provider made an employee assistance programme available to staff. This programme included a confidential helpline and access to counselling for staff who required it.

The provider supported staff and managers with their professional development. In addition to mandatory training, staff and managers were supported to undertake training leading to qualification. This promoted the continuous development of skills and knowledge.

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

Staff said they felt able to speak up and raise concerns if needed. They reported confidence that managers would take their concerns seriously and act appropriately. Staff said they felt psychologically safe and able to challenge or suggest improvements. A whistle-blowing policy and Freedom to Speak Up posters were visible in services, helping to promote an open and safe culture

People were encouraged to share their views. Staff supported people to attend tenants’ meetings and the provider created a people’s voice group. The group engaged in a range of empowerment activities including making short information videos for people, participating in interviews and representing people in coproduction projects.

People were matched with staff in the role of keyworkers. Keyworkers are members of staff with specific responsibilities for people. These included planning activities, attending appointments, tenancy sustainment and person-centred planning. One member of staff told us, “You get to know likes and dislikes, work with people, understand them and build a relationship.” The provider carried out detailed surveys of people’s views. The results of these surveys were reviewed by the registered manager, quality monitors and other leaders and were used to plan and improve people’s care and support.

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 celebrated diversity. A number of forums were available to staff and promoted by the provider. These included groups centred around black staff, gay and lesbian staff and mental health and wellbeing, with an emphasis on the lived experiences of participants. Staff were supported to work flexibly to accommodate caring responsibilities for children and parents.

Most of the staff we spoke with told us that their team worked well together, with one member of staff telling us,” It is positive here. I feel included. There are no problems between cultures.” However, in one service healthcare professionals and staff told us there were internal difficulties within the team. One member of staff said, “It was difficult. There were cliques. The cliques made you feel outside the team and very isolated.” We brought this to the registered manager’s attention who, in partnership with the locations’ manager, arranged for a team building day to take place. This meant the provider was taking action to improve team cohesion.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

The registered manager used electronic records to assist in quality monitoring. For example, location managers, the registered manager, senior managers and quality assurance officers monitored care records and staff training. The electronic systems generated alerts when changes were needed to care records and when staff training in specific areas was due. This meant that leaders had oversight of quality and developments at the service.

The registered manager and the quality team undertook spot checks at services. These took place in the day time and at night. When spot checks identified issues, actions were taken. These included staff training, increased support for location managers and, where necessary investigations leading to formal action.

The managers of each supported living service undertook a range of audits which were reviewed by the registered manager. For example, location managers reviewed people’s medicines management and carried out health and safety checks. The registered manager held monthly meetings with the location managers of the 26 supported living services each month. This meeting was used to discuss challenges, areas for improvement and best practice.

The provider worked in partnership with others to monitor and improve the quality of care and support people received. For example, supported living services were visited by local authority quality monitoring teams. These teams audited people’s care and support and offered practical support to staff teams such as pre-planning hospital admissions and discharges. We saw that one hospital had written to the provider to commend their collaboration in a complex discharge.

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.

Staff worked closely with a range of services and organisations to meet people’s needs. People were supported with referrals and meetings with health and social care professionals. These included social workers, GPs, physiotherapists, and occupational therapists. Staff also supported people to attend hospital outpatients appointments and to visit dentists and opticians.

People were supported to be active in their local communities. Staff supported people to attend places of worship, day services, employment opportunities, adult education classes, cultural events and social organisations. The provider represented people’s interests in on-going liaison with the housing associations who owned the properties people lived in. For example, managers and staff reported any maintenance and repairs issues to landlords.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They actively contributed to safe, effective practice and research.

The provider supported the professional development of the workforce. Staff were supported to complete courses such as the care certificate and national vocational qualifications. Managers were supported to complete courses to develop their management and leadership skills. These included courses such as fact finding for investigations. This course enhanced the abilities of managers to review incidents and participate in safeguarding processes.

Staff were encouraged to reflect on incidents and learn from experience. Team meetings included time for discussing what had gone well and what could be improved. Supervision records showed individual learning goals and reflective discussions. This meant the provider valued learning as a driver for improvement.